Qualifying Life Events for Health Insurance Change – Aetna | Changing Your Plan After Open Enrollment
aging: max looks forward to his 26th birthday.
max is a graphic designer at a philadelphia magazine. Even though his employer offers health coverage, Max found it easier to stay on his parents’ health plan. but after he turns 26 in several months, he will no longer be eligible for his parents’ coverage. Because the expiration of his parents’ plan is a qualifying life event, Max can enroll in his employer’s plan the day after his parents’ coverage ends (either on his birthday or the last day of the month). calendar). he will now have to pay for his own coverage, but he is happy to have access to quality health care.
Other types of loss of health coverage include:
- lose existing health coverage, including work-based, individual, and student plans
- lose eligibility for medicare, medicaid or chip
- marry or divorce
- death in the family
- having a baby or adopting a child. (read more about this below).
- moving to a different zip code or county
- a student moving to or from the place where he/she attends school
- a seasonal worker who moves to or from where they live and work
- moving to or from shelter or other transitional housing
- To make changes to your health plan, you must be experiencing a “qualifying life event.” If you’re not sure if an event qualifies, visit healthcare.gov or contact your current or future health plan sponsors (such as your employer) for more specific information.
- Qualifying life events trigger a “special enrollment period” that typically lasts 30 to 60 days, depending on your plan, during which you can select a new plan or add a new dependent to your plan.
- To change your plan selections, please notify your current or future health plan sponsor of the qualifying life event as soon as possible.
- Other qualifying life events include getting married, losing coverage due to divorce, losing Medicaid eligibility, and exhausting your cobra coverage.
- Different plans have different rules. Contact your plan administrator about any changes in status that affect your health coverage to learn about your rights.
Learn more about changing your coverage.
death in the family: lisa begins a new chapter.
lisa, 53, recently lost her husband, james, to a heart attack. Her friends have been great at checking in on her and lifting her spirits. They have also helped her update financial accounts and other practical matters. Before James’s death, for example, Lisa was covered by her employer’s health insurance plan. now, lisa no longer qualifies for that plan.
In cases like lisa’s, surviving spouses are entitled to cobra coverage, but lisa chooses another option. Since the death of a spouse is a qualifying life event, you can enroll in your employer’s health plan. Under her new cover, she finds a counselor who helps her cope with her grief and look to the future with hope and gratitude.
Other changes in the home include:
have a baby: javier adopts a girl.
javier, 38, and his husband live in miami, florida. they just adopted a three-month-old girl, lucia, and they want to give her daughter the best of everything. At this time, Javier’s high deductible health plan only covers him and his spouse. but he can easily change that. when he welcomes a child into his family by birth or adoption, that is considered a qualifying life event. After bringing Lucía home, Javier contacts his health plan to inform them of the event and chooses a lower deductible plan suitable for his entire family.
Read more about adding a new baby to your plan.
change of residence: gwen moves her family across the country.
gwen, 46, is a single mother of three in raleigh, north carolina. She just got some great news: Her employer has offered her a promotion to oversee a large sales force in Los Angeles. Ella’s current plan has a strong network of health care providers in Raleigh, but none in Los Angeles. while not all changes in residence are considered a qualifying life event, gwen’s move out of her plan’s service area is. Ella Gwen notifies Ella’s human resources department that she would like to change health plans so that finding covered providers near her new home won’t be a challenge.
if you have questions about health savings accounts, read all about fsas and hsas.
other changes of residence include:
key takeaways about qualifying life events
The bottom line is that you may not need to wait for your employer or the government to open the next enrollment period to make changes to your health plan. Here’s what else you need to know: