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What Is a Qualifying Life Event?

Life is full of twists and turns, and sometimes those unexpected changes can impact your health insurance coverage. This is known as a qualifying life event.

But what exactly constitutes this? How do they work? Let’s dive in.

Understanding Qualifying Life Events

A qualifying life event is a significant change in your life that allows you to make adjustments to your health insurance plan. These changes can happen outside of the regular open enrollment period.

For example, these events can include:

  • Marriage or Divorce: Whether you’re saying “I do” or parting ways, changes in marital status can trigger a qualifying life event. Newlyweds can add their spouse to their plan, while divorcees may need to find new coverage.
  • Birth or Adoption: Welcoming a new family member is cause for celebration, but it also means you’ll need to update your health insurance. Adding a newborn or adopted child to your plan is essential.
  • Loss of Other Coverage: If you lose coverage through your job, Medicaid, or another source, you can qualify for a special enrollment period.
  • Relocation: Moving to a new state or even a different ZIP code can impact your health insurance options. Make sure to update your address and explore local plans.
  • Turning 26: If you’ve been covered under your parents’ plan, turning 26 means you’ll need to find your own individual health insurance.

This list gives you an idea of what a qualifying life event looks like, but it’s not exhaustive. For a full list of qualifying life events visit HealthCare.gov.

What Should I Do If I Qualify for Special Enrollment?

When a qualifying life event occurs, you have a limited window of time to make changes to your health insurance. Typically, you have 60 days from the date of the event to take action. Here’s what you should do:

  1. Notify Your Insurer: Contact your health insurance provider as soon as possible. They can guide you through the necessary steps and help you understand your options.
  2. Review Your Plan: Take a close look at your current plan. Does it still meet your needs? If not, consider switching to a different plan that aligns with your new circumstances.
  3. Explore Special Enrollment: Visit the Health Insurance Marketplace or your state’s exchange website. You’ll find information on available plans and can enroll during the special enrollment period.
  4. Compare Plans: Use online tools to compare individual health insurance plans. Look at premiums, deductibles, and coverage details.
  5. Gather Documentation: Be prepared to provide proof of the qualifying life event. This might include marriage certificates, birth certificates, or other relevant documents.

Remember: our team of experts is here to help. Whether you have questions or need assistance comparing plans, reach out to us and we’ll help guide you through the process.

Navigate Qualifying Life Events With Ease

Life is full of surprises. But with the right health insurance, you can be better prepared for whatever comes your way. If you experience a qualifying life event, take advantage of your special enrollment period and secure the coverage you deserve.

Our team at Health & Benefits Partners is committed to helping you navigate the complexities of health insurance, so you can focus on what matters most: your well-being. If you have questions or need help comparing plans, contact our health insurance brokers today!