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Understanding Qualifying Life Events

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If you would like to purchase health insurance outside of the yearly Open Enrollment window, then you will need a qualifying life event (QLE) to do so. Open Enrollment begins on November 15th and lasts through February 15th each year. Without such an event, insurance companies will turn down your application.

How Do Qualifying Life Events Work?

There are several events that will allow you to purchase health insurance outside of Open Enrollment. We list the most common ones just below. It’s important to know that these Special Enrollment Periods only last 60 days, however. If you do not seek out and purchase health insurance within this 60 day window, you may have lost your opportunity to enroll in a health plan.

It’s also important to know that voluntarily canceling your health insurance outside of Open Enrollment does not constitute a QLE. Some carriers will allow you to change plans if your plan is renewing outside of Open Enrollment, but if you simply cancel your coverage because you are not happy with it, you may not be able to find new coverage.

Listing The Most Common Qualifying Life Events

  • Involuntarily losing health insurance that meets minimum standards
  • Marriage or divorce
  • Gaining or losing a dependent due to adoption or death in the family
  • Becoming a U.S. citizen or gaining lawful status in the U.S.
  • Moving to a new coverage area that your current insurance does not serve
  • Gaining or losing eligibility for a government subsidy
  • Government error during enrollment on the exchange

There are several common QLEs that will allow for a Special Enrollment Period. Insurance can be purchased on or off the Federal (or your State) Exchange during this window of time.

The only place where you can enroll and claim a tax credit or subsidy (based on your income and family size) will be the exchange that serves your state of residence. We can help you understand how that works while also helping you to find coverage that meets your needs and budget.

What About Short Term Health Insurance Plans?

If you have missed your Special Enrollment Period or otherwise do not want to enroll in an Obamacare compliant plan, then short term insurance can help to fill a gap. These plans can be purchased for up to 6 months (12 months in some states) and will help to cover catastrophic costs.

It’s important to understand that short term health insurance plans are not compliant with the Affordable Care Act. In other words, you can face a penalty for not owning Minimum Essential Coverage. And they are medically underwritten – which means you can be turned down. Finally, short term plans do not usually provide coverage for preexisting conditions.

Typically, short term coverage works best to fill gaps for 6 months or less. They may not be advisable as plans to purchase in lieu of more permanent ACA compliant coverage. But if you have missed your Special Enrollment Period, they can be your next best option.

Contact Us For Quotes, Coverage & Enrollment Assistance

If you are experiencing a Qualifying Life Event and would like to explore your health insurance options during your 60 day Special Enrollment Period, we can help. We work both on and off the Federal Marketplace and can assist you with your needs. Contact us today to get started.

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Category: Health Care Reform, Health Insurance