When can you change your health insurance?
Just the Essentials...
- Open Enrollment runs from the beginning of November until the end of January.
- Those who are enrolled in a plan can change health insurance plans at any time during the Open Enrollment period.
- You cannot change your plan after Open Enrollment unless you qualify for an exception.
- Exceptions are Government extensions of Open Enrollment periods. These are known as Special Enrollment periods, and are typically triggered by certain major life events.
When is the right time to change health insurance?
“When can you change your health insurance?” This is a question we hear a lot. If you’re looking to find a new health insurance plan that works for you, a period known as “Open Enrollment” is, in most cases, your best chance.
Most Americans see the Affordable Care Act (ACA) Open Enrollment period as a great opportunity to review their insurance plans. Some of you may elect to make changes, while others may choose to keep their plan or be placed in a similar one. Today, we’ll look at how you can navigate the Open Enrollment process to change your current health insurance plan to one that works for you.
Don’t wait until Open Enrollment to begin comparing health insurance rates. Start comparing them today by using our FREE tool above.
Reviewing Your Options
During the Open Enrollment period, you have the ability to improve your existing coverage and find a plan that best fits your needs or the needs of your family. The ACA encourages customers to compare plans, with an emphasis on premiums and the percentage of coverage.
By comparison shopping, you’ll find the best health insurance plan for you by focusing on the things that matter most. These can include:
- Convenient locations
- Specialists inside the network
- Individual preferences for services
Understanding Health Insurance Enrollment and Changes
The Open Enrollment period and your opportunity to change your health insurance plan have similar deadlines. During the Open Enrollment period, you can select and change plans as often as you wish, with the last day to change your health insurance plan being the last day of Open Enrollment.
If you need to change your plan after Open Enrollment, there is a period of time during which you can do so. If you have a qualifying life event, you can take advantage of an extension period, known as Special Enrollment, which is allowed by the rules and requirements of the ACA. The Special Enrollment period reflects the flexibility needed to accommodate changes in status that may occur after the Open Enrollment period.
In some instances, the government has announced extensions to the Open Enrollment period, with the most recent extension occurring in 2021 due in part to issues caused by the COVID-19 virus. These extensions cover those who had begun the enrollment process, but had not completed it. State marketplaces have also used extension periods to help applicants complete enrollments.
The “Metal” Plans
The ACA Marketplace offers tiers of health insurance plans that correspond with different types of metals. These are known as the ACA “metal” plans. These health insurance plans are ACA-exclusive and can only be purchased or changed during the Open Enrollment period. “Metal” plan tiers are as follows:
- Bronze: Low premium, but high deductible. Your insurance company pays 60% and you pay 40% after meeting the deductible.
- Silver: Second-lowest premium, second-highest deductible. Your insurance company pays 70% and you pay 30% after meeting the deductible.
- Gold: Second-highest premium, second-lowest deductible. Your insurance company pays 70% and you pay 30% after meeting the deductible.
- Platinum: High premium cost, but offers the lowest deductible. Your insurance company pays 90% and you pay 10% after meeting the deductible.
Life Events and Special Enrollment
Typically, you are not able to change or purchase health insurance plans in the ACA Marketplace after the close of Open Enrollment. The last day of Open Enrollment is January 31 of the year in which your policy will take effect.
There is an exception, however. A life event is a sudden change that requires that you be given a new opportunity to get insured. The life events that will allow you to change or purchase health insurance during a Special Enrollment period include:
- Marriage
- Divorce
- The birth of a child
- Adoption
- Relocating to a different state
- Losing a job-based health insurance plan
- Losing health insurance as a dependent
Automatic Re-Enrollment: An Important Note
Your existing plan insurer and the federal or state marketplace provide notices toward the end of the year about health insurance plan renewal and purchasing new coverage. Renewal options allow you to keep a plan that you like and accept an increase or decrease in premiums and changes in the terms of coverage. Some plans, however, may not continue into a new year, which means you’ll have to find a new one.
Can I Change Health Insurance Plans Outside of Open Enrollment?
Yes and no. Insurers are not legally prohibited from offering qualified health insurance plans outside of Open Enrollment. Many choose not to because prices, terms, and coverage all apply to certain markets and pertain to conditions that existed during a previous term.
If you have experienced a qualifying life event, however, you have specific periods of time during which you change your coverage if necessary. An extension period, known as Special Enrollment, allows you to change your health insurance plan for up to 60 days after Open Enrollment ends.
Moving Outside of the ACA Marketplace
The ACA brought many sweeping reforms to the health insurance industry. With these reforms, the ACA put a stop to many practices that had harsh effects on consumers, such as denials for pre-existing conditions.
If your income exceeds a certain limit, you will not qualify for premium and payment assistance from the ACA. For example, if you’re near or above the 400% threshold on the federal poverty line, you should look outside of the ACA Marketplace for a health insurance plan.
While the ACA Marketplace may not be the best option for you, you still get all of the most essential health benefits wherever you buy coverage. You’ll also have access to plans through private insurers that aren’t available through the ACA Marketplace. Shopping outside of the ACA is truly the best way to access the complete range of plans that are available to you.
Making the Best Selection For You
Comparison shopping is an excellent tool to help you make the best selection for health insurance coverage. Whether you’re selecting a brand-new policy or switching an existing plan, comparison shopping helps you focus on plan features that matter most to you.
By comparison shopping, you’re getting an opportunity to go beyond factors such as price, premium, and out-of-pocket expenses and dive into deeper features that may appeal to you. Factors such as facility locations or the ability to use out-of-network specialists may be important for you and/or your family. Comparison shopping helps you highlight these specific features.
Do you need assistance with finding a health insurance plan that’s right for you? Enter your zip code below to find available health insurance plans in your area.
Key Resources:
1: Dates and Deadlines for 2022 Health Insurance
2: CFR 155.420 – Special Enrollment Periods
4: The ‘Metal’ Categories: Bronze, Silver, Gold & Platinum
5: Enroll In or Change 2022 Plans – Only With a Special Enrollment Period
