You may have wondered ‘when can I make changes to my health insurance plan?’. This is a great question that comes up all the time.
First we’ll talk about employer based health insurance.
If you have health coverage through an employer, your employer will host what is called ‘open enrollment’ once per year, typically 1-2 months prior to the health insurance plan resetting for the new plan year. During open enrollment, you can choose to make changes to your health insurance enrollment, and these changes will go into effect when the new plan year begins. During this timeframe, you can:
- Enroll in the health plan for the first time if you previously had declined coverage
- Change plans if your employer offers multiple plan options
- Add or remove a spouse or dependent children from your plan
- Or, decline coverage moving forward if you previously were enrolled
Typically, you are limited to making these changes only during open enrollment, unless you experience what’s called a Qualifying Life Event. If you experience a qualifying life event, you will have a certain number of days in which you can make changes to your health plan enrollments. Qualifying life events include:
- Losing other health insurance coverage
- Experiencing a change in your household makeup, including:
- Getting married or divorced
- Having a baby
- Adopting or fostering a child
- Experiencing a death in the household
Next we’ll talk about health insurance through the WA State Marketplace, called Washington Healthplanfinder. If you have coverage through the marketplace, open enrollment takes place from November 1 – January 15 each year. During this time, anybody can enroll in a health plan through the marketplace, or make changes to their existing health plan selections. Selections made during open enrollment are effective January 1.
Just like employer plans, you are typically limited to making changes during open enrollment, unless you qualify for a special enrollment period based on experiencing a qualifying life event. You have 60 days from experiencing a qualifying life event to make changes. Qualifying life events include:
- Losing other health insurance coverage, unless you lost coverage due to non-payment of premiums
- Experiencing a change in your household makeup including:
- Getting married or divorced
- Having a baby
- Adopting or fostering a child
- Experiencing a death in the household
- Experiencing a change of income of $150 a month or more
- Moving to a new county in WA state
- Or, Experiencing a change in citizenship status
These are the most common qualifying life events, but there are more. If you’re unsure if you have experienced a qualifying life event, and want to make changes to your plan or enroll in a plan for the first time, reach out to us so we can screen your eligibility.
And one last note, you can enroll in Apple health (Medicaid) at any time if you meet the income requirements.
As always, if you have any questions, reach out to us here at Mountain View Insurance!
