In certain circumstances, a change in health insurance eligibility can lead to a Special Enrollment Period for your family. When a Special Enrollment Period is granted to one member of the family, the whole family acquires the option to re-evaluate coverage and move from one plan to another, or even from one insurer to another. Keep in mind that such a change can result in a loss of progress towards meeting a deductible. For that reason, it can be advantageous to remain on the same plan with the same insurer, provided a sudden loss of eligibility is not the immediate cause for the change.
Let’s take a look at five situations where a change in health insurance status or eligibility would qualify for a Special Enrollment Period under the Affordable Care Act (ACA):
- Losing Group Coverage after Switching to Part-Time Hours: If you moved from a full-time position within your company to a part-time position, and the move resulted in you losing your employer-sponsored group coverage, then you qualify for a Special Enrollment Period under ACA. The enrollment period will last for sixty days from the date you lost health coverage.
- Losing Group Coverage After Changing Employers: If you previously maintained insurance through a group plan at your job, and you lost coverage after leaving your employer (either voluntarily or otherwise), then you’ve experienced a qualifying life event. You may apply for a Special Enrollment Period for up to sixty days from the date group coverage was lost.
- COBRA Termination: If you have been on COBRA coverage for a year and a half, and your COBRA benefit is expiring, this constitutes a change in health insurance and opens the door for a Special Enrollment Period. ACA allows you to purchase coverage for up sixty days from the date your COBRA benefits expire.
- Loss of MEDICAID Eligibility: If you recently received a letter indicating that your child is no longer eligible for MEDICAID benefits, that loss of coverage starts a Special Enrollment Period and allows you to add the child to your family plan. You can choose to add the child to your current coverage, or choose a completely new plan for your entire family, for up to sixty days from the date MEDICAID coverage ends.
- Loss of Coverage Due to Divorce: If you divorced a spouse who had you on his/her insurance, and you are no longer insured through your ex-spouse, then you qualify for a Special Enrollment Period for up to sixty days from the date you lost coverage.
If you live in North Carolina and think you’ve experienced a change in health insurance circumstances that may qualify you for a Special Enrollment Period, contact the agents at WNC Health Insurance. We offer free assistance with Special Enrollment Period verification and can help you find a truly affordable insurance plan!