Understanding insurance often feels like a full-time job.
When you are trying to understand everything from deductibles to enrollment times, one major theme is probably coming up in your search: qualifying events. But, what the heck is a qualifying event?
Qualifying Events Are Actually Your Friends
Qualifying events are those various life situations that allow you to purchase insurance outside of the open enrollment period.
What is open enrollment?
Open enrollment is a limited period of time when you can select or change the benefit options you’ve selected through your employer.
Most qualifying events let you enroll in a plan that will start coverage as soon as insurance takes effect, as well!
We put together an entire list of qualifying events as a quick reference for you.
This list isn’t exhaustive, but it’s a great place to start if you need an explanation of some events that make it possible for you to get insurance.
You are Turning 26!
In the United States, you are allowed to stay on your parent’s insurance until you are 26. Once that birthday comes around though, you are responsible for finding your own insurance.
It’s important to remember that most insurance companies find it cheaper to provide insurance for your parents then it is for you and your parents. Be prepared to potentially pay a higher premium then your parents were.
Changes to a Family Policy
Still on the family plan? Great! Remember if your family policy changes, you and your family have the option to choose new insurance or modify the policy that you have. This usually happens when a sibling ages off the policy.
Most insurance carriers want you to stay, so they will give your family options when the time comes. It’s ultimately cheaper for them to keep you than it is to recruit new policyholders!
Moving Across Country
Changes in residency, especially if you are moving between states, is a common reason for insurance companies to let you enroll in a new policy. You can even get new insurance if you change zip codes!
For students, this can be an opportunity to potentially ger insurance through your school or the state. Although you might be covered under your parents, it might be cheaper for everyone involved to shop around a bit. If you are moving from California to Iowa, for example, your insurance could be a lot cheaper because of the cost of living in either state.
Congratulations, You are Getting Married!
Getting married is not just a right of passage or the culmination of years spent together, its also a qualifying event for insurance! Many companies will often include newly married couples in their insurance premiums. This is one way to include a spouse who has problems getting insurance with pre-existing conditions: since you are adding them as a dependent to your insurance policy, their conditions won’t apply.
Bonus: You can usually join your spouse’s insurance right away! But, not all policies have effective immediate coverage. This is why it’s really important to read thoroughly all of the documentation you receive.
Divorce Is Also Covered
Divorce is never easy, especially when it results in you losing your health insurance. If you were covered under your spouse’s insurance, or they under yours, the insurance companies will take that into account. You can enroll in new insurance if you’re divorcing.
Having a Baby or Adopting a Child
Hopefully, you had some kind of insurance before you had the baby, but if not, you can purchase health insurance right after giving birth. This also applies if you adopt a new family member.
There are some insurance providers who give you up to thirty days to enroll yourself and your children under twenty-six years old.
Your Current Employer Changes Their Insurance Policy
Employers and insurance companies are always negotiating coverage: employers want the best rates and the insurance company wants to make a profit. This can be good or bad for you, depending on the result.
Most employer purchased coverage has low monthly premiums and out-of-pocket costs. (Not always, but usually!) Since most insurance companies view insurance as unaffordable once your monthly premium and out-of-pocket expenses exceed a certain percentage of your income, this can trigger a change in your policy.
You Lose Your Employment
If you are giving up insurance because of employment loss, moar providers usually let you have thirty days to purchase insurance outside the open enrollment period. This is especially true if you are being laid off, but not if you quit voluntarily.
You Have a New Employer
The easiest qualifying event is when you gain employment with a new employer.
If you are getting insurance through an employer-based insurance plan, then insurance providers will allow you to purchase insurance after a change in employment status even if insurance was already being provided for you.
This includes if you are only working “part-time” or have just joined the company. This is especially useful for seasonal workers who live paycheck to paycheck. Not every insurance provider will accept this as a qualifying life event, so it’s best to check with your insurance provider to make sure they will.
Your Work Hours Change
If you have an increase or a decrease in your work hours, then insurance companies will let you enroll yourself or your children due to a change in those employment hours.
As always, read through your insurance plan or provider’s handbook to make sure you’re not violating any enrollment rules!
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