Health Insurance

Can I Change My Health Insurance After Enrollment?

After you enroll in health insurance, there are only a few circumstances where you can change your coverage. Learn the qualifying life events that allow you to make adjustments to your policy. 

Can I Change My Health Insurance After Enrolling

For the majority of health insurance plans, there are two set times each year when you can make changes to your current insurance plan or sign up for a new plan: annual open enrollment periods, as well as non-standard periods when you experience certain qualifying life events.

This is important because the effectiveness of your existing insurance policies may change after major life events, such as moving out of state or getting married. Your current health insurance coverage can have benefits that may not apply to your new circumstances. For example, if you get a raise, expand your family, or have changes in your health, you might find that your plan is no longer the right fit. 

How to Change Health Insurance Plans During Open Enrollment

Open enrollment for health insurance typically opens on November 1 and closes on January 15, aside from the exceptions below:

StateAdjusted Enrollment Period for 2022
CaliforniaNovember 1 – January 31
IdahoNovember 1 – December 22
KentuckyNovember 1 – January 31
MarylandNovember 1 – February 28
MassachusettsNovember 1 – January 23
New JerseyNovember 1 – January 31
New YorkCurrently open all year; enroll by 15th of each month to receive coverage on 1st of following month
Rhode IslandNovember 1 – January 31

This enrollment period is when anyone can make changes to their health insurance, regardless of whether a qualifying life event has occurred. This means that during open enrollment, you can:

  • Buy your first health insurance plan
  • Add or drop someone from your health insurance
  • Modify your coverage
  • Change your plan and associated deductibles or copay options
  • Cancel your insurance altogether
  • Add additional health insurance plans, such as stand-alone dental and vision health plans

If there’s something you dislike about your current insurance, open enrollment is the time when you can make changes to that coverage outside of a qualifying life event. This is also the time when you can make changes to a health insurance plan that you purchase through your employer because employer-sponsored plans still abide by regular health insurance enrollment guidelines.

How to Change Health Insurance Plans Outside of Open Enrollment

Outside of open enrollment, you are able to purchase or change your health insurance plan when you experience a qualifying life event. A qualifying life event (QLE) is when a major life event triggers a potential need for additional health insurance, thus creating a special enrollment period (SEP). These can include marriage, having a child, divorce, or loss of coverage due to job loss or your insurer discontinuing your existing plan.

When you trigger a special enrollment period, you typically have 60 days to make any necessary changes to your health insurance plan. Depending on the event, the SEP may occur 60 days before or after the life event.

Qualifying Life Event: Changes In Your Household

A household change is any significant change to the composition of your family, also known as your household. Qualifying household changes may include:

  • Birth of a child
  • Adoption of a child
  • Marriage
  • Divorce or legal separation
  • Death of a covered family member
  • Dependents aging out of coverage or buying their own plan

If you are experiencing an addition to your family, the special enrollment period allows you to add this person to your coverage. This ensures that your new family member doesn’t have a lapse in coverage and can still get affordable access to care in the months between the SEP and open enrollment. If you’re getting married, your spouse may have better insurance coverage, and you may choose to cancel your plan at this time to enroll in theirs, or vice versa. 

In the case of a divorce or separation, the special enrollment period gives you and your former spouse time to purchase separate insurance plans. If dependent children are involved, the SEP also provides time for parents to decide whose health plan will include the children. If death occurs, it’s important to use the SEP to officially remove that person from the health plan so you’re not paying an additional premium during an otherwise difficult time. 

Qualifying Life Event: Changes In Your Employment and Finances

Changes in your income and employment may also trigger a special enrollment period, such as a loss of employer coverage or a significant increase or decrease in your wages. For example, if you quit your job or are fired, you can lose your employer-provided coverage. In this case, taking advantage of the SEP can help you keep some health coverage in place by purchasing an individual health plan from the Marketplace, especially if you expect to use it before open enrollment. 

If your income changes dramatically, you may also be eligible for a change in coverage. Depending on your circumstance, you may get a better price or better coverage options.

Qualifying Life Event: Changes In Your Location

If you move or otherwise permanently relocate, your health plan options may change, which can trigger a special enrollment period. It may be helpful to reevaluate your health plan at this time so you can have the exact coverage you want. For example, coverage options can change by state. This may mean your deductibles, copays, and provider network can change. 

In some cases, your existing health plan may not have coverage options in your new area at all. Even if you didn’t relocate far, moving across state or county lines can change your network availability. If you’re a student or seasonal employee, you may have to reevaluate more often to ensure you still have coverage options no matter where you’re currently living.

Qualifying Life Event: Changes In Your Age

While not every birthday can trigger a special enrollment period, there are a few important milestones when it comes to your health insurance plan. 

Turning 26 years old is a qualifying life event. This is when dependents can no longer be covered on a parent or guardian’s health insurance plan. For parents of a 26-year-old, this means you can remove the child from your health plan and realize some savings. For those turning 26, this is an opportunity to shop for your first health plan if you don’t already have one in place. 

Turning 65 is another age milestone that triggers a SEP. At this time, you become eligible for Medicare. This is federal insurance that you can have in tandem with existing health insurance, or choose to switch entirely to Medicare or Medicare Advantage to avoid paying for two different health insurance policies. This SEP would be an ideal time to adjust your existing coverage to get the most benefits at the optimal price tag for your budget. 

Qualifying Life Event: Changes In Your Current Health Insurance

Sometimes, your current health insurance plan may change even without you doing anything new, in which case it can be considered a qualifying life event. These changes include:

  • Losing COBRA coverage
  • A grandfathered health plan with a different enrollment cycle

COBRA coverage is temporary health coverage for those who lose their employer-sponsored group health insurance benefits. This gives families the chance to keep important parts of their health plan active. When this coverage comes to a close, a special enrollment period opens so you can purchase a new health plan. Following the SEP closely can prevent a lapse in coverage.

In the case of a grandfathered health plan, your coverage may operate on a different cycle than the current healthcare market. The enrollment period for this type of plan may be considered a special enrollment plan. This is a good time to reevaluate your coverage to see if it is still meeting your needs. 

Need to Change Coverage But Do Not Have a Qualifying Life Event?

If you want to change your health insurance plan and don’t fit the criteria for a qualifying life event, you may have a few options. However, in many cases, you may still have to wait for the open enrollment period in November. 

For example, if you have a job-based health insurance plan, you may have a different open enrollment period than the federal level. If you have an employer health plan and you’re ready for a change, check with your employer to see what your options are. 

If you don’t have health coverage or have a lapse in coverage that does not qualify for a special enrollment period, you may be able to secure a short-term health plan, also commonly called temporary health insurance. Putting a temporary health plan in place can help you cover medical costs in the months until open enrollment, or even until you are eligible for a special enrollment period or Medicare. 

Short-term health insurance policies are typically less than a year in length and can be cancelled at any time, such as after enrolling in a different option during open enrollment. However, short-term policies are not held to ACA regulations and standards, and so may be stricter in eligibility criteria and not offer as robust of coverage. Depending on where you live, short-term health insurance may not even be available as an option.

Another option, specifically for those who have low income, is to enroll in Medicaid or CHIP. These federal and state-regulated programs offer health insurance coverage to those who meet the eligibility criteria, and unlike ACA plans, enrollment is open year round.