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Can You Change Your Health Insurance After Enrolling?

Yes, you can change your health insurance after enrolling, but there are limitations based on when you decide to change plans. In short, you can make changes to your plan as often as you’d like during the annual Open Enrollment Period (OEP). For example, if you enroll in one plan at the beginning of OEP, you may change your mind multiple times until the end of OEP. Once that enrollment period is over, you cannot make any more changes until the next OEP, or until you experience certain qualifying life events that would qualify you for a Special Enrollment Period.

Changing Needs, Changing Coverage

In early 2022, the number of people without health insurance reached a historic low of 8% as 5.2 million previously uninsured people gained coverage since 2020. While this marks a worthwhile milestone in increasing access to health insurance, simply having coverage in and of itself is not sufficient.

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 and a change is necessary. 

When Can You Change Your Health Insurance Plan?

For the majority of major medical 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:

  • Open Enrollment Period: This occurs every year between November 1 through January 15 of the following year, though some states have adjusted dates.
  • Special Enrollment Period: This occurs when you experience certain qualifying life events, such as getting married or moving to a different ZIP code or county.

Within each enrollment period, you may make changes up until the last day of the enrollment period. Once the enrollment period ends, your plan will remain in force until either the next Open Enrollment Period or you experience another qualifying life event.

Outside of these two windows, you cannot make changes to your current health insurance plan. The only exception is for those enrolled in an employer-sponsored group health insurance plan, which may have its own enrollment period for employees to make changes to their coverage.

Open Enrollment Period (OEP)

The Open Enrollment Period (OEP) for health insurance typically opens on November 1 and closes on January 15, aside from the exceptions below:

Adjusted Enrollment Period for 2022
November 1 – January 31
November 1 – December 22
November 1 – January 31
November 1 – February 28
November 1 – January 23
New Jersey
November 1 – January 31
New York
Currently open all year; enroll by 15th of each month to receive coverage on 1st of following month
Rhode Island
November 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 OEP, 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

This is also the time when you can make changes to your employer-sponsored health insurance plan because group health insurance plans still abide by regular health insurance enrollment guidelines.

Special Enrollment Periods (SEP)

Outside of OEP, you are able to purchase or change your health insurance plan when you experience a qualifying life event. A qualifying life event is a major change that triggers a potential need for additional health insurance, such as marriage, having a child, divorce, or loss of coverage due to job loss or your insurer discontinuing your existing plan. These would create a Special Enrollment Period (SEP).

When you trigger an SEP, 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. For example, when you get married, you have 60 days from the day you sign your marriage certificate to make changes, such as adding your spouse to your health insurance plan.

However, these changes can be limited depending on the qualifying life event. In most cases, the new plan must be within the same metal category as your existing plan, and you may not have every option available as you would during the Open Enrollment Period.

Changing Plan Metal Categories

Every Affordable Care Act (ACA) plan is sorted into four metal tiers: Bronze, Silver, Gold, and Platinum. In the majority of cases, when you change health insurance during an SEP, you must pick a plan within the same metal category. For example, if you had a Gold plan, you must pick another Gold plan if you want to change health insurance during the SEP.

However, there are some situations that allow you to change metal categories, such as moving from Bronze to Silver or Platinum to Gold:

  • New Dependents: If you have new dependents due to marriage, birth, adoption, or fostering, you have the rest of the year to enroll them in any health insurance plan you see fit. This includes plans that differ in metal category than yours, though you may only go one level up or down. For example, if you have a Silver plan, you may enroll your new family in a Bronze or Gold plan, but not Platinum. Also note that the SEP for this specific qualifying event extends beyond the usual 60 days.
  • Gaining or Losing Cost-sharing Reductions (CSRs): Those enrolled in Silver plans may be eligible for CSRs, which are discounts to help lower out-of-pocket expenses like deductibles and copays. If you gain or lose eligibility for CSRs, you may join a Silver plan or leave it for a Bronze or Gold plan.
  • Complex Situations: Exceptions can also be made for those in particularly complex situations, such as those who are members of a federally recognized tribe, those whose enrollment was disrupted by a national or state-level emergency, and technical errors on that prevented your application from going through.

How to Make Changes to Your Health Insurance

You may want to review your insurance coverage when you’ve had a significant personal or financial change. For example, if your household has changed through marriage, divorce, birth, or adoption, you may need to add or remove individuals from your plan. Or, perhaps a newly diagnosed medical condition has prompted you to consider a change in benefits. 

The process of changing your health insurance plan varies depending on the specific type of changes you’re trying to make, but these are the general steps to make changes to your health insurance plan:

  1. Log into your Marketplace account and locate your existing application. 
  2. Then, select “Report a Life Change.” 
  3. If the life change qualifies you for a Special Enrollment Period, the site gives you the option to make the allowed changes to your coverage. 

You may also make changes over the phone, or by contacting your insurance company directly or working with a trusted agent.

How to Add or Remove Someone from Your Current Plan

You can add or remove household members from your health insurance plan at any time during the annual Open Enrollment Period. If the size of your household changes outside of the Open Enrollment Period, you may be eligible for a Special Enrollment Period to make adjustments.

  1. Take note of enrollment windows. Some qualifying life-changing events include marriage, divorce, birth, adoption, court order, or foster care. You typically have a 60-day window after an eligible event occurs to make plan changes.  
  2. If additions are needed, determine whether to add members or get a new plan together. Some plans do not allow you to add new members. When this happens, your entire family can enroll together in a new plan, as long as it is in the same metal tier. If no other plans are available in your current metal tier, you may be able to enroll in plans that are one level up or down from your current plan’s level. 
  3. Provide documentation, if needed. In some cases, you may need to provide documentation to prove that the event has occurred, such as a birth or marriage certificate or a divorce decree.

How to Increase or Decrease Your Current Plan’s Deductible

Raising or lowering your healthcare plan’s deductible can change your monthly premium and impact your out-of-pocket costs. However, unless you have a qualifying event, you cannot change your health insurance deductible until the next enrollment period.

  1. Contact your current insurer to ask about options. When you’re eligible to make changes, depending on your plan and provider, you may be able to keep your current plan and adjust the deductible. However, you may need to choose a new plan with a deductible that is appropriate for your needs.
  2. Keep current deductible balance in mind. If you have a qualifying event and the changes you make include raising or lowering your deductible mid-year, the payments you’ve already made during the year may not apply to your new deductible.

How to Change Plans and/or Insurers Entirely

You can change to a completely new health insurance plan or insurer during the Open Enrollment Period. You may also be able to make this change when you qualify for a Special Enrollment Period, depending on the circumstances.

  1. Be aware of possible limitations on options. During a Special Enrollment Period, there may be a limitation to the number of health plan categories you can choose from, or you may be required to choose a new plan that is in the same category as your current plan.
  2. Shop around and make the switch. To change plans, browse your options on the Health Insurance Marketplace or work with a trusted agent to complete the change.

How to Cancel Your Health Insurance

Unlike other plan changes, you can cancel your Marketplace health insurance at any time. However, it’s important to note that if you cancel your Marketplace coverage, you’re not allowed to re-enroll until the next Annual Open Enrollment Period unless your circumstances qualify you for a Special Enrollment Period.

To cancel your health insurance plan, follow these steps:

  1. Log into your Marketplace account.
  2. Click on “Start a new application” or “Update an existing one.”
  3. Click on your name and choose your existing application.
  4. Select “My Plans & Programs.”
  5. Click on “End (Terminate) All Coverage.”

You can either choose to end your coverage immediately or select a date when you want your coverage to end. If you prefer, you can also cancel your plan by calling the Marketplace Call Center.

Reasons to Change Your Coverage

As you experience changes to the size of your household or to your personal or financial circumstances, your health insurance needs may change as well. It’s common to make coverage changes based on affordability, changes in your health, relocation, changes in employment, and more.  

Changes In Your Household

A household change is any significant change to the composition of your family, including getting married or divorced, the birth or adoption of a child, the death of a covered family member, or your dependent aging out of coverage under your plan. You may want to:

  • Add a dependent or spouse to your health insurance. If you are experiencing an addition to your family, the SEP allows you to add this person to your coverage.
  • Move to your spouse’s insurance plan. 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. 
  • Separate your health insurance plans. In the case of a divorce or separation, the SEP 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.
  • Remove someone from your health insurance. 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. 

Changes In Your Employment and Finances

Changes in your income and employment include losing employer coverage or a significant increase or decrease in your wages. You may want to:

  • Purchase new individual health insurance. If you leave your job or are let go, you can lose your employer-provided coverage, making it necessary for you to find individual health insurance.
  • Increase or lower your deductible. Depending on your health needs, increasing or decreasing your deductible could help you save on health costs in the long term. Increasing your deductible typically helps lower monthly premium, while lowering your deductible would increase your monthly premium but make your insurance coverage kick in sooner.
  • Increase or lower your plan tier. Depending on your health needs and income changes, you may want to change your health plan tier. Higher plan tiers tend to be more expensive but offer more coverage, while lower plan tiers tend to be more affordable but offer less coverage.
  • Change plans entirely to find better benefits, affordability, and/or customer care. You may be dissatisfied with your current plan, in which case changing to another plan could help mediate those pain points.

Changes In Your Location

If you move or otherwise permanently relocate, your health plan options may change. You may want to:

  • Enroll in a plan that serves your new residence. It may be helpful to reevaluate your health plan when you move 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. 
  • Enroll in a plan that includes your preferred healthcare providers. Even if you didn’t relocate far, moving across state or county lines can change your network availability.

Changes In Your Age and Health

While not every birthday can trigger a Special Enrollment Period, there are a few important milestones when it comes to your health insurance plan. You may want to:

  • Enroll in a new individual health insurance plan. When you turn 26 years old, you can no longer be covered on a parent or guardian’s health insurance plan. This is an opportunity to shop for your first health plan if you don’t already have one in place through an employer or a spouse. For parents of a 26-year-old, this means you can remove the child from your health plan and realize some savings.
  • Enroll in Medicare. When you turn 65, 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. 
  • Increase your health benefits coverage. If your health changes and you need more care, it could be worthwhile to increase your health coverage to better account for increased visits to the doctor, visits to specialists, increased medication usage, and testing.

Changes In Your Current Health Insurance

Sometimes, your current health insurance plan may change even without you doing anything new, such as losing COBRA coverage or being on a grandfathered health plan with a different enrollment cycle. You may want to:

  • Purchase a new individual health insurance plan. COBRA coverage is temporary health coverage for those who lose their employer-sponsored group health insurance benefits. When this coverage comes to a close, a Special Enrollment Period opens so you can purchase a new health plan.
  • Reevaluate your grandfathered plan. In the case of a grandfathered health plan, your coverage may operate on a different cycle than the current healthcare market. When it comes time to renew coverage, it is a good time to reevaluate your needs to see if your current plan still works or if you want to change to a new major medical insurance plan.

Need to Change Coverage But Don’t Have a Qualifying Life Event?

In many cases, if you want to change your health insurance plan and don’t fit the criteria for a qualifying life event, you have to wait for the Open Enrollment Period to begin in November. However, you may have a few options.

Employer-sponsored Health Insurance

If you have a job-based health insurance plan, you may have a different enrollment period to make changes than the federal Open Enrollment Period. If you have an employer health plan and you’re ready for a change, check with your employer to see what your options are. 

Short-term Health Insurance

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. You can apply and enroll in short-term health insurance at any time in the year.

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 OEP. However, short-term policies are not held to Affordable Care Act (ACA) regulations and standards, which traditional major medical health insurance plans must adhere to. This means short-term health insurance plans 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.

Medicaid and CHIP

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. Unlike ACA plans, enrollment is open year round.

What This Means For You

It can make a big difference in your healthcare coverage and costs to review your health insurance coverage regularly, especially as your life changes. For example, if you develop a new health condition or your current plan stops covering a treatment you need, switching to a different plan can help you get covered care.

Some insurance companies may change their policies from one year to the next too, or your preferred physicians and pharmacies may leave the network. This means the plan you enrolled in last year might not be the best option for you moving forward. Being proactive and staying informed about your health insurance options can ensure that you have the coverage you need, especially if your changes make you eligible for a health insurance change outside of the annual Open Enrollment Period.

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