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Changing Your Health Care Insurance Outside the Open Enrollment Period

Posted by David Ghiorso, CPA, September 28, 2015

Under typical circumstances, you can only change your health insurance plan during open enrollment. However, if you have a qualifying life event, it is possible for you to change your health insurance plan outside the open enrollment period.

Life events that qualify for special enrollment are:

  • Getting married
  • Having a baby or adopting a child
  • Leaving incarceration
  • Becoming a recognized U.S. citizen
  • Losing other health care coverage
  • Moving to a new permanent residence
  • Having a substantial change in your household income

In some extreme situations you are also able to apply for special enrollment to receive health benefits. Some of these situations would include:

  • An unexpected hospitalization
  • A natural disaster like an earthquake or tornado
  • Enrollment error which could include technical errors, casework being filed incorrectly or anything along those lines
  • A victim of domestic abuse
  • Misconduct by a non-marketplace enrollment assister which resulted in not getting enrolled in a plan or the correct coverage

If for some reason your application requesting special enrollment was denied, you can file an appeal through your state’s health insurance marketplace. It is recommended that you provide any further documentation that may help support your case in order to get your appeal approved in a timelier manner. If your appeal is accepted you will receive health coverage backdated to the time your initial request was made.

It is important to note that you are free to change your plan at any time during the open enrollment period which is from November 1, 2015 – January 31, 2016. In addition, federally recognized Indian tribes and Alaska Native shareholders can apply one time a month and do not need to wait to apply during the open enrollment period.

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