Understanding Qualifying Life Events in Health Insurance

Healthcare Writer

Published on April 11th, 2024

Fact checked by: Colleen McGuire

We want to help you make educated healthcare decisions. While this post may have links to lead generation forms, this won’t influence our writing. We adhere to strict editorial standards to provide the most accurate and unbiased information.

Life can throw you curveballs sometimes, but there’s a way to get health insurance even when it’s not the usual time to sign up. It’s called a Qualifying Life Event (QLE). These events allow you to join a health insurance plan within 60 days, no matter the time of year.

Here’s what counts as Qualifying Life Events:

  • Getting married
  • Getting divorced
  •  Having a baby or adopting a child
  •  Someone in your household passing away, which might change how many people are in your family for insurance purposes
  •  Changes in your family size affect how much money you get from the government to help pay for insurance
  •  Changes in how much money you make, whether you start making more or less, which might change how much help you get with paying for insurance
  •  Making more money and not being able to get free insurance from Medicaid anymore
  •  Losing the health insurance you had through your job
  •  Your health insurance company is stopping your coverage even though you’ve been paying for it
  •  Your COBRA insurance is running out
  •  Turning 26 and not being able to stay on your parent’s insurance anymore
  •  Moving to a different area with a different ZIP code
  •  Getting out of jail
  •  Being a victim of domestic abuse
  •  Leaving the military
  •  Making mistakes on your health insurance application that keep you from getting insurance

Any of these things can let you change your health insurance plan.

Here’s what you need to know about Special Enrollment Periods:

 They last for 60 days after your Qualifying Life Event happens.

 Usually, your new insurance starts on the first day of the next month after you sign up.

Your 60 days start counting from the day your Qualifying Life Event happens. If you don’t sign up during those 60 days, you might have to wait until everyone can sign up for insurance.

Some Special Enrollment Periods have extra rules depending on what happened. For example, if you have a baby or adopt a child, you can sign up for insurance within 60 days of that happening, and your new insurance can start right away.

You might still have some options if you miss your chance to sign up during your Special Enrollment Period. These include getting temporary insurance or another chance to sign up if you’re too sick or hurt to do it on time.

Final Thoughts 

Remember, signing up during a Special Enrollment Period doesn’t cost extra monthly. Also, insurance companies have to accept your application.

And don’t wait until something bad happens to get insurance. Life can change suddenly, and not having insurance can be risky for your health and your wallet. Stay aware and ensure you have the insurance you need to feel safe.

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