What Are Qualifying Events In Regards To Health Insurance?

You may have heard the term “qualifying event” after the implementation of the Affordable Care Act; also known as Obamacare. The reason that this term exists is due to the annual window that opens up to allow people to sign up for healthcare or make changes to their existing plan. Each year, this Open Enrollment period starts on November 1st for most of the country. However, in the state of California, the enrollment period starts on October 15th. However, with a qualifying life event, you don’t have to worry about the enrollment period.

What is a Qualifying Life Event?

qualifying eventsSo, what exactly is a qualifying life event? It is an event that happens in your life that makes you eligible to get insurance without having to wait for an open enrollment period. There are four types of qualifying life events that are considered to be valid by the Affordable Care Act. If any of these things happen to you, then you do not have to wait for an open enrollment period to apply for new health insurance. It can be done anytime. Ideally, you should apply directly after these events happen to you so that you can get back on an insurance plan as quickly as possible. However, you have a grace period for most of these that may extend weeks or months after the actual event. It is also worth noting that you may need to prove that this event happened in order to quality. Now, let’s look at the four Qualifying Life events.

Loss of Health Coverage

The first Qualifying Life event is the loss of health coverage. The loss of health coverage is something that qualifies you to apply for a new insurance plan in some cases. However, there are only certain situations in which this is valid. For example, if you were a student who recently lost their health coverage due to leaving school then you might qualify. In addition, anyone who has recently left a job or has been deemed eligible for Medicare or Medicaid plans may be eligible. Finally, those that are turning 26 and can no longer be on their parents’ plans may be eligible for a special window in which they can apply for their own insurance.

Changes in Residence

Second is a change in residence. There are several different aspects of this which can mean that you don’t have to wait until the window opens in order to apply. First of all, if you are moving to a completely different ZIP Code or County – and especially to a new state – the new do not have to wait until the window opens before you apply for health insurance. You can apply directly after you arrive. Seasonal workers then move around are also eligible for applying for health insurance without having to worry about waiting for the window. In addition, if you have recently been in a homeless shelter or transitional housing and you have moved into your own place, then you may be eligible for applying for health insurance without having to wait for the window to open.

Changes in Household

There are some changes in your household that will also qualify you for being able to apply for health insurance outside of the window. For example, if you are currently in the process of getting married or if you have just gotten divorced, then you may be eligible to apply for health insurance on your own or as a couple. This is the most common scenario in changes in household. You can also apply after you have had a baby or adopted one, as well as after you have had a death in the family, as long as that death actually directly affects your health insurance.

Other Qualifiers

There are a few other qualifiers that you should be aware of as well. For example, if you have had a significant change in your income that affects the coverage that you qualify for, you do not have to wait for a window to open up for you to apply for health insurance. In addition, if you have recently been added to a federally recognized tribe or as an Alaskan native, then you can apply for health insurance. The same goes for those who are a member of AmeriCorps, have just gotten out of jail or prison, or have just become a US citizen.

The Bottom Line

The bottom line is qualifying events are those that happen in your life that makes you able to skip the wait time for the windowed open up change your health insurance plan or get new health insurance. This is an extremely useful clause in the health insurance law because it allows you to continue having health coverage even if your circumstances change drastically.

Leave a Reply

Your email address will not be published. Required fields are marked *