Qualifying Life Event

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There are many rules and guidelines involved in health insurance. One of these is the Open Enrollment period which is the specific period every year that you are allowed to enroll in new health insurance benefit plans or make any changes to existing health insurance plans. But what can you do if you want to make changes to your benefit plan outside the open enrollment period? Is it possible? It will depend on the reason behind it. Did a qualifying life event happen? Let’s talk about qualifying life events below. 

What is a “qualifying life event”? 

In the health insurance space, a qualifying life event refers to any change in an individual’s life circumstance or situation that can make them eligible to buy a health insurance plan or make changes to an existing benefit plan even if it is not during the open enrollment period. Common examples of qualifying life events are getting married, having a baby, or a death in the family. 

In this case, a qualifying life event can allow the individual to make these changes in a Special Enrollment Period, named such because it falls outside the yearly designated open enrollment period. A special enrollment period provided by health insurance providers usually lasts 60 days after the occurrence of a qualifying life event during which an individual can make the necessary changes in their health insurance plans or sign up for a new plan. While this is the usual duration of a special enrollment period, it is best to contact your health insurance provider for more detailed information on the enrollment process. 

What are examples of a qualifying life event? 

A qualifying life event may be planned or unplanned. There are generally four types of qualifying life events:

Let’s take a look at examples under each category. Note that these are just some examples and not a complete list. 

Loss of Health Insurance

 

Changes in Household

Changes in Residence

Other Qualifying Changes

Aside from these qualifying life events, there can also be what is called an “exceptional circumstance” or “special circumstance” that may allow a person a special enrollment period. 

Here are some examples of a special enrollment period:

Remember that a qualifying life event is a change that impacts your health insurance needs. It has to be an event that alters your health benefit plans. 

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