What Are Qualifying Events?

qualifying events

What Are Qualifying Events?

The health insurance plan you bought when you were single with no kids, will not necessarily serve you the same way if you get married or have children. Luckily, those types of changes are considered qualifying events, which means that you can make the necessary changes to your health insurance coverage outside of the usual enrollment period.

Qualifying events can fall under any of these categories- loss of health coverage, a change in residence, or a change in the household. More specifically, though, they can include:

  • Having a baby or adoption
  • Marriage or divorce
  • No eligibility for Medicaid, Medicare, CHIP
  • Loss of health coverage because of job loss
  • Death of insurer of family
  • Relocation which changes your health plan area
  • Being removed from parent’s coverage once you turn 26

You are typically allowed 60 days from the time of the qualifying event to make the necessary changes to your health plan. In order to determine your eligibility, you should make your insurance provider aware as soon as you experience any of those circumstances.

To prove eligibility, there will be some extra steps to take and documentation that needs to be shown. These things can include:

  • Paperwork that shows there has been an addition to your family (birth certificate, adoption record, marriage license)
  • Anything to prove you have relocated and need to adjust your health plan (rental agreement, mortgage paperwork)
  • Something to prove that you have lost family and need to reconsider your coverage (divorce papers, death certificate)

These are just some examples of the type of paperwork you might be required to show to prove your eligibility. But if you want to be 100 percent sure, it is always advised that you check in with your insurance provider to determine what is truly needed.

While certain life changes may seem big to you, not every single one will allow you a special enrollment period. In that case, there are always other options. If you qualify and you need health insurance, you can apply for Medicaid. They accept applications all year round so there is no extra waiting time. Another option would be to shop around for other health plans that do not abide by certain enrollment periods.

Got Medicare Questions?

We hope this information on qualifying events is helpful to you.

If you have questions about your Medicare coverage, call Empower Brokerage today. Let us help with your Medicare questions so you can get back to the activities you enjoy the most. (888) 446-9157 or click here to get an INSTANT QUOTE

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About Kayla Gonzalez

Kayla Gonzalez is a graduate of Texas A&M University and joined the Empower Brokerage marketing team in early 2021. She creates content for the company websites and assists with various marketing campaigns. LinkedIn Profile

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