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Think you’re ready to change up your health insurance? Though health insurance companies have to follow a few regulations that limit the time period in which you can switch your plan, you may qualify for an exception to these rules.
Before you decide to switch, make sure you read Benzinga’s comprehensive guide about what you need to know before you switch health insurance plans.
Switching your health insurance involves two steps: Canceling your current plan and signing up for a new plan. With very few exceptions, you can cancel your health insurance plan at any time for any reason. However, if Open Enrollment hasn’t arrived, you may have trouble finding a plan to cover you right after you cancel. Though anyone can get health insurance during Open Enrollment periods, you must have a qualifying event to sign up for a plan outside of Open Enrollment.
Understanding Open Enrollment, what you need in a healthcare plan and how to qualify for a Special Event Period to make the process of switching your health insurance plan much simpler.
1. Figure Out if You’re Eligible to Enroll for a New Plan
Everyone is eligible to buy a new healthcare plan during the ACA’s Open Enrollment period. Enroll by December 15, 2020, and coverage starts January 1, 2021.
If Open Enrollment isn’t open, you may sign up for a new healthcare plan if you qualify for a Special Enrollment period. Some of the events that can trigger a Special Enrollment period include:
- Loss of current healthcare coverage: If you lose your job and your employer-sponsored healthcare coverage, you graduate from college and lose your student coverage or you turn 26 and lose coverage through a parent’s plan, you qualify for a Special Enrollment period. You may also qualify if you lose eligibility for Medicare, Medicaid or CHIP.
- Changes in your family situation: You may qualify for a Special Enrollment period if you have a baby, adopt a child or the main policyholder in your household passes away. You can also qualify if you get married or finalize a divorce.
- You change your residence: You may qualify if you move for school or work or move from temporary to permanent housing. Your new residence must be in a different ZIP code to trigger a Special Enrollment period — you can’t just move across town.
- You escape a domestic violence situation: If you’re a survivor of domestic abuse or spousal abandonment and you want to enroll in your own plan to escape dependence on your abuser, you can qualify for a Special Enrollment period. Your dependents can also get on your new plan.
- You missed Open Enrollment due to an accident or disaster: Did you experience a coma or other sudden cognitive disability due to a natural disaster like an earthquake, hurricane or flood? You can qualify for a Special Enrollment period.
- Other reasons: If you were recently released from prison, became a U.S. citizen or gained membership in a federally recognized tribe, you qualify for a Special Enrollment period.
If you qualify for a Special Enrollment period, you have 60 days from the onset of your qualifying event to enroll. To begin the enrollment process, contact the Marketplace Call Center at 1-800-318-2596. The representative will ask you a few questions about your circumstances and will help you enroll in a plan.
If you currently have a plan and you qualify for a Special Enrollment period, your representative can help you cancel your current plan and make sure you don’t have any coverage gaps.
If you don’t qualify for a Special Enrollment period, you have a few options to get covered. If you believe that your rejection was incorrect, you can file an appeal. If a representative accepts your appeal, you’ll gain access to a Special Enrollment period.
To complete an appeal, download your state’s appeal form, fill it out and mail it.
You should also include eligibility documentation with your appeal form. While this isn’t required, it will help your appeal go through faster.
If you can’t get a Special Enrollment Period through an application or an appeal, your next best option is to enroll in a temporary insurance plan that provides coverage until Open Enrollment period arrives. Temporary health insurance plans only bridge gaps in coverage — you shouldn’t see that as a long-term health insurance solution because it has a number of restrictions that aren’t found in ACA-compliant plans.
You can also purchase a standard or Medicare supplemental insurance plan to fill minor gaps in coverage until Open Enrollment opens again. If you’d like to learn more about short term health insurance options, check out our review of the best temporary health insurance plans.
2. Looking for in a New Plan
Before you start searching for a new plan, you want to consider what exactly you’re looking for. Think about what your current plan lacks — some areas you might want to look at include:
- Deductibles and copay percentages
- Monthly premiums
- Mental health coverage
- Pregnancy coverage and maternity care options
- Drug coverage options
Create a wish list of everything you need in a plan and use your needs to guide you when you compare plans and speak with representatives from health insurance companies.
3. Documents You Need
If you do qualify for a Special Enrollment period, you’ll need to provide documentation to a representative that backs up your claims. The specific documentation you need depends on which qualifying life event you claim.
Some examples of documentation a representative might ask you to provide include:
- Birth, adoption or legal guardian status through a birth certificate, adoption record or court order that grants guardianship or a child support order.
- Marriage license, including proof of coverage for at least one spouse.
- Loss of coverage documentation from either your employer or your insurance provider that states when coverage ends. If you lose health insurance because you turn 26, you’ll need some form of proof of qualifying health insurance coverage valid for at least 60 days before your 26th birthday. If you lost coverage because you graduated from college and were on a school-sponsored plan, contact your health insurance company and request a document that confirms your plan cancellation date.
- Divorce or legal separation papers, including a clause that ends spousal healthcare provisions, along with documentation that proves that you had health insurance through your spouse for at least 60 days prior to your separation.
- If you’ve moved out of your previous ZIP code, you’ll need to provide proof of your former health insurance coverage as well as some form of documentation that confirms your new address. This can include a lease or rental agreement, a letter from your current or future employer that states that you moved for your employment, official school documentation that includes information on your dormitory or student housing address or an official U.S. Postal Service change of address confirmation.
- Release from prison or another form of incarceration. A document from the Department of Corrections can confirm your release date, as well as any outstanding parole certificates.
If you have a different qualifying life event, your Marketplace representative will help you decide what type of documentation you need to provide.
4. Pick a Provider
Compare quotes from these top health insurance providers.
UnitedHealthcare offers many plan types, from accident insurance to student health insurance and more. UnitedHealthcare helps you get coverage that works with your lifestyle, helps you get the best care possible and fits the financial piece of the puzzle as well.
UnitedHealthcare also has a diverse network of doctors, clinics and hospitals across the nation, where you’ll get access to many options with Golden Rule Insurance Company, a UnitedHealthcare company. You’ll get high quality care and affordable prices with UnitedHealthcare.
Get a quote from UnitedHealthcare today.
Need Medicare, Medicaid, vision, dental, pharmacy and more? Humana improves healthcare and makes it more accessible for all. Humana really delivers to the communities it serves.
Find information about the Medicare Advantage, prescription drug (Part D)and Medicare Supplement plans. Additionally, you’ll see:
- Monthly premiums
- Primary care copays
- Specialist copays
- Maximum out-of-pocket costs
Check out which of your doctors are in each plan’s network and view included coverage, such as long-term care benefits and drug, dental, vision or fitness coverage through your ZIP code.
Aetna’s health insurance plans and services include medical, pharmacy and dental plans, Medicare plans and Medicaid services. An estimated 39 million people rely on Aetna, a CVS Health company. Every day, Aetna works to make the system easier and more convenient for our customers. Aetna also offers:
- A range of insurance and employee benefits products
- Programs and services that help control rising costs and strive to improve the quality of healthcare
- Tools and information to help people make better-informed decisions about healthcare and financial well-being
Look into Aetna today.
5. Complete Your “To-do” List
When you finish your application, the Marketplace will present you with a “to-do” list of steps that you need to take to finalize your application. You may have to upload documentation that confirms your qualifying life event and you may have to enter information on your assets or income or select policy preferences. Complete all of your required steps and click “Final Review” to confirm your new enrollment.
6. Cancel Your Current Coverage
If your current health insurance isn’t through the ACA, you’ll need to cancel your coverage independently. As a general rule, you can cancel any kind of medical insurance or dental insurance at any time for any reason.
However, you don’t want to cancel your plan before you’re covered with a new plan because this will leave you with a gap in coverage. Call your insurance provider after you’ve enrolled in a new plan and request a cancellation. Request written documentation from your policy provider that confirms that your plan is canceled and when your coverage ends. Keep this documentation for your records.
7. Make Sure Your Policy is Actually Canceled
For the first few months after your policy cancellation, double-check your bank and credit card statements to make sure that you aren’t still paying for your old plan. If your old insurance company still attempts to charge you, send your former representative the documentation stating when you canceled your policy and request that the charge is reversed.
Get the Healthcare You Need
Beginning in 2019, the Trump administration removed the individual mandate penalty that charged fees to the uninsured. However, living without health insurance can leave you and your family on the hook for expensive medical treatment and care in the event of an accident or emergency. If you’re currently uninsured, take the time today to review your options for getting covered — your body (and your wallet) will thank you.
Frequently Asked Questions
1) Q: Is health insurance required?
The federal mandate that required health insurance has been lifted but some states have enacted state-level mandates that require residents to have health insurance. Even where not required, health insurance can protect your family against catastrophic healthcare costs and help make routine medical expenses more predictable. Get your most affordable quote through our top providers today.
2) Q: What does health insurance cover?
Most health insurance plans provide the 10 essential health benefits that were part of Obamacare requirements. Coverages include preventive and wellness services, prescription drug coverage, emergency services, ambulatory services, lab services, pediatric services and more. Many plans cover a wider range of healthcare expenses but may cost more than basic plans or may have higher out-of-pocket costs for some services. Get a custom health insurance quote to cover you and your family today.
3) Q: How can I save money on health insurance?
For healthcare plans that comply with the Affordable Care Act, only a handful of rating factors affect your premium. These include age and location, at least one of which can’t be changed. Smokers will pay more in most cases and your choice of plan level can affect premiums as well. Choosing a high deductible health insurance plan can reduce the cost of premiums. These plans can be combined with a health savings account to take advantage of tax-free savings for healthcare expenses. Get the cheapest health insurance premium from top providers.