Qualifying Events
Missed Open Enrollment?
You Still Have Health Care Coverage Options
Change is the only constant in life. And navigating those changes, both the good ones and the bad ones, can be complicated. It’s no small matter that many of these changes affect your health care coverage, adding one more stress to your already full plate. We’re committed to helping you make your health care insurance decisions as easy as possible.
But what can we do for you if you are outside that annual open enrollment period when you can choose your own health insurance plan?
The good news is many of life’s changes are considered qualifying events, meaning they may trigger a special enrollment period when you can make changes to your health care coverage outside of Open Enrollment. So if you’ve just turned 26 and come off your parent’s insurance, returned from military service, gotten married, lost your job, retired or found yourself facing one of life’s many changes, you may qualify for Special Enrollment.
How Long Do I Have To Choose?
If you qualify for Special Enrollment, you generally have 60 days to make changes to your health insurance. If you miss this window, you may have to wait up to 10 months for the next Open Enrollment. That’s where we come in! Let us help you find the right plan for you right now.
Missed Your Special Enrollment Window?
We Can Help With That, Too
Short Term health insurance, also called Temporary insurance or Term health insurance, may be just the thing to get you to that next Open Enrollment period. It’s designed to bridge gaps so you’re covered until you decide on a long-term health care solution. Learn more about Golden Rule Insurance Company Short Term health insurance.F5
QUALIFYING EVENT
A Change of Address
Moving out-of-state or out of your existing coverage* area may give you a chance to choose a new health insurance plan.
A change of address may be a qualifying event that opens up a short special enrollment period when you can select a new individual health insurance plan. Your move is a qualifying event if you are:
- Moving to an area where your existing coverage* isn’t available.
- Moving to an area where your existing coverage* is still available but new plans are also available.
* For a permanent move to be eligible as a qualifying life event, your existing coverage must be minimum essential coverage (MEC).
Replacing your health insurance coverage can easily get lost in the chaos of moving. Don’t let that happen! You have only 60 days from the date you move to apply for new coverage.
Start with a quick, short call to one of our friendly Product Advisors at 1-800-273-8115. We can help you find new coverage in next to no time.
QUALIFYING EVENT
Turning 26
You’re turning 26 and rolling off your parents’ health insurance plan. Now’s your chance to get a plan that meets your own needs and budget.
Replacing your health insurance coverage can easily get lost in the chaos of moving. Don’t let that happen! You have only 60 days from the date you move to apply for new coverage.
Start with a quick, short call to one of our friendly Product Advisors at 1-800-273-8115. We can help you find new coverage in next to no time.
1. Determine what type of plan you want
- Compare new plans to what you’ve had before.
- Check out the scope of benefits offered.
- Determine what benefits you like and what you don’t.
2. Look for coverage that meets your health care needs
- Do you visit the doctor’s office or hospital often?
- What are your dental or vision needs?
- Are there any medications you take regularly?
- What current or upcoming health needs do you have?
3. Figure out your health care budget
- Get a plan with a deductible, the amount you pay before your insurance pays anything, you are comfortable paying.
- Choose a monthly premium, what you pay to have your insurance coverage, that fits your budget.
4. Know the cost benefits of in-network care
- Look at your provider’s network options.
- Make sure your health plan covers the providers you need.
QUALIFYING EVENT
Getting Married
Getting married opens up a special enrollment period when you have an opportunity as a couple to update or select new health insurance.
Now, we know health insurance isn’t exactly the most thrilling topic for newlyweds, but it’s important. You’ve just created a new family, and your family has unique needs and goals. Your health insurance plan should reflect those. That’s the beauty of individual, or private, health insurance – you make it your own. Take a moment to sit down together and look over our selection of health insurance plans.
Getting married is all about joining things together — lives, bank accounts, furnishings, families and even health insurance. As a new couple starting out, it’s important to be on the same page. We’ll walk you through key areas to discuss while choosing your new health insurance.
Medical History
In sickness and in health, right? Part of being married means keeping each other as healthy as possible. Make sure you’re both up-to-date on each other’s medical history, so you can encourage each other to invest in the right care. Check out our HealthiestYou health and wellness program (not insurance).
Budget
Make sure to include health insurance in your new family budget. How much are you comfortable spending on monthly premiums? What has your health care spending been in the past? Does it make more financial sense for you to be covered under one of your employer-sponsored plans or under an individual family plan?
Frequency of Doctor Visits
Talking about how often you see health care providers helps you decide on the right insurance plan. For example, people who visit their health care providers regularly might want to especially consider Copay plans.
Family planning
Maybe you’re thinking about growing your family. Or maybe not. However, getting married is often an important time to think ahead toward any prenatal/maternity benefits you might need later. Maternity and newborn coverage is a part of the essential benefits in all qualified plans under the Affordable Care Act.
Medications
Now is a good opportunity to discuss what medications you each take regularly and how much coverage you’ll need. Some plans have set amounts, or copays, and others are less structured. Prescription drug coverage can look quite different from plan to plan.
Preferred Doctors
Do you and your spouse have current providers you want to keep? Or maybe you don’t mind switching around. Everyone feels differently, so make sure to have this discussion. You’ll want to find a health insurance plan with a provider network you’re both comfortable with.
QUALIFYING EVENT
Adding a Child to the Family
Adding a child to your family can mean big changes. To include your new bundle of joy, your health insurance coverage needs to change, too.
Whether you just had a baby, adopted or added a foster child, your family is growing. From choosing a pediatrician to lining up childcare or school options, you want only the best for your child.
Adding a child to the family brings great joy and lots of adjustments. Fortunately, it's also a qualifying event that makes you eligible for a special enrollment period. So, finding the right health insurance plan can be at the top of your to-do list.
If you have not done so already, you’ll want to find the right pediatrician within your network. You can use these pointers to make your decision easier.
- How close do you live to the pediatrician’s office?
Finding a pediatrician close to home comes in handy. Driving long distances with sick kids is no fun for anyone involved.
- What’s the doctor’s office like?
Stop by and take a look around. Is the waiting room clean and welcoming? Are the staff members friendly and helpful? Do patients look frustrated with long wait times?
- What are the office hours and after-hours polices?
Little ones can need medical attention at all hours of the day or night. Find out when the office is open and how they handle after-hours needs.
- Is the doctor a solo practitioner or part of a group practice?
Is it easy to get an appointment with your doctor when you need it? What happens if he/she is unavailable? Find out who else your child might see for medical care.
- Ask around. Check your network.
Find out which pediatricians your own doctor recommends. Ask your friends and family who they take their kids to. Look for online reviews as well. Check your network for recommended pediatricians.
QUALIFYING EVENT
Divorce
Divorce is a life-changing event that can mean getting health insurance for your new family structure, health care needs and budget.
You may not be focused on your health insurance coverage right now. We get that. But here’s something you should know: Losing your ACA-compliant health care coverage because of a divorce is a qualifying event (for the spouse losing coverage) that opens up a special enrollment period when you can purchase your own health insurance plan.
You have a golden opportunity to purchase new coverage in order to accommodate your reconfigured family.
Finding the right individual health plan that meets your new needs and budget is a great way to gain a renewed sense of independence and move forward with your life.
1. Determine what type of plan you want
- Compare new plans to what you’ve had before.
- Check out the scope of benefits offered.
- Determine what benefits you like and what you don’t.
2. Look for coverage that meets your health care needs
- Do you visit the doctor’s office or hospital often?
- What are your dental or vision needs?
- Are there any medications you take regularly?
- What current or upcoming health needs do you have?
3. Figure out your health care budget
- Get a plan with a deductible, the amount you pay before your insurance pays anything, you are comfortable paying.
- Choose a monthly premium, what you pay to have your insurance coverage, that fits your budget.
4. Know the cost benefits of in-network care
- Look at your provider’s network options.
- Make sure your health plan covers the providers you need.
QUALIFYING EVENT
Retiring Spouse
Losing your employer group coverage because your spouse is retiring is a qualifying event that opens a Special Enrollment period.
Now that your spouse can rely on Medicare for health coverage, you might feel left behind. But having your very own health plan has its perks: You can find one that meets your personal health needs and timeline.
Just need something temporary until you’re Medicare eligible? Check out our Golden Rule Insurance Company Short Term health insurance plans.F5
If you’re interested in longer term coverage, a different type of health plan may be more appropriate for your personal needs and retirement budget. It may be the perfect time to make a change from the kind of plan you’ve had before. Take a look at the types of individual health insurance plans we offer.
You and your spouse may also want to consider some additional coverage options together, such as Dental Insurance, which Medicare typically doesn’t cover, or Travel insurance as you begin to enjoy retirement living.
QUALIFYING EVENT
Loss of a Loved One
Losing a loved one is an event that may make finding a new health insurance plan a necessity. We're here to help.
One Step at a Time
If you lose health coverage due to the death of a loved one, you have 60 days (a special enrollment period) from the date you lost coverage to find a new health insurance plan. While you’re likely overwhelmed right now, it’s easier to take care of getting new health coverage than you might think.
You can speak personally with of one of our Product Advisors at 1-800-273-8115.
1. Determine what type of plan you want
- Compare new plans to what you’ve had before.
- Check out the scope of benefits offered.
- Determine what benefits you like and what you don’t.
2. Look for coverage that meets your health care needs
- Do you visit the doctor’s office or hospital often?
- What are your dental or vision needs?
- Are there any medications you take regularly?
- What current or upcoming health needs do you have?
3. Figure out your health care budget
- Get a plan with a deductible, the amount you pay before your insurance pays anything, you are comfortable paying.
- Choose a monthly premium, what you pay to have your insurance coverage, that fits your budget.
4. Know the cost benefits of in-network care
- Look at your provider’s network options.
- Make sure your health plan covers the providers you need.
QUALIFYING EVENT
Insurer Changing Coverage
When a carrier terminates or renews a non-calendar year health insurance plan, you can pick another plan during Special Enrollment.
Know that you have choices. Plan cancellations are a reality. The good news is that most plans are changing for the better.
Due to the Affordable Care Act (ACA), coverage has expanded to include essential health benefits like preventive care, mental health services, maternity benefits and much more. Now that your old plan is no longer an option, we’re here to help you find something that suits your current needs.
You might not be a huge fan of health insurance companies right now. We get that, but going without insurance just doesn’t make sense. You’d be taking too big of a risk.
QUALIFYING EVENT
Not Eligible for Medicaid
You may qualify for special enrollment to purchase a health insurance plan if you lose your coverage under Medicaid or Children’s Health Insurance Program (CHIP).
- You lose your Medicaid eligibility (because you have a change in household income, for example).
- Your child passes the maximum age for CHIP coverage. Only individuals covered on the CHIP plan and losing coverage are eligible for Special Enrollment.
Just because your income is low today doesn’t mean it always will be. You can take advantage of a temporary Short Term health insurance plan.F5 You can drop your coverage anytime, whenever your situation changes.
Our insurance plan portfolio offers you a broad range of coverage, plan types, deductibles and supplements – each with its own particular advantages. Our goal is to provide you with comprehensive and personal health plan choices that fit your needs and budget.
The advantages of your own health plan:
- Fitted – You can select a plan that’s a good fit for your specific health concerns or tight budget.
- Portable – You can base your job decisions on your career goals, not the benefits offered.
- Stable – If your job changes, you keep your plan and any deductible you’ve paid.
Going through Changes at Work?
Work-related transitions might have you feeling uneasy or even frustrated. It's time to take control. You may be eligible for special enrollment if you lose your health insurance coverage due to one of these job-related events:
QUALIFYING EVENT
Job and Coverage Loss
Losing a job involuntarily or voluntarily can mean changes to your health coverage – changes that can put you in charge of your health insurance.
Losing your health care coverage when you leave your job is a qualifying life event that opens a special enrollment period, and that may be a real opportunity for you. Now you can buy your own individual health insurance plan that:
- May be less expensive than your former group plan
- Stays with you regardless of your employment status.
However, the clock is ticking! You have 60 days before and 60 days after the date you involuntarily lost coverage to apply for an individual health insurance plan.F76
You’ve resigned, quit or retired early and now you’re wondering what’s next. You might be looking at a new job or a completely new career path and you may or may not be eligible for Medicare. There’s much to think about.
One opportunity you have: Losing your health care coverage when you leave your job is a qualifying life event that makes you eligible for a special enrollment period.F76 ;Now you have the freedom to select your own individual health insurance plan. We can help with that. Explore our plans. But don’t take too long. You have 60 days before and 60 days after the date you lost coverage to apply.
QUALIFYING EVENT
Starting a New Job
A new job can mean health insurance options: Losing your previous job-related coverage may open a Special Enrollment period.
Let’s say your employer offers group health insurance. Just not yet. Many employers require a waiting period before starting coverage.
Our Short Term health insurance plans can give you the security you need to fill your temporary health insurance gap.F5 These plans can be canceled, without any penalty.
View your Golden Rule Insurance Company Short Term health insurance plan options now.
Employers are increasingly dropping group employee health insurance coverage as a benefit. Some are offering stipends for you to buy your own individual health insurance, others are not. But, the good news is that you have more options than ever before for finding the right coverage for you.
If you’ve participated in group plans before, you know that your employer calls the shots when it comes to your coverage. With individual health insurance, you get to choose what’s right for you.
View the full range of your Health Insurance plan options now.
QUALIFYING EVENT
Losing COBRA Benefits
COBRA expiring? Losing job-based health insurance for any reason means you may be eligible for health insurance during a Special Enrollment period.
Is your COBRA coverage about to expire? After months of not worrying about health insurance, do you know what to do next?
Here’s the good news: Rolling off of COBRA coverage is a qualifying event that opens a special enrollment period for you to purchase your own health coverage. And you’ll have more options, flexibility and control of your health plan outside of COBRA with an individual health insurance plan.
So now you get to call the shots, and we can guide you along the way. We have plans of all shapes and sizes. We’ll help you find a plan that provides the health care you need within your budget.
1. Determine what type of plan you want
- Compare new plans to what you’ve had before.
- Check out the scope of benefits offered.
- Determine what benefits you like and what you don’t.
2. Look for coverage that meets your health care needs
- Do you visit the doctor’s office or hospital often?
- What are your dental or vision needs?
- Are there any medications you take regularly?
- What current or upcoming health needs do you have?
3. Figure out your health care budget
- Get a plan with a deductible, the amount you pay before your insurance pays anything, you are comfortable paying.
- Choose a monthly premium, what you pay to have your insurance coverage, that fits your budget.
4. Know the cost benefits of in-network care
- Look at your provider’s network options.
- Make sure your health plan covers the providers you need.
QUALIFYING EVENT
Losing Union Coverage
Losing job-based health insurance for any reason triggers a Special Enrollment when you can find individual health insurance.
Strike and lockout situations can be difficult to handle. There’s usually plenty of confusion and frustration to go around. Amidst the strain of it all, you may have lost your health insurance due to these changes at work. Or maybe your life has changed and you’re now leaving the union and losing your health coverage.F75
No need to worry. Losing your job-based health insurance coverage may be a qualifying event that triggers a special enrollment period when you can find a private, individual health insurance plan.
We know that times are tough and that’s why we have plan options for budgets big and small. Even if you’re eligible to receive COBRA benefits, we can help you weigh all of your options from long-term to Short Term insurance plans.
Let’s say though, that you’ve decided to walk away from a union for good. Leaving a union, for any reason, brings with it some uncertainty. You may have had close relationships there and a variety of benefits including health insurance.
No need to worry if you lost health coverage. You can now find insurance on your own. Losing group health coverage from your employer or union is a qualifying event that opens a special enrollment window when you can find an individual health insurance plan.
QUALIFYING EVENT
Returning from Military Service
Losing your coverage for returning from the military opens a Special Enrollment period when you can pick your own health insurance plan.
Good news: If you lost your health coverage after returning from military service, this qualifying event opens a special enrollment period for you. In an effort to make your transition into post-military life smoother, let us help you find a health insurance plan that gives you the coverage you need.
1. Determine what type of plan you want
- Compare new plans to what you’ve had before.
- Check out the scope of benefits offered.
- Determine what benefits you like and what you don’t.
2. Look for coverage that meets your health care needs
- Do you visit the doctor’s office or hospital often?
- What are your dental or vision needs?
- Are there any medications you take regularly?
- What current or upcoming health needs do you have?
3. Figure out your health care budget
- Get a plan with a deductible, the amount you pay before your insurance pays anything, you are comfortable paying.
- Choose a monthly premium, what you pay to have your insurance coverage, that fits your budget.
4. Know the cost benefits of in-network care
- Look at your provider’s network options.
- Make sure your health plan covers the providers you need.
QUALIFYING EVENT
Starting an Unpaid Leave
Losing your job-based coverage for starting an unpaid leave may open a Special Enrollment window when you can buy health insurance.
A leave of absence means a time of transition and change. You’re likely dealing with a lot. On top of it all, depending on the type of leave, FMLA or otherwise, you may also find yourself looking for new health insurance.F74
The good news: Losing your job-based health insurance coverage for any reason may be a qualifying event that opens a special enrollment window giving you 60 days from the day you lose your coverage to buy your own individual health insurance.
We realize that dealing with health insurance right now may feel overwhelming. It’s our job to make it easy for you to find a plan that meets your needs and your budget. With our helpful online tools and licensed Product Advisors, we can help you find a plan that meets your specific needs.
1. Determine what type of plan you want
- Compare new plans to what you’ve had before.
- Check out the scope of benefits offered.
- Determine what benefits you like and what you don’t.
2. Look for coverage that meets your health care needs
- Do you visit the doctor’s office or hospital often?
- What are your dental or vision needs?
- Are there any medications you take regularly?
- What current or upcoming health needs do you have?
3. Figure out your health care budget
- Get a plan with a deductible, the amount you pay before your insurance pays anything, you are comfortable paying.
- Choose a monthly premium, what you pay to have your insurance coverage, that fits your budget.
4. Know the cost benefits of in-network care
- Look at your provider’s network options.
- Make sure your health plan covers the providers you need.
Always Double-check!
If you don't see your personal situation listed here, you may still qualify. Talk to one of our Personal Advisors.
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