What’s the deal with “Qualifying Events”?

Penguin Judo. Is this a thing?

Penguin Judo. Is this a thing?

If you’re like me, you think about enrolling in something at about the exact time you need it. That judo class at the Learning Annex that starts on Saturday? I’ll think about enrolling Saturday morning. Getting renter’s insurance for my new apartment? I’ll think about enrolling when the roof starts leaking. And health insurance? I’ll think about enrolling the next time I get sick.

 

The fact that I still don’t know judo is the first hint that this process isn’t working very well for me. It turns out, you almost always have to enroll in things well before the start date. There’s usually a window of time, and that window closes. At the Learning Annex, sometimes you can beg and plead and get the judo instructor to make an exception for you. But with important things like health insurance, there are laws that control when you can enroll. Begging and pleading? Forget about it.

With healthcare reform, there are now specific times of the year when you can enroll in health insurance. Those times are called “open enrollment periods” and, hint, they don’t last forever! If you don’t enroll during an open enrollment period, you have missed your window, and you have to wait until the next time open enrollment comes around.

Unless – HI-YA (Judo chop) – you have a “qualifying event.” These are life events that are significant enough that the law allows you to enroll in health insurance right then, and not have to wait until the next open enrollment period. The following are the qualifying events that will allow you to enroll in health insurance coverage:

  • You lost your existing health insurance coverage
  • You moved to a new area not served by your current health plan
  • You gained a dependent through marriage, domestic partnership, birth or adoption
  • You had a change in marital status
  • You had a change in employment

If you had one of these qualifying events, and want to enroll in health insurance – get moving! The window won’t stay open for long.

If you missed the window to enroll in health insurance, and you didn’t have one of these qualifying events, then the next open enrollment period for most of us will be November 2014 – February 2015. Remember, that unlike my judo class, you can enroll for health insurance and it doesn’t have to start right away. So if you want health insurance for January 1, 2015, you can enroll in November with a start date in January. You don’t have to be like me, and wait until the last day of December to enroll.

In fact, don’t be like me. Plan ahead. Enroll early. And also, learn judo. It might come in handy.

Leave a comment

2 Comments

  1. Are there any instances that the Health Care I currently have will not be available in the State that I am moving in? Is that the reason why I have to apply again for another health care when I move out?

    Reply
    • Picky Eater

       /  May 29, 2014

      Hi Farrah, thanks for your comment. Some health insurance companies, like ours, are regionally-based. For example, we do business in Oregon, Idaho and Montana. Of course, we have a “wrap network” that protects you when you are traveling to another state, say, Connecticut. But if you actually moved to Connecticut, that move would provide you with an opportunity to switch health plans, (even in the middle of the year), so that you could select an insurance company who was based/did business in your new region.

      Also, anyone who enrolled through a state exchange would need to cancel that coverage and enroll with the new state’s exchange. It’s a little more complex if a state exchange is involved, so be sure to check with a licensed insurance agent if that’s the case in your situation. They can provide you with more in-depth advice.

      Thanks for reading!

      Reply

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