What Is a Qualifying Event for Health Insurance?

During open enrollment periods, insured individuals can make changes to their healthcare insurance, whether those are individual or employer-sponsored health insurance plans. But life events occur year-round and may change your specific needs for health insurance. In many cases, you may qualify for a special enrollment period — an opportunity to enroll in a health plan or adjust coverage for you and your family.

Consider these seven situations that are qualifying events for health insurance.  

  1. You Get Married

    Don’t miss your window of opportunity when you’re on your honeymoon or reminiscing about your wedding day. Getting married qualifies you for a special enrollment period. During this time, you’ll be able to add your spouse or other dependents to an existing plan, be added to your spouse’s plan or shop for new coverage.

  2. You Have a Child

    When you have a baby, adopt or gain a family member through foster care, take a moment to examine everyone’s medical needs. If your current healthcare plan doesn’t meet them, you can make adjustments. Use your special enrollment period to add your new family member or make other plan changes for your children.

  3. You Get Divorced

    What happens if you’re currently on your spouse’s policy and you’re getting divorced? In the case of divorce, a special enrollment period opens up. You’ll no doubt have your hands full with other logistics but be sure you make all necessary healthcare insurance changes while your window is open.

  4. You Lose Your Job

    If you leave your job or get laid off, you will likely lose your employer-sponsored health insurance. There is a silver lining to be found during this trying time: This counts as a qualifying event for health insurance and opens a special enrollment period.

  5. You Graduate or Turn 26

    New graduates who had student health plans and people turning 26 who are currently covered under a parent’s plan are also granted a special enrollment period. The Affordable Care Act allows children to remain on their parents’ health insurance plan up to age 26. However, once you “age off” your parents’ plan, you must obtain your own coverage during this qualifying period.

  6. You Move

    Moving doesn’t always count as a qualifying event for health insurance. However, because most insurance plans are specific to a particular geographic area, you might qualify for a special enrollment period so that you have the opportunity to obtain health coverage in your new location.

  7. You Lose a Loved One

    Coping with the loss of a loved one is emotionally difficult and will bring many life changes. Frustratingly, some need to be addressed on the sooner side. Among the many things to consider is health insurance. If your loved one was providing your coverage, you will be able to obtain new coverage during a special enrollment period. 

Here for You, Always

Knowing that you and your family have the right coverage can give you peace of mind. At any stage of life, a Farm Bureau Agent can be a resource for answers, education and the coverage you need to protect your health.