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  • Subscribers can change health insurance during open enrollment, extensions, and special enrollment periods.
  • Open enrollment is the best time to change health insurance plans
  • Open enrollment is the best time to renew, replace, or find new health insurance coverage
  • Open enrollment is the time of year when every eligible person has a right to buy insurance, cancel and replace a policy, and make changes to coverage
  • After open enrollment, subscribers can change plans only if they find an extension or a special enrollment period


The individual mandate requires every eligible person to get and keep qualified health insurance.

Open enrollment is the annual period when everyone can buy insurance. It is the best time to change health plans. Using comparison shopping, subscribers can focus on the features of greatest importance to them.

Make sure you’re covered by the best health insurance plan – compare quotes on our site today!

Qualified Health Insurance


To get federal approval for sale on the healthcare.gov or state marketplace, health insurance plans must provide essential health benefits. Metal names are used to group healthcare plans as “bronze”, “silver”, and “gold” levels.

Comparison shopping is an excellent way to consider plans from various metal bands. When comparing benefits, consumers can use the features that matter most.

Special Enrollment Periods

When particular events occur, they make changes in insurance status that require a new opportunity to purchase health insurance.

These special enrollment periods run for 60 days from the time they begin.

Extensions of Open Enrollment

The states and federal government can authorize extensions to their open enrollment periods.

Extensions ensure a fair opportunity for the public to sign up for qualified health plans. Extensions helped persons who failed to complete applications before the end of open enrollment. Extensions have helped persons who could not complete applications due to system crowding and long wait times for online and telephone assistance.

Special Enrollment Periods

The rules provide for a 60-day period for getting new insurance after a listed change in insurance status. Many changes in status called “life events” require new insurance such as moving to a location that is outside of an existing policy service area.

Determining a Life Event


The rules provide for special enrollment periods after open enrollment. These occur when subscribers change from one status to another on the list of approved life events. These events include the below-listed types of changes.

  • Marriage
  • Divorce
  • Giving birth to a child
  • Adopting a child
  • Loss of coverage as a dependent
  • Loss of employer-sponsored coverage as an employee

Medicaid and CHIP

When the change in health insurance is related to a Medicaid program or a CHIP coverage plan, consumers can change at any time without regard to open enrollment. Medicaid and CHIP satisfy the requirements of the individual mandate for qualified health insurance coverage.

Medicaid expansion increased the number of applicants eligible for coverage by millions. Many states have refused to expand Medicaid leaving a substantial gap and millions of Americans uncovered.

Finding the Best Value


The ACA groups policies by metal bands based on amounts of insurance paid benefits.

The below-itemized section describes the amounts of insurance benefits in each type. When making changes or getting new coverage during a special enrollment period, consumers can improve results by comparison shopping.

The ACA uses bands to show the value of insurance paid benefits. By focused comparison, the consumer can consider important features beyond the amount of insurance paid benefits.

The Types by Actuarial Value

  • Platinum plans pay an average of ninety percent of insurance benefits and leaves about ten percent for the consumer. These plans have high premiums and the lowest deductibles.
  • Gold plans pay about eighty percent of insurance benefits. These plans have high premiums and low deductibles.
  • Silver plans pay about seventy percent of benefits and leave thirty percent for the consumer.
  • Bronze plans pay sixty percent or more and leave the consumer to pay up to forty percent. These plans have low premiums and high deductibles.

Using Open Enrollment to Get Coverage

The open enrollment period for the 2016 calendar year ran from November 1, 2015, through January 31, 2016. During this period, consumers could purchase qualified health insurance. This type of insurance provides the essential health benefits and satisfies the requirements of the individual mandate.

Penalties for No Insurance

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Any change to your health insurance must not result in you being uninsured. The law requires coverage or an individual responsibility penalty. The penalty applies on the basis of 1/12th of the total amount due for each month of no qualified insurance. The IRS uses the below-listed terms to apply the individual responsibility payment penalty for the 2016 calendar year.

  • For an adult individual – $695.00
  • For an individual child – $347.50
  • For a family – maximum of $2,085 or two-and-a-half percent of family income, whichever is greater

Time for a Change

When moving from a qualified health plan to Medicaid, Medicare or CHIP, consumers can make the change at any time allowed by the programs. Medicaid and the CHIP do not have open seasons and can accept applicants at any time.

Medicare accepts applicants after they achieve an age or disability status.

Making a Change for the Better

When changing health plans, it is important to get qualified coverage which provides essential benefits and the individual mandate.

Comparison shopping is the most effective way to focus on the features that are important to a family or individual situation. Comparison shopping takes advantage of knowledge and experience to find the best fit for expected health care needs.

Compare health insurance today with our free quotes tool!

[su_spoiler title=”References:” icon=”caret-square” style=”fancy” open=”yes”]

  1. http://obamacarefacts.com/obamacare-individual-mandate/
  2. http://obamacarefacts.com/essential-health-benefits/
  3. http://www.cigna.com/individuals-families/understanding-health-care-reform-metal-levels
  4. http://obamacarefacts.com/special-enrollment-period/
  5. http://obamacarefacts.com/2016/02/02/extensions-in-some-states-for-open-enrollment-2016/
  6. https://www.healthcare.gov/glossary/qualifying-life-event/
  7. http://obamacarefacts.com/2015/08/14/950000-enrolled-in-2015-special-enrollment/
  8. http://obamacarefacts.com/2015/11/02/open-enrollment-2016-rate-increases-and-the-medicaid-gap/
  9. http://obamacarefacts.com/insurance-exchange/health-insurance-plans/
  10. http://obamacarefacts.com/2015/10/28/open-enrollment-2016/
  11. http://obamacarefacts.com/individual-shared-responsibility-payment/
  12. http://obamacarefacts.com/insurance-exchange/qualified-health-plan/
  13. http://obamacarefacts.com/2015/01/13/renew-health-plan-open-enrollment/