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- Everyone can switch health insurance once per year during open season
- The open season runs from November through the following January each year
- One can switch policies during an exception or extension to open enrollment
- After open season, one can change only if qualified for a special enrollment period
Switch on the State or Federal Exchange
Switching health insurance is relatively quick and easy during the open enrollment period and more difficult afterward. During open enrollment, one can renew coverage, select new coverage, and cancel a policy. After canceling, one can select a new policy. During open enrollment, one has a right to select a policy. At the end of open enrollment, the right to select or switch policies ends.
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How to Switch Health Insurance
During the open enrollment period or any special enrollment period for which one qualifies, one can switch plans. There are many methods for carrying out a switch. The methods include instant online access, in-person at a state or federal healthcare office, and paper mail. One can switch insurance by the below-listed methods.
- Online with federal marketplace
- Online state insurance exchange
- By telephone with federal or state exchange
- By hard copy at state or federal office location
- By hard copy mail.
One Can Switch during the Open Enrollment Period
Insurers develop plans and present them to state and federal authorities for approval. The plans apply to particular geographic areas, and consumers must reside in an area covered by a selected plan. Once approved, the insurance providers can offer plans to consumers directly, on a state exchange, or federal marketplace.
The open enrollment period runs from November through the end of January each calendar year. For calendar 2016, the open enrollment period was November 1, 2015, through January 31, 2016.
Exceptions and Special Enrollments
The states and the federal government have used exceptions to extend the time for applications during the open enrollment period. These exceptions have usually permitted the completion of partial applications. Exceptions are narrow periods announced for particular policy reasons.
For example, if the government experienced downtime of overcrowding online. The federal government defines special enrollments by rules that lay out the qualifications for them. If within the preceding 60 days, one experienced divorce, marriage, childbirth, or loss of coverage from employment, one can qualify for a special enrollment period.
One Can switch during Special Enrollment Periods
One can change health insurance policies during a special enrollment period. These may be announced by the federal government or established by rules. The rules provide for special enrollment period for life events. Upon the occurrence of a life event, the rules provide a 60-day period for obtaining insurance.
Life Events Create Special Enrollment Periods
Life events include changes in status that justify a new opportunity to get coverage. For example, a person covered by a parent’s policy has his or her 26th birthday. The birthday disqualifies the individual from further use of the parent’s policy. The rule authorizes a special period for getting coverage.
To find the best insurance coverage for an individual or family, one must shop and compare.
Comparison shopping can identify the features most important to the consumer and focus on them when considering alternative offers from insurance providers. The events or changes that create special enrollment periods include the below-listed items.
- Birth of a child
- Marriage or divorce
- Move to a different state or area
- Loss of insurance from employment
- The occurrence of the 26th birthday
- Discontinuance of service by a current insurance provider
Shop Using the Metal Tiers
The federal and state marketplaces use the system of metal tiers to group policies that have comparable value. This concept of value relates to the amount of services paid by the policies as opposed to those paid by the consumer.
For example, the Bronze tier policies cover about 60 percent of the services with the balance paid by the consumer as deductibles and out of pocket costs.
The four tiers are Platinum, Gold, Silver, and Bronze. Comparison shopping is an effective way to identify the best plan for a family or individual subscriber. One can determine the costs and benefits in terms of health history, past usage, or actual needs.
Shop the Entire Market
Comparison shopping can involve going outside of the federal or state marketplace. Some insurers offer qualified health plans outside of the marketplaces that have excellent terms for an individual or family situation.
Those with incomes near the upper range of subsidies, at or near 400 percent of the poverty line, gain little from subsidies. These consumers should compare the widest range of offers and not limit their selections to the marketplaces.
Medicaid and CHIPs do not have time Limits
The Children’s Health Insurance Program and Medicaid have continuous open enrollment periods. These programs offer immediate coverage for those who can qualify by income.
The states set limits on incomes that may qualify and in some cases those who exceed income can qualify with deductibles.
Referral for Medicaid and CHIPs coverage
Federal and state agencies routinely refer applicants that cannot enroll outside of the open enrollment period to Medicaid and CHIPS. These state-operated programs provide comprehensive medical care for qualified participants. Some states expanded Medicaid coverage as part of an agreement with the federal government.
The expansion raised the qualifying income levels to include more applicants.
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