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Health Insurance Qualifying Event

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Group health insurance is not carved in stone. You are assured of the plan’s coverage at the time you enroll in it until the next open enrollment. It does not mean, however, that everything is locked solid, and there is no chance for any changes to be made. Health insurance plans are flexible enough to consider circumstances that have suddenly happened that can change the status of a person’s coverage. These are qualifying events, and they enable someone to make a few changes in coverage after the enrollment period has ended.

What are qualifying events?

You cannot always plan for changes that happen in your life. You can be single when you sign up for coverage and get married during the plan year. You want to have your spouse covered for medical insurance and getting married is a qualifying event. On the other side of the table, if you are divorced or legally separated, you may wish to drop your former spouse from the plan to go back to single status. That can reduce your premium, and this, too, is a qualifying event for insurance. Or you might move states, change jobs, or any number of other life events that qualify for a special enrollment period to enroll in a health insurance plan through the healthcare marketplace. Keep in mind, if you need health coverage now and do not have a qualifying event, you can enroll in private health coverage at any time.

Change in dependents qualifying event

Divorce or legal separation are not the only reasons for wanting a change in dependent coverages. Birth of a child, adoption, or placing a child in foster care can affect the sizable household. It is also possible that a dependent might drop out of the household coverage, such as the adult child who is now 26 years old. These are all qualifying events that can permit you to make some changes.

Other Qualifying Events

A qualifying event for health coverage can be moving to another state for a job or for going to school. The ability to pay for coverage and family changes that qualify you for Medicaid or the Children’s Health Insurance Program (CHIP) are reasons to allow you to make some alterations in your coverage.

Do I have a qualifying event?

Of course, there are incidents that are not qualifying events and you ought to know them. You might lose the opportunities to enroll in Medicaid or CHIP if your income substantially increases. While moving can be a qualifying event, going to another state for an extended vacation is not. Voluntarily dropping your health insurance is not a qualifying event.

Do I Qualify for a Special Enrollment Period?

Your eligibility for a qualifying event depends on the interpretation of your current situation. You might think that you have a right to change your health insurance, but you might not have what constitutes as a qualifier. There are some nuances to health insurance that can be confusing to the average person. It is easy to get frustrated when you do not know all the rules. Working with an experienced and licensed health insurance agent can make it all much clearer and understandable.

We can help you.

We are insurance professionals who are familiar with health insurance coverage. We know what does and what does not constitute a qualifying event. We can share that information with you and help you determine whether your circumstances merit being defined as a qualifying event. We also can show you some options that you may want to use. Those can result in you having even better medical coverage than you had before.

Qualifying events are intended to make insurance flexible enough to allow changes that are important and necessary. We will be glad to review your situation and advise you on what is possible. 

It starts with you contacting us.


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Michelle from Tampa, Florida
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