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Qualifying Events

Qualifying Events for the Individual Market


New health laws mandate that all individuals have health insurance, either through an individual policy or through their employer or face a potential penalty. However, individuals can only purchase policies during the annual open enrollment of November 1st through January 31st of each year.


You can still sign up for health insurance after the deadline if you meet any of the following qualifying events:


-change in legal marital status

-a change in the number of dependants

-a change in place of residence and the current carrier is not available

-significant cost or coverage change

-a change in coverage of a spouse or dependant

-a COBRA qualifying event

-legal judgements, decrees and orders

-entitlement to Medicare or Medicaid


Signing up for Medicare and Qualifying Events


To sign up for Medicare Parts A & B, most will have a 7 month period that begins 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65.


Once enrolled, if you wish to change or purchase Supplement Plans, you must act during the open enrollment period.


When open enrollment is closed, there are special circumstances in which one may qualify to enroll outside of the enrollment period.  Listed below are the qualiying events:


-You are turning 65

-You move to a new area that is not in your current plan’s service area

-Recently moved back to the US

-You lose your current coverage (either Group or Medicaid)

-You now need a SNP (Special Needs Plan) or you no longer need a SNP

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