10 Major Qualifying Life Events for Insurance

Qualifying life events (QLEs) are certain major life changes that allow you to make changes to your health insurance coverage outside of the annual Open Enrollment period. These events typically involve a change in your household, marital status, or employment situation.

1. Loss of Health Coverage

If you lose your health insurance coverage through your employer or another group plan, you can enroll in an individual or family health insurance plan within 60 days of the loss. This is known as a Special Enrollment Period (SEP).

2. Marriage

Getting married is a QLE that allows you to add your spouse to your health insurance plan or enroll in a new plan together. You have 30 days from the date of your marriage to make this change.

3. Divorce

When you get divorced, you can enroll in your own health insurance plan or add your child(ren) to your existing plan. You have 30 days from the date of your divorce to make this change.

4. Birth or Adoption of a Child

The birth or adoption of a child is a QLE that allows you to add the child to your health insurance plan. You have 30 days from the date of the child's birth or adoption to make this change.

5. Change in Income

If your income changes significantly, you may be eligible for a Special Enrollment Period to enroll in or change your health insurance plan. This is especially important if your income decreases and you qualify for Medicaid or other government-sponsored health insurance programs.

6. Moving

Moving to a new state or county may be a QLE if it affects your health insurance coverage. You may need to enroll in a new health insurance plan or change your existing plan to one that is available in your new area.

7. Gaining or Losing Dependent Care

If you gain or lose a dependent, such as a child or elderly parent, you may be eligible for a Special Enrollment Period to add or remove the dependent from your health insurance plan.

8. Change in Employment

Starting a new job or losing your job can be a QLE that allows you to enroll in or change your health insurance plan. You may have a Special Enrollment Period to enroll in your new employer's health plan or to enroll in an individual or family health insurance plan.

9. Death of a Family Member

The death of a family member may be a QLE if it affects your health insurance coverage. You may need to enroll in your own health insurance plan or add your child(ren) to your existing plan.

10. Incarceration

If you are incarcerated, you may be eligible for a Special Enrollment Period to enroll in or change your health insurance plan.

Why QLEs Matter

QLEs are important because they allow you to make changes to your health insurance coverage when you experience a major life event. This can help you avoid a lapse in coverage or ensure that you have the right coverage for your needs.

Benefits of QLEs

• Avoid a lapse in coverage
• Ensure that you have the right coverage for your needs
• Save money on premiums
• Get access to better benefits

Pros and Cons of QLEs

Pros:

• Flexibility to make changes to your coverage when you need it
• Avoid penalties for not having health insurance
• Get access to better benefits

Cons:

• May have to pay higher premiums if you enroll outside of the Open Enrollment period
• May not be able to find a plan that meets your needs
• May have to wait for coverage to start

Conclusion

QLEs are an important tool that can help you manage your health insurance coverage when you experience a major life event. By understanding QLEs, you can take advantage of the opportunities they provide to get the coverage you need.