If you have an individual health plan you want to replace, your options will depend on what kind of coverage you have and whether enrollment is open.
If you have a plan you bought through the Marketplace
You can enroll in new Marketplace coverage outside Open Enrollment only if you have a qualifying life event that qualifies you for a special enrollment period.
Find out if you qualify for a Special Enrollment Period or Medicaid and CHIP.
If you don’t have a special enrollment period, you must wait for the next Open Enrollment period to enroll in a Marketplace plan to replace your current plan.
The Open Enrollment period for 2015 coverage is November 15, 2014 through February 15, 2015. Coverage can start as soon as January 1, 2015.
Cancelling your Marketplace coverage
While you can’t replace your Marketplace coverage outside Open Enrollment without a special enrollment period, you can cancel your coverage. To cancel coverage you bought through the Marketplace, log in to your Marketplace account and select the red “Terminate/end all coverage” button.
Important: If you cancel coverage without replacing it, you may have to pay a fee for the months you’re not covered. You’ll also have to pay all of your medical expenses yourself.
If you have a plan you bought outside the Marketplace
If a health insurance plan you bought outside the Marketplace is ending or being cancelled, you may qualify for a special enrollment period to buy a new plan through the Marketplace.
- Most health plans are sold by “plan years.” If you bought a plan outside the Marketplace it may end outside the Open Enrollment period. If it does, when the plan year ends you qualify for a special enrollment period.
Important. Voluntarily ending your plan, or being terminated for not making your premium payments, doesn’t qualify as losing your coverage. You don’t get a special enrollment period that would allow you to enroll outside Open Enrollment.
Learn about your options if your plan is being cancelled.
If you voluntarily end your health insurance plan and have no health coverage, you may have to pay a fee for the months you don’t have coverage.
Change plans with a special enrollment period
If you have a special enrollment period you usually have 60 days from the qualifying life event to enroll in a new plan.
You can change plans with a special enrollment period 2 ways:
- Online. Create an account in the Marketplace or log in to your existing account and report your life changes on your application by selecting the “Report a Life Change” button. If your new eligibility notice says that you qualify for a special enrollment period, you can then shop for plans and change to a new one.
- By phone. Contact the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325)
You can appeal a Marketplace decision to deny you a special enrollment period. Learn how to file an appeal.
Source: HealthCare.gov, “Replacing an individual health insurance plan.” http://www.healthcare.gov website. Accessed December 2, 2015. https://www.healthcare.gov/what-if-i-want-to-change-individual-insurance-plans/
© Copyright 2016. All rights reserved. This content is strictly for informational purposes and although experts have prepared it, the reader should not substitute this information for professional insurance advice. If you have any questions, please consult your insurance professional before acting on any information presented. Read more.
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