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What is the definition of a "qualifying event" for health insurance coverage?



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A qualifying experience is a significant life change that makes it possible to enroll in an alternative health plan outside the open enrollment periods. A qualifying event can include adopting a kid, having a newborn, or moving to a different residence.

As a parent, having a baby is the most important thing you can do. It's also a good time to consider the type of coverage that works best for your family. Add a newborn child to your health insurance coverage if you have a plan with a high deductible. This will lower your out of pocket costs.

Special enrollment periods may be triggered by major life changes, giving you more flexibility to choose a plan. These special enrollment period can happen at any time during the year. You are usually able to select a plan 60 days prior to a qualifying life event, like a marriage or birth.


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Loss of coverage is a qualifying event

Losing the minimum essential health coverage is one of the most common events that can trigger a special period. You must show proof that you lost your coverage if, for example, you got divorced.


A special enrollment period can also be created if there are other qualifying events. An example is if your plan ends when you reach 26. The reason is that turning 26 is the age at which you will no longer be eligible for coverage of the same level as when you were a younger adult.

A new job qualifies as a qualifying event

You should expect a special registration period if you are starting a job. During this time, you can sign up for the employer's coverage. If you purchase your own coverage you'll have to wait for the next enrollment period before your current coverage takes effect.

Change of residence is a qualifier

Gwen and her children may be able enroll in a different plan after moving from Miami. The new plan will cover her health as well as that of her family. It could be an excellent way to save some money as Gwen won't have to pay the same premiums if she had stayed in Miami.


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Divorce is a Qualifying Event

Max, a Brooklyn resident of 25 years, who gets divorced, can enroll into a new health plan to ensure that his family and he continue to receive the care they need. Reviewing your Anthem coverage options is a great idea, since many insurance companies offer flexible plans to accommodate changing circumstances.

There are some exceptions. For example, if a student is a brand new one and does not yet have dependents. Or if a special enrollment has already been established. A special enrollment period may be available if you're part of a religion congregation.



 



What is the definition of a qualifying event for health insurance coverage?