Health insurance is complicated. With so many numbers and coverage details to keep track of, you’re not alone if you find it hard to keep everything straight.
Maybe you visit the doctor and don’t have the benefits you think you did. Or maybe you’re pregnant and you’re not sure how a new baby might change your coverage or premiums.
Don’t worry – these situations aren’t unusual, and you’re not locked into your health insurance plan forever. In fact, every fall during Open Enrollment Period, you have the opportunity to update your current health insurance plan to make sure it still fits your family’s needs. Or, if you experience certain life changing events during the year, you can make updates sooner during a Special Enrollment Period.
Keep reading to learn the details of how and when to change your health insurance, what the differences are between the Open Enrollment and Special Enrollment periods, and what to look for when you’re thinking about changing plans.
Changing your health insurance: Reasons why you might want to (or need to)
People choose to change their health insurance plans for all kinds of reasons. A few of the most common include:
- Changes in your plan’s network – If your preferred doctors or specialists stop accepting your insurance, you could pay significantly more. Other health insurance options may help lower your overall medical bills.
- You need more or less coverage – If, for example, you visit the doctor frequently and copays are eating into your budget, a different plan may help you keep medical expenses under control. On the other hand, if you’re paying for top-tier coverage but don’t often use it, a more modest plan could be a better fit.
- Moving to a new area, changes to your employment or your family – These events are often good times to review your entire financial situation. Referred to as qualifying life events, they’re also times when you’ll be able to change your health insurance coverage.
No matter why you want to switch or make changes to your health insurance plans, there are two windows of opportunity when you can: Open Enrollment Period and a Special Enrollment Period.
Changing health insurance during the yearly Open Enrollment Period
Open Enrollment is the time of year when anyone can change their health insurance plan, for any reason. It typically runs from November 1 to December 15, yet is sometimes extended. Medicare Open Enrollment periods may vary.
This is the time when you can accept your current plan’s health insurance renewal, or you can shop around to find a better fit for you and your family. The plan you choose will begin January 1, or February 1, depending on when you enroll.
Want to shop around? Here are a couple ways to make the experience a little simpler:
- If you want to look at new plans with your same insurance provider, you can usually compare plans online or call their team. At HealthPartners, it’s easy to review health insurance plans online or get personal help by calling 877-838-4949.
- If you want to see options from different health insurance providers, you can either contact them directly, call your broker or use the health insurance marketplace.
On the health insurance marketplace, you can see plan information from many different companies all at once. You can also find out if you qualify for financial assistance. In Minnesota, get started at MNsure.org. In Wisconsin, go to healthcare.gov.
Changing health insurance after open enrollment: Can I switch anytime?
In most cases, you can only sign up for or update your health insurance during the annual Open Enrollment Period. However, if you experience certain qualifying life events, you may also become eligible for a Special Enrollment Period.
Special enrollment periods for health insurance
Special enrollment periods are so named because that’s exactly what they are: special. During a special enrollment period, only you and your family have the chance to decide on new coverage options.
Special enrollment periods are triggered by specific events, including:
- Getting married, divorced or legally separated
- Giving birth or adopting
- Starting, ending or losing a job
- Losing other health insurance coverage
- A death in the family
- Moving to a new ZIP code or county
- Certain other qualifying events
If one of these events applies to you, you’ll usually have 60 days to switch to a new plan or make changes to your existing one.
Just like with open enrollment, you can shop around and compare plans by talking to your existing health insurance provider, your broker or visiting your state’s health insurance marketplace. In some cases, you’ll need to provide evidence of your qualifying life event before enrollment is complete.
How to cancel health insurance
Unlike enrolling in health insurance, you can cancel your health insurance at any time. (But if you get your health insurance through an employer, you may have more limited choices – check with them for more details). You may choose to cancel your existing plan if you become eligible for health coverage in another way, like through a new job or through your spouse’s insurance plan.
To cancel, contact your insurance provider or the health insurance marketplace where you purchased your plan. You can usually either cancel immediately or choose a specific date to end your coverage. You may need to fill out some forms to make the cancellation official.
However, it’s very important to make sure you have other plans in place for your medical care. Remember – while you can usually cancel your health insurance anytime, you can’t usually enroll anytime: only during annual open enrollment or a special enrollment period.
Before canceling your health insurance plan, make sure you’ve thought through what you’ll do if you need medical care – and how you’ll pay for it.
Ready to switch health insurance plans? Here’s what to keep in mind
What’s the right health insurance plan? Everyone wants to know, but the truth is there’s no easy answer. The right plan is different for everyone, and that’s because health is different for everyone.
However, there are a few things you can compare and consider to help choose a plan that’s right for you:
- Monthly premiums, deductibles, copays and coinsurance – Usually, higher monthly premiums mean lower deductibles, copays and coinsurance (and vice versa). Would you rather pay more every month? Or would you rather pay more when you see the doctor? How often you get medical care can influence your personal preference.
- What kind of coverage you need – You’ll want to look at which preventive care services are covered at 100% and how much you’ll need to pay for specialty appointments. If you’re planning on starting a family soon, you’ll want to review pregnancy and maternity care coverage. If you see a therapist regularly, you’ll want to review mental health coverage. And if you or your family members get prescriptions, you’ll want to review drug coverage. Which parts of your plan matter most to you will depend on your personal situation and might be different from others.
- What kind of network you’re looking for – Many people have a preferred doctor or health care system. So when you’re thinking about switching health insurance plans, it’s important to make sure who you see and where you go are covered in-network. If you’re not sure, you can always check with your doctor’s office or review the plan’s documents before you buy.
Getting help with health insurance
Not sure where to begin? At HealthPartners, we help people in Minnesota and western Wisconsin find the right plan with the right coverage.
Whether it’s open enrollment time or you have a special enrollment period, we’re here to help make things simple. That way, you can choose a health insurance plan you’re confident in.