Health Insurance 101: Can You Change Your Plan in the Middle of the Year?

In short: It depends. Here’s where qualifying life events come into play.

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Each year, you might participate in open enrollment and pick your health insurance plan for the next policy year. You might be wondering: Are you locked into that choice? What happens if you change jobs? Or if you want to switch to your partner’s health insurance, or even add a new dependent to your policy? Are you allowed to change health insurance plans before the next open enrollment?

Can you change health insurance plans midyear?

You can't change the plan you’ve chosen when your health coverage is tied to your employer, until your next open enrollment period. The one exception is if you have a qualifying life event (more on this below). This means it’s important to plan ahead and pick the health insurance plan that will meet your needs for the next 12 months.

One tip to pick the best plan is to keep records of your medical costs. This way, you can understand what you generally spend in a year. Then, you can make more informed decisions about what insurance plan would benefit you in the future. Need ideas? Learn our top 3 ways to keep your medical records organized.

What types of life events qualify you to change your plan?

You can only change your elections once you’ve had a qualifying life event. These are changes to your living situation that make you eligible to change your plan’s elections. Examples of qualifying life events include:

  1. Marriage
  2. Having a baby
  3. Death in the family
  4. Losing a job or hours for eligibility
  5. Moving to a new ZIP code

You can usually change your insurance plan up to 60 days after a qualifying life event. For instance, if you switch to your new partner’s plan after your marriage, or increase coverage for a child you are expecting, you or your partner can upgrade policies to cover more people.

What happens to the progress I’ve made towards my old deductible?

Unfortunately, the previous payments you made won’t go towards your new deductible. However, the Health Insurance Marketplace has open enrollment year-round for certain plans, such as government-subsidized Medicaid or CHIP. Since pregnant women can sometimes qualify for CHIP prior to childbirth, it’s worth looking into.

Of course, if you are starting a new job or enrolling in health insurance for the first time, you can usually buy into a plan year-round. Visit your health insurance website to be screened for eligibility or to start your application for a new healthcare plan on Healthcare.gov to see if you’ve qualified for a special enrollment period.