What is a Qualifying Event to get Health Insurance?

The Open Enrollment period is closed, yet there are still a few ways to get health insurance coverage. Below is a summary of what to do to get Health Insurance and what documents are needed to “prove” that you are eligible to get coverage midway through the year.

The next OPEN ENROLLMENT: Nov 1st 2015 to Jan 31st 2016

Once you’re on a plan you can only switch once a year during the Open Enrollment period, so pick wisely.

The steps to get Individual Health Insurance are:

  1. Give us a call at 425-802-2783.
  2. Let us help you go over Pricing and Coverage options (Platinum, Gold, Silver or Bronze).
  3. Enroll in a plan Direct or through the Health Exchange.
  4. Send in supporting documents (yes this is required).

Qualifying Events:

  • Work coverage ending. Usually when you are leaving a job and need an individual plan (you ONLY have 63 days from when work coverage ends to sign up for a NEW plan).
  • COBRA coverage ending. If you elect to stay on work coverage for up to 18 months you need to show the “Certificate of Coverage” end date for you and all family members.
  • The birth or adoption of a child. Documents needed are; copy of birth certificate, adoption or court order showing you are now the appointed guardian.
  • Loss of Medicaid (Apple Health) when you are now making too much money to remain on the free program. Will usually need to show current Income Documents.
  • Loss of other coverage due to marriage or divorce. Need to show a marriage license, or divorce paperwork.

Above are 95% of reasons you would be able to get coverage…however there are always some additional exceptions. The key is to give us a call as soon as possible so we can aquatically plan to get you on the best plan for your budget and coverage needs.

NOTE: If you are pregnant and do not have health insurance this in itself is NOT a qualifying event.

Below are our areas of expertise:

Gary Franke, MBA
Independent Broker
Achieve Alpha Insurance, LLC           
12507 Bel-Red Rd, Ste 103
Bellevue, WA 98005
(425) 802-2783

Achieve Alpha