qualifying life event

If you’re a millennial, odds are you’ve already gone through some major life milestones, or perhaps you’re about to embark on an exciting new life chapter soon. Maybe you’ve changed employers, married the love of your life, or even welcomed a new family member into the world. In the health insurance world, significant occurrences such as these are known as “qualifying life events,” and they can impact when you can apply for Affordable Care Act (ACA) health insurance.

What is a qualifying event?

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A qualifying life event is a major life change that can affect your health insurance needs. These could happen pretty often to millennials (those born between 1980 and the early 2000s), as members of this generation are are currently experiencing a lot of life transitions.

Generally, Open Enrollment is the only time of year that you can apply for health insurance through the Affordable Care Act’s federal and state exchanges. However, it’s also possible to purchase health insurance outside of the Open Enrollment Period, as long as you’ve experienced one of these events.

Whether you’ve changed jobs, moved, just got married or recently had a baby, you may need to adjust your health insurance coverage. Read on to discover additional information on these qualifying life events that allow you to apply for health insurance any time of year during a Special Enrollment Period.

Is marriage a qualifying life event?

Yes, marriage is a qualifying life event. Millennials are squarely in the marriage sweet spot—according to the U.S. Census Bureau, the average age is 30 for men and 28 for women.1 After the vows are exchanged and toasts are made, a married couple has the opportunity to reconcile their health insurance coverage. The individual plans that were right for them when they were single may not meet their needs as a couple, or one spouse may not have coverage at all.  As a qualifying life event, marriage gives the happy couple 60 days to purchase a new health plan or change an existing one. As part of that process, couples should review their health insurance options, apply for premium tax credits (subsidies), and then apply for the health plan that’s right for their needs.

Does having a baby count as a life changing event?

Yes, having a baby–or adopting a baby or child—counts as a life-changing event and it’s important to protect your child’s health. New parents need to find the right pediatrician, as well as apply for the health care they need now and understand what they may need in the future. Your current health plan, however, may not be the right one for a growing family, which is why the government considers a birth or adoption a qualifying life event to give you the chance to find a plan that best serves the needs of your loved ones.

Is getting a new job a qualifying life event?

No, getting a new job is not a qualifying life event. However, the loss of job-sponsored health insurance is considered qualifying, and gives you time to find a plan. Whether you were laid off or voluntarily left your job, you’ll probably face a period of time without health insurance. One caution: if you voluntarily drop a job-based plan without leaving your job, you won’t be eligible for the Special Enrollment Period.

Is turning 26 a qualifying life event?

Yes, turning 26 is a qualifying life event. If you’re 25 and currently covered under a parent’s health plan, it’s important to know that your coverage will end when you turn 26. The Affordable Care Act says 26 is the age at which individuals must be responsible for their own health insurance. Of course, lots of birthdays fall outside the Open Enrollment Period, which is why that 26th birthday qualifies you for a Special Enrollment Period.

Once you turn 26, you’ll have 60 days to apply for a health insurance plan that’s right for your needs and budget. If you apply before your 26th birthday, coverage can start as soon the first day of the month you lose your current coverage. If you apply during the 60 days after your birthday, coverage can start the first day of the month after you pick a plan.

Find health insurance coverage

Millennials who have experienced a qualifying life event and are shopping for health insurance can get help from HealthMarkets, at no cost to you. Call (800) 827-9990 to speak with a licensed insurance agent today. You can also review your options online now.

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References

1. “Census Bureau Releases New Estimates on America’s Families and Living Arrangements.” Census.gov. November 2021. Retrieved from https://www.census.gov/newsroom/press-releases/2021/families-and-living-arrangements.html

Premiums vary based on plan selected and subsidy eligibility. Subsidy eligibility is based on total household income and family size, and cost sharing for zero premium plans may be higher than for other available plans.

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