What is Qualifying Event for Health Insurance?

There are many people who don’t know what a qualifying event for health insurance is. A qualifying event may be as any of the following:

  • You lose your job or change jobs and your new employer does not offer group health coverage.
  • You divorce or legally separate from your spouse.
  • Your dependent child reaches the age of 26.
  • Your spouse dies, you become widowed, or you find out you are no longer able to be on their plan due to them losing eligibility for their employer’s plan.
  • Or, an individual becomes eligible for Medicare.

How to know about qualifying event for health insurance?

A person may have to take the initiative and seek health insurance coverage on his or her own if their company doesn’t offer it as part of an employee benefits package.

This might make it difficult for some people to obtain adequate health insurance coverage. When this is the case it may be necessary to know what a qualifying event for health insurance is.

Health insurance

Individuals that are in need of health insurance due to an unfortunate circumstance, such as those in the above list, may find that they become eligible for coverage through their spouse’s employer. However, there are other circumstances that people may find themselves in where they aren’t eligible for coverage through their spouse unless they can prove that a qualifying event occurred. It is these events where individuals will have to look elsewhere for health insurance.

If you are in a situation where you do not have coverage through your employer, insurance that is specifically designed for those that are self employed or unemployed may be the best option. This type of plan will allow you to obtain medical care during the time that your health insurance is not available and gives you the opportunity to seek out other options if necessary.

If an employee loses their job or changes jobs and thus loses their group health benefits, they may be able to obtain insurance through an individual plan, which can be obtained prior to and after the qualifying event.

Health insurance plans

The benefits involved with an individual plan are the same as those listed in the group plan. However, one of the biggest differences that someone who is dealing with a qualifying event will find is that they will be able to go to another company’s plan if they find another job. This would mean that your health insurance would automatically change if you found a new job.

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Although there are many types of health insurance available, the individual plans have some advantages over others depending on what type of situation a person finds themselves in.

One of the advantages that an individual might find with an individual plan is how easy it is to change companies or jobs. Some benefits that an individual might not find as easy change can be seen in group plans.

An individual plan may be appropriate for someone who experiences a qualifying event, such as a job loss or divorce with their spouse, but is not available through their spouse’s employer due to their own employment situation.

A person who finds him or herself in this situation would have to decide what type of coverage they would like. They would have the option of obtaining an individual policy through his or her own employer and then being able to apply for coverage with other companies afterwards or they could choose to go with a group plan, if one was available through work, and then obtain insurance after the fact.

Coverage and policies

The benefits and coverage that one might find in a group policy after the qualifying event is necessary is the same as that of any other policy a person would purchase. You can choose how much coverage you want and how much you will be required to pay up front.

If someone has been unable to get health insurance due to a qualifying event and they find themselves without employment, or their employer has stopped offering coverage, then they might be able to look into buying insurance on their own. One can do it through the individual market, if one finds himself or herself in this situation, or through joining with other people who have lost their employer’s plan due to a qualifying event.

Reasons behind obtaining health insurance

There are a lot of reasons for a person to obtain health insurance coverage. Here is the list of some of the more common reasons below:

Obtaining health insurance
  • To avoid paying with your own money for any situation that could require medical attention
  • To prevent financial hardship if you, or anyone you are responsible for, gets sick or injured and needs to have legal counsel or financial help from a lawyer.
  • If you have preexisting conditions in your family, there is a possibility that you could become ill yourself. Protecting yourself financially is important.

Getting insurance when someone has experienced a qualifying event is not always easy. There are many different companies that offer insurance and it can be difficult to know which ones can help you. If a person is able to secure an individual plan, they will still have to look around for the right insurance plan.

The right policy will provide coverage for the event that occurred and allow for the person who has lost their group health coverage to obtain medical services. There are deductibles and coinsurance associated with every policy, but overall it is important that you obtain a plan that you feel comfortable with.

Also Read: 8+ Ways to Get Your Insurance Agency Clients More Leads

Sources of information about health insurance

In the same way, there are several different websites where you can get information about qualifying events in relation to your health insurance coverage.

There are free resources that provide information about insurance companies in your state and various other resources that give basic facts about finding health insurance through your employer or buying coverage on your own after losing a job. Websites are also available that can give information specific to types of policies.