What if I have an individual insurance plan that I want to replace?
If you have an individual health plan you want to replace, your options will depend on what kind of coverage you have and whether enrollment is open.
If you have a plan you bought through the Marketplace
Open Enrollment ended March 31, 2014. Now that Open Enrollment is over, you may not be able to replace your coverage.
If you don’t have a special enrollment period, you must wait for the next Open Enrollment period to enroll in a Marketplace plan to replace your current plan.
The Open Enrollment period for 2015 coverage is November 15, 2014 through February 15, 2015. Coverage can start as soon as January 1, 2015.
Cancelling your Marketplace coverage
While you can’t replace your Marketplace coverage outside Open Enrollment without a special enrollment period, you can cancel your coverage. To cancel coverage you bought through the Marketplace, log in to your Marketplace account and select the red “Terminate/end all coverage” button.
Important: If you cancel coverage without replacing it, you may have to pay a fee for the months you’re not covered. You’ll also have to pay all of your medical expenses yourself.
If you have a plan you bought outside the Marketplace
If a health insurance plan you bought outside the Marketplace is ending or being cancelled, you may qualify for a special enrollment period to buy a new plan through the Marketplace.
- Most health plans are sold by “plan years.” If you bought a plan outside the Marketplace it may end outside the Open Enrollment period. If it does, when the plan year ends you qualify for a special enrollment period.
Important. Voluntarily ending your plan, or being terminated for not making your premium payments, doesn’t qualify as losing your coverage. You don’t get a special enrollment period that would allow you to enroll outside Open Enrollment.
Learn about your options if your plan is being cancelled.
If you voluntarily end your health insurance plan and have no health coverage, you may have to pay a fee for the months you don’t have coverage.
Change plans with a special enrollment period
If you have a special enrollment period you usually have 60 days from the qualifying life event to enroll in a new plan.
You can change plans with a special enrollment period 2 ways:
Online. Create an account in the Marketplace or log in to your existing account and report your life changes on your application by selecting the “Report a Life Change” button. If your new eligibility notice says that you qualify for a special enrollment period, you can then shop for plans and change to a new one.
By phone. Contact the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325)
You can appeal a Marketplace decision to deny you a special enrollment period. Learn how to file an appeal.
What if I'm eligible for insurance through an employer?
If you are eligible for job-based coverage that you haven't enrolled in, you may have bought an insurance plan yourself. If this is the case, if you change to Marketplace insurance you may not be able to get lower costs on monthly premiums or out-of-pocket costs.
It will depend in part on whether the insurance your employer offers meets certain standards for cost and coverage. Your employer should provide information to help determine whether the plan meets those standards. The Marketplace will also provide tools that help you determine whether the plan meets the standards.
Can I get coverage outside the Marketplace?
You can choose to buy individual insurance outside the Marketplace—directly from an insurance company or with the help of an agent or broker. But you won't have access to lower costs on your monthly premiums or out-of-pocket costs outside the Marketplace.
Note: Not all plans you buy outside the Marketplace meet the health care law's requirements for minimum essential coverage. That means if you buy one of these plans you could still wind up having to pay the fee that people without insurance coverage may face for 2014 and beyond. Insurance plans must tell you whether they provide minimum essential coverage.
All Marketplace plans offer minimum essential coverage.