Abel Insurance Agency

HealthCare: Life Changes & Qualifying Events

If you're enrolled in the Oregon Health Plan, Healthy Kids or a private health plan through HealthCare.gov Marketplace, you’ll need to keep us up to date about certain life changes. It’s important to tell us about these changes, because you could end up qualifying for a different amount of financial help or a different type of health coverage.

If you or members of your household have experienced the following life changes since applying for health insurance, you must report the change(s).

Tell us if:

  • Your household income goes up or down
  • Someone becomes pregnant
  • Someone gets married or divorced
  • Someone moves to a new residence
  • Someone gives birth to or adopts a child (or a child is placed in your home for adoption)
  • Someone is offered other health coverage (from an employer or Medicare, for example)
  • Someone enrolls in other health coverage (from an employer or Medicare, for example)
  • Someone loses other health coverage (from an employer, COBRA or VA health care, for example)
  • Someone gains or loses a tax dependent
  • Someone’s citizenship or immigration status changes

Other changes to report:

Changes in tax filing status; incarceration or release from incarceration; changes in American Indian/Alaska Native enrollment status; other changes that may affect your income or household size; corrections to name, date of birth, or Social Security number.

Certain life changes, called qualifying events, will allow you to change your existing plan and/or add a plan for a new household member during a special enrollment period.

  • If you have a qualifying event, you’ll receive an enrollment packet with instructions on how to choose a plan. In most cases, you’ll have up to 60 days from the date of the qualifying event to change or enroll in a plan.
  • If you qualify for the Oregon Health Plan or Healthy Kids, you can enroll at any time.

What is a Qualifying Event?

A qualifying event will allow you to change your existing 2014 private health plan or enroll in a plan for the first time during a special enrollment period through Cover Oregon. For most people, a qualifying event is required to change or enroll in a plan outside open enrollment.

The following life changes are qualifying events:

  • Marriage
  • Birth or adoption of a child, or placement of a child in your home (for adoption)
  • Loss of other health coverage (due to a job loss, divorce, or expiration of COBRA, for example)*
  • Moving to Oregon from another state
  • Gaining legal immigration status
  • Release from incarceration

In some situations, these life changes may also be considered qualifying events:

  • Change in household income
  • Change in permanent residence within Oregon
  • Change in family size (gaining or losing a dependent)
  • Change in tax filing status

*Loss of other health coverage does not include: voluntarily dropping coverage, being terminated from coverage for not paying premiums or losing coverage that is not minimum essential coverage.