Qualifying Life Events: When You Can Enroll in a New ACA Health Plan

March 12, 2025

Life is full of changes, and some of these changes can impact your health insurance needs. While the Affordable Care Act (ACA) Marketplace has a set Open Enrollment Period each year, certain Qualifying Life Events (QLEs) allow you to enroll in or change your health insurance plan outside of that window. Understanding these life events can help ensure that you and your family have the coverage you need when you need it.


At YourMedPlan, we specialize in helping individuals navigate the ACA Marketplace and find the best health insurance options tailored to their needs. If you've recently experienced a Qualifying Life Event, you may be eligible for a Special Enrollment Period (SEP)—allowing you to enroll in a new plan outside of the standard Open Enrollment timeframe.

What is a Qualifying Life Event?

A Qualifying Life Event (QLE) is a major life change that allows you to enroll in or switch ACA health insurance plans outside of the annual Open Enrollment Period. These events trigger a Special Enrollment Period (SEP), giving you 60 days from the date of the event to apply for new coverage or make changes to an existing plan.

Common Qualifying Life Events for ACA Enrollment

1. Loss of Health Coverage

Losing your current health insurance may qualify you for a Special Enrollment Period. This includes:


  • Losing coverage through an employer-sponsored plan (voluntarily or involuntarily).
  • Aging out of a parent’s health plan at age 26.
  • Losing Medicaid eligibility due to income changes.
  • Losing COBRA coverage when it expires.


*YourMedPlan Insight: Even if you’re losing job-based coverage, you may qualify for subsidies and lower monthly premiums through the ACA Marketplace. We can help you compare plans to find the most cost-effective option.

2. Changes in Household

Certain family changes allow you to enroll in a new health plan, including:


  • Marriage: If you recently got married, you and your spouse can sign up for a Marketplace plan.
  • Divorce or legal separation: If this results in losing health coverage, you can enroll in a new plan.
  • Birth or adoption of a child: Your child can be added to your existing plan, or you can switch plans to better fit your family's needs.


*YourMedPlan Insight: When adding a new family member, consider a plan that covers pediatric care, dental, and vision for comprehensive protection.

3. Change in Residence

Moving to a new location may qualify you for new ACA coverage if:


  • You move to a new ZIP code or county where different health plans are available.
  • You move from out-of-state or from outside the U.S.
  • You relocate for work, school, or to be closer to family.
  • You move to or from a shelter or transitional housing.


*YourMedPlan Insight: Not all health plans are available in every state or county. If you're moving, we can help you find the best local coverage options.

4. Changes in Income

If your income changes, you may qualify for different levels of financial assistance, including:


  • Becoming eligible for ACA subsidies due to a drop in income.
  • No longer qualifying for Medicaid, requiring you to enroll in a Marketplace plan.
  • Losing employer-sponsored insurance due to reduced work hours or job loss.


*YourMedPlan Insight: Many individuals don’t realize they qualify for premium tax credits or cost-sharing reductions based on income. We can review your options and ensure you maximize your savings.

5. Other Life Events

Additional circumstances may also qualify you for a Special Enrollment Period, including:


  • Gaining U.S. citizenship or lawful residency.
  • Leaving incarceration and re-entering society.
  • Experiencing a marketplace plan error that prevented enrollment during Open Enrollment.

What If You Miss the Special Enrollment Window?

If you don’t enroll within the 60-day window following a Qualifying Life Event, you may have to wait until the next Open Enrollment Period (typically from November 1 – January 15) to get coverage. However, you may still have options through short-term health insurance or Medicaid, depending on your situation.

How YourMedPlan Can Help

Navigating the ACA Marketplace and determining your eligibility for Special Enrollment Periods can be complicated, but YourMedPlan makes it easy. Our team of expert advisors will:


  • Determine if your life event qualifies you for a new plan.
  • Help you compare ACA health plans that fit your budget.
  • Check if you qualify for subsidies to lower your monthly costs.
  • Assist with the application process to ensure smooth enrollment.
  • Support you throughout the policy year with any health insurance questions or concerns.


📞 Contact us today at +1 (855) 376-3186 or visit YourMedPlan.com to get started!



Don’t miss your chance to enroll—let us help you find the right coverage now!

Medicare Advantage Plans for 2025: A Guide for Those Turning 65

March 12, 2025
Turning 65 is a major milestone, and one of the most important decisions you’ll make is choosing the right Medicare plan . For many new enrollees, Medicare Advantage (Part C) is an attractive option, offering all-in-one coverage that includes hospital, medical, and often prescription drug benefits.  If you’re approaching your Medicare eligibility and wondering what your options are for 2025 , this guide will help you understand the key features of Medicare Advantage plans , how to choose the best one for your needs, and how YourMedPlan can provide expert guidance during the enrollment process.

Health Insurance for Self-Employed Individuals: What 1099 Contractors Need to Know

March 12, 2025
Being self-employed gives you the freedom to be your own boss, set your own schedule, and grow your business on your terms . However, one challenge many freelancers, independent contractors, and gig workers face is finding affordable health insurance . Unlike traditional employees who receive coverage through their employer, 1099 contractors must navigate the health insurance marketplace on their own. At YourMedPlan , we specialize in helping self-employed professionals find the best health coverage that fits their budget, lifestyle, and healthcare needs . If you’re a freelancer, consultant, or gig worker , here’s everything you need to know about securing health insurance as a self-employed individual .

Your Guide to Choosing the Right Health Insurance Plan for 2025

By Chaney Jassmann • November 27, 2024
As we move through the annual enrollment period, millions of Americans are making crucial decisions about their health insurance for 2025. Whether you’re considering Medicare Advantage options or individual plans under the Affordable Care Act (ACA), selecting the right plan requires more than just comparing premiums. At YourMedPlan, we’re here to guide you through the process, helping you find coverage that meets both your health and financial needs. Why Price Isn’t Everything While $0 premium Medicare Advantage plans and ACA tax credits may be tempting, focusing solely on premiums can lead to high deductibles, unexpected out-of-pocket costs, or limited provider networks. To make an informed choice, it’s essential to evaluate these critical factors: 1. Deductibles: Know the Costs Upfront Your deductible is the amount you must pay out of pocket for covered services before your insurance kicks in. Low-premium plans often come with high deductibles, which can exceed $1,000 for individuals or several thousand for families. YourMedPlan Tip: Understanding how deductibles apply—whether for routine care or specialist visits—is crucial. Our advisors can help you navigate these details and choose a plan that minimizes your financial risk. 2. Copays vs. Deductibles: What’s the Difference? Copays are fixed fees for specific services, like doctor visits, and usually don’t count toward your deductible. Balancing these costs is key to managing your healthcare budget. YourMedPlan Tip: Our team can help you calculate both copays and deductibles to ensure your plan works for your financial and medical needs. 3. Provider Networks: Stay Covered Many insurance plans limit coverage to specific networks of doctors and hospitals. Seeking care outside the network can lead to higher costs or no coverage at all. YourMedPlan Tip: Let us verify whether your preferred doctors, specialists, and hospitals are in-network, so you can avoid surprises and stay covered even in emergencies. 4. Prescription Drug Coverage: Plan Ahead Each insurance plan includes a formulary, or a list of covered medications, grouped into cost tiers. The tier of your medication determines how much you’ll pay out of pocket. YourMedPlan Tip: Not sure if your prescriptions are covered? We’ll review your plan’s formulary and explore cost-saving options like discount programs or alternatives. 5. Coinsurance: The Often Overlooked Cost Coinsurance is the percentage of medical bills you pay after meeting your deductible. Plans with lower premiums often have higher coinsurance rates, which can add up for expensive treatments. For instance, a $25,000 medical bill with a $1,000 deductible and 20% coinsurance could leave you responsible for $5,800. YourMedPlan Tip: Our experts can help you calculate potential coinsurance costs and find a plan that balances affordable premiums with manageable out-of-pocket expenses. 6. Out-of-Pocket Maximums: Your Safety Net Once you reach your plan's out-of-pocket maximum, insurers cover 100% of your in-network, covered care. For ACA marketplace plans in 2025, these caps are $9,200 for individuals and $18,400 for families. YourMedPlan Tip: Understanding how out-of-pocket maximums reset annually is key to planning your healthcare expenses. We’ll help you prepare and avoid surprises. YourMedPlan: Your Partner in Health Insurance As you evaluate your health insurance options, let us be your trusted partner. Navigating deductibles, provider networks, and cost-sharing can be complex, but our advisors simplify the process and provide year-round support. We can assist with: Comparing plans and premiums Reviewing provider networks and prescription drug coverage Breaking down deductibles, copays, and coinsurance Identifying savings opportunities, including tax credits and discounts Our goal is to ensure you select the best plan for your unique needs, giving you peace of mind and confidence in your coverage. Get Started Today As you consider your health insurance options for 2025, we’re here to guide you every step of the way. Contact YourMedPlan to schedule a consultation and get expert insurance recommendations tailored to your healthcare needs. Let’s find the perfect plan together!