If you go through a life event that qualifies you for Special Enrollment, you can update or choose a new plan. You normally have 60 days after your life event to pick a plan.
Visit our shopping platform to compare coverage options and their prices. Once you've found the right plan, enroll and make your first premium payment.
How Do I Know if I'm Eligible for Special Enrollment?
If you go through a "qualifying life event," you're eligible for Special Enrollment. Learn more about some common life events:
Some common changes in your family that qualify you for Special Enrollment are:
- Having or adopting a child, or gaining a dependent through court-order
- The passing of a policy holder
- Getting married, or establishing a Civil Union or domestic partnership
- Separating or divorcing your spouse
Some common residential changes that qualify you for Special Enrollment are:
- Moving to a new area with different plans or HMO network
- Moving to or from a place you attend school, live or work as a seasonal worker or live in for transitional or shelter housing
- Relocating to Texas from another state
Some common reasons for losing coverage that qualify you for Special Enrollment are:
Losing or getting denied for Medicaid or the Children’s Health Insurance Program (CHIP) coverage
Turning 26 and losing coverage under your family member’s policy
Some common changes to your job or income that qualify you for Special Enrollment are:
Some other life events that qualify you for Special Enrollment are:
Your health care coverage ending on a date other than December 31st of the current plan year
Becoming a U.S. citizen
A health insurance company violating its contract with you
Becoming a member of an American Indian or Alaska Native tribe
Experiencing an error or other issue when trying to enroll
Can I Use Special Enrollment to Switch to a Better Plan?
Sometimes, a life change means a change in your needs. Special Enrollment is the perfect chance to update your plan to coverage that better fits your needs:
- Choose a plan with lower costs
- Explore plans with different benefits
- Add a dependent or a spouse to your coverage
Do I Need to Show Proof of My Event or Insurance Coverage?
Depending on your life event, you may need to submit some documentation.
These documents normally fall into 1 of 2 categories:
1. Proof of your life event.
These documents show when your life event was. A few examples are:
- A marriage license
- A birth certificate
- A letter from your employer
2. Proof that you had insurance.
Depending on the documents you submit, you may also need to send proof of insurance like a:
- Letter from your insurer
- Printout from a benefits administration website
- Certificate of Credible Coverage
What Happens If I Miss My Special Enrollment Deadline?
Can I still get insurance?
You normally have 60 days after your life event to enroll through Special Enrollment. If you miss that deadline, you may have to wait until Open Enrollment, beginning November 1.
You can also check if you qualify for Medicare or Medicaid plans. These plans are offered by the government. Eligibility is based on age, income or disability.
Additional Questions
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I missed my premium payment and lost my healthcare coverage. Is this a qualifying life event?
Missing your premium payment normally isn't a life event that qualifies you for Special Enrollment.
If you still want to enroll in an Individual and Family health insurance plan, you'll likely have to wait until Open Enrollment. Open Enrollment begins every Novermber 1. You don't need to go through a life event to enroll during Open Enrollment.
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Can I change my health insurance plan after I complete Special Enrollment?
Once you've submitted your application and made your premium payment, you can't choose a different plan through Special Enrollment.
You can update certain details of your plan, like your primary care provider (PCP). Refer to our Contact Guide to learn how you can make updates.
If you want a different plan than you selected, you can update your coverage during Open Enrollment. Open Enrollment begins every year on November 1.
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I'm not happy with my insurance provider. Can I switch to BCBSTX during Special Enrollment?
You can! If you've gone through a life event that qualifies you for Special Enrollment, you can choose a new insurance provider, like BCBSTX. Shop with us to find a plan that better fits your needs.
If you don't qualify for Special Enrollment, you'll be able to update your plan starting November 1 during Open Enrollment.
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Do I have to re-enroll in my BCBSTX plan during Open Enrollment?
If you're happy with the plan you chose during your Special Enrollment Period, there's nothing you need to do during Open Enrollment. Just continue making your premium payments for your coverage to stay active.
If you have updates to your coverage, like adding dependents, you should make those changes during Open Enrollment.
Please note, your plan costs and benefits may change for the new year.
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Can I enroll in or update a BCBSTX plan before my life event takes place?
If you know your life event is coming up, you may have the chance to enroll in new coverage or update your plan up to 60 days before your life even taks place. However, if you enroll early, you may have to revisit your application to provide documentation showing the date your life event took place.
Some common life events you may know ahead of time are:
- Moving
- Having or adopting a baby
- Getting married
- Leaving your job
If you have questions, please visit Healthcare.gov.
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Can I switch from an individual plan to a family plan during the Special Enrollment Period?
You can. If you want to keep your BCBSTX individual coverage but add your partner or children, you can update your plan details in our shopping platform. Or, if you want to choose a new plan, you can find coverage that best fits your family. If you add your partner or any dependents, it will likely impact your plan's costs.
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Will my deductible reset if I change plans during Special Enrollment?
It's likely that your deductible and other health plan costs may reset or change when you update your coverage through Special Enrollment. If you have questions or concerns, please check and enroll with an independent authorized agent.