Cómo cambiar su seguro de gastos médicos
Things change. Your health coverage can too.
Whether you have health insurance through an employer, the Health Insurance Marketplace®, an insurer like BCBSIL, Medicare or Medicaid, you may be able to change your health plan. The timing and process depend on the type of coverage you have and whether you've experienced a qualifying life event.
Here's what you need to know about changing your health insurance plan.
How do I change my employer or group health insurance plan?
For group plans, you can enroll or make changes to your plan during the group's annual enrollment period. Your employer sets their annual enrollment dates. To learn when yours is, contact your Human Resources (HR) department or benefits administrator.
You can also change your coverage during a Special Enrollment Period if you go through a qualifying life event, like:
- Matrimonio o divorcio
- Birth or adoption of a child
- Loss of other health coverage
- Certain employment changes
If you’re a BCBSIL group member, here are 3 simple steps to change your group health plan:
- Reach out to your employer's HR department or benefits administrator.
- Compare your plan options within your enrollment deadline. Normally, your Special Enrollment Period lasts 30 or 60 days from your event date.
- Complete your enrollment, making sure you upload any needed documentation, like proof of your life event.
If you have coverage through a former employer or union, contact the benefits administrator or the number on your member ID card for plan-specific enrollment rules.
How do I change my individual and family health insurance plan?
If you have an Individual and Family health plan, also known as Affordable Care Act (ACA) coverage, you change your plan during Open Enrollment. Open Enrollment happens once a year and usually starts Nov. 1.
You may also qualify for a Special Enrollment Period (Período especial de inscripción) if you experience a qualifying life event, including:
- matrimonio or divorce
- Child birth or adoption
- Changing ZIP codes or moving out of your coverage area
- Loss of qualifying health coverage by cumple 26 años o losing group coverage
How you update your ACA plan depends on where you enrolled:
- Directly through an insurer, like BCBSIL: If you enrolled with BCBSIL, you can update your individual and family health insurance plan through our plataforma de compras. Start by comparing your health insurance options, then complete your enrollment. To reach out to a sales agent for help, give us a call at 1-866-514-8044.
- Through the Marketplace: If you enrolled through Get Covered Illinois, visit getcovered.illinois.gov to learn more and make your updates. There, you can understand that steps you need to take to compare plans and enroll in new coverage.
If you enroll in a new Marketplace plan, when your plan's coverage starts depends on your enrollment timing and applicable federal guidelines. Normally, coverage starts the first day of the month after you apply.
How do I change my Medicare plan?
You have a few opportunities each year to change your Medicare coverage, depending on the type of plan you have:
- Annual Enrollment Period: During the Annual Enrollment Period, sometimes called Medicare Open Enrollment, you can enroll in, switch or drop your Medicare plan if you’re eligible for Medicare coverage. Normally, Annual Enrollment begins Oct. 15 each year.
- Medicare Advantage Open Enrollment Period: If you're enrolled in a Medicare Advantage plan, you may be able to switch to another Medicare Advantage plan or go back to Original Medicare coverage during this period. Medicare Advantage Open Enrollment typically starts Jan. 1 each year.
- Special Enrollment Period: You might qualify for a Special Enrollment Period if you go through certain life events, like retirement, losing your employer or union coverage, moving, entering or leaving a care facility or losing your health coverage.
Learn more about the Medicare enrollment periods.
What happens to my Medicare Advantage and Part D coverage?
If you enroll in a different Medicare Advantage o Parte D plan during one of the enrollment periods, your old plan will be automatically terminated.
Medicare Supplement (Medigap) Plans
Coberturas Suplementarias Medicare enrollment and switching rules may vary by state and plan type. Some states offer birthday-related enrollment protections that allow members to switch to comparable coverage without answering health questions. Contact the number on your member ID card for details specific to your state and plan.
How do I change my Medicaid health plan?
Medicaid enrollment rules vary by state. In Illinois, visit enrollhfs.illinois.gov para recibir más información.
You can select or change your managed care plan when you first enroll in Medicaid. A managed care plan is a Medicaid plan offered by a private insurer, like BCBSIL, when they contract with the state.
You may also be able to change your Medicaid plan when:
- You become newly eligible
- You move to a different service area
- Your health plan leaves the Medicaid program
- You experience another state-approved reason for a plan change
To change your Medicaid health plan:
- Contact your state's Medicaid agency.
- Review and compare your available coverage options.
- Complete any required forms, like an enrollment application or plan-change form.
Since Medicaid rules vary by state, check your state's Medicaid website or call the number on your member ID card for more help.
Need help choosing your best health insurance plan?
The best health insurance plan for you depends on your needs, health care preferences and budget. When you're comparing your options, think about:
- Your preferred doctors, other providers and hospitals
- Your prescription drug needs
- How much you want to pay for your monthly premiums
- What you want your deductible and out-of-pocket expenses to be
- The coverage benefits you need or expect
- Your eligibility for financial assistance or government programs
To learn more or start comparing your options, visit our BCBSIL Shop Plans page.