Is Losing Coverage Due to Nonpayment a Life Event?

The short answer: no. Generally, losing coverage because you did not pay your monthly premium is not considered a qualifying life event. There are quite a few different life events that allow you to purchase health insurance midyear. While these life events are designed to help people adjust to a new situation without a lapse of health coverage, they are pretty specific and will only apply to certain people. Below is an explanation as to why not paying a premium is not a life event.

The Reason

The most common life event that allows someone to buy coverage midyear is an involuntary loss of coverage. Losing coverage involuntarily starts a 60-day window to enroll in another plan. While it may sound like you lost coverage involuntarily because the insurance company terminated you for not paying, that is not the case. Nonpayment is specifically defined in the ACA as an exclusion from this life event. Insurance companies have a requirement to give you a 30-day window before ending the plan. This means if your premium is due on the first, you will have until the 30th that month to pay. If you miss that window, they can end your plan and deny you from getting back on.

What To Do Next

If you miss that window, there will be no way to get back on your policy unless your insurance company makes an exception. The first thing to do is to call them and ask if this can be done. In Nevada, there is no way to purchase health insurance mid-year without a qualifying life event. Since losing coverage due to nonpayment is not a life event, another option would be to check if you can get enrolled on either your employer’s health insurance plan or see if you are eligible for a group health insurance policy if you are a business owner. Speaking with a health insurance broker can be a great next step. You can usually go through all the options with them without any fees or costs to you.