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Working With Medical Insurance


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Working With Medical Insurance

For a few years, we really struggled with medical problems. Our kids were always coming down with something, and it seemed like we could never figure out what to do about illnesses. I started thinking about how to make things right, and a friend of ours mentioned that seeking regular medical help could really benefit us. We worked with our medical insurance provider to get the help we needed, and it was amazing to see how much better our children felt. I decided to make a blog all about working with medical insurance, because going to the doctor today could make your life a lot better tomorrow.

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Qualifying Life Events And Health Insurance

If you have ever had a health insurance policy, you have probably seen the term — Qualifying Life Event (QLE). However, just because you have seen the term, it does not mean you fully understand it. In case you are ever in a predicament where you need to rely on this coverage component, it is a good idea to ensure you are knowledgeable.

Importance of QLE

When most people shop for health insurance, they are not necessarily shopping for the future. Instead, they are shopping for coverage that they need at the moment. When you couple this idea with the fact that health insurance plans typically have set open enrollment periods in which you can sign up or adjust your coverage, a major life event that changes your health insurance needs outside this enrollment window can be an issue. 

A QLE is important because it provides you the opportunity to adjust your coverage outside the enrollment window if you experience any of these events so that you can be confident you have the coverage you need at any time. 

Standard QLEs

In the same fashion that different insurance policies have different guidelines, there may be instances when the definition of a qualifying life event might vary. However, there are some events that almost always meet the guideline of a qualifying life event. 

Adopting or having a child, having someone on the policy pass away, getting married or divorced, or suffering a loss of employment are just some of the standard events. Generally, any life event that would alter the type of coverage you need or have could qualify as a QLE, but make sure you ask questions. 

Proof May Be Required

The ability to change your health insurance due to a QLE is a great benefit, but it is important to keep in mind that this benefit is not something that is automatically granted. Typically, you first need to contact the insurance company and let them know that you have experienced this life event.

Next, the insurance company may require you to submit supporting documentation that proves you have experienced the event. For example, if you have a child or adopt a child, you may need to provide the birth certificate or an adoption decree. The insurance company will let you know what you need to provide based on your circumstances. 

Remember, QLEs can vary between insurance providers and the type of policy you have. Speak with a health insurance professional for specific help with your situation.