Working With Medical 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.