This Quick Guide explains steps to take before your current plan ends, enrollment deadlines and coverage start dates, common health insurance transitions, and what to confirm after your plan begins. Rules, deadlines, and options are different based on the type of insurance, the reason for the change, and where you live.
Changing health insurance may affect how much you pay, which health care providers and facilities you can use, and whether your prescriptions are covered. It may also affect ongoing treatment, scheduled procedures, prior authorizations, and access to specific pharmacies.
A health insurance transition may happen when:
Contact your current health insurance plan or employer to ask when your current coverage ends (e.g., on your last day of employment, at the end of the month, or on another date). Also ask if coverage will end automatically or if you need to do something. If possible, ask for the end date and the reason that your coverage is ending, in writing.
Find out how much you have paid toward your current plan’s deductible and out-of-pocket maximum. If your plan has a separate out-of-pocket maximum for prescription drugs, find out how much you have paid toward that too. When you move to a new plan, amounts you paid under your old plan may not count toward the new plan’s deductible or out-of-pocket maximum(s). This may be true even when the same insurance company offers both plans. Ask both plans if any amounts will transfer or if a deductible or out-of-pocket credit is available. Try to get the answers in writing.
Keep copies of documents about your current plan and the transition, including insurance ID cards, employer benefits materials, plan termination notices, recent explanations of benefits, prescription information, prior authorization approvals, and premium payment records. Also keep records of communications with your employer, your insurance company, the Marketplace, Medicare, and/or Medicaid.
You may need these documents to:
The types of plans available to you will depend on your situation. Options may include:
You may have more than one option. For example, if leaving your job, you may be able to choose COBRA, your spouse’s employer plan, or a Marketplace plan.
For each plan you are considering, review:
Triage Cancer has resources to help you compare plan options:
Most types of health insurance have specific times when you can sign up (“enroll”) or change plans.
Open enrollment period: an annual time when eligible individuals may enroll or make changes to coverage.
Special enrollment period (SEP): may be available after certain events. For example: losing other health insurance; getting married or divorced; having or adopting a child; aging out of a parent’s plan; or moving.
Enrollment deadlines are different for every type of insurance. An employer-sponsored plan may have a 30-day SEP, while the Marketplace usually has a 60-day SEP.
Ask the plan you want to join about:
Try to get the answers in writing.
Tell your health care team that your insurance is changing, as early as possible. Share your new insurance information, and when the new plan starts. Ask if there is anything you need to do about appointments, tests, or procedures that are already scheduled. Ask if you should get any medications refilled, referrals, or prior authorizations before your current plan ends.
A prior authorization approved by your old plan probably won’t transfer to your new plan. Ask your new plan if you need a new prior authorization and how the process works.
If you are losing an employer-sponsored plan, your options may include:
For more information: Quick Guide to Losing Employer-Sponsored Health Insurance: TriageCancer.org/QuickGuide-LosingInsurance
A young adult is usually able to stay on their parent’s employer-sponsored plan until age 26. Some plans or states may allow you to stay on it for longer. Before turning 26, ask the plan when your coverage will end, as well as whether COBRA or state COBRA coverage is available. Aging out of your parent’s plan generally triggers a SEP. Other options include your own or your spouse’s employer plan, a Marketplace plan, Medicaid, or student health insurance.
A permanent move to a new state or a new zip code usually triggers an SEP; temporary travel generally does not. You may need to provide documents showing your previous address, your new address, the date of the move, and prior health insurance coverage. For more information: Quick Guide to Navigating Health Insurance When Moving: TriageCancer.org/QuickGuide-HealthInsuranceWhenMoving
Medicare has many enrollment periods and rules about how coverage works with other health insurance options.
Whether you must enroll when you’re first eligible, and which parts of Medicare you’re required to have, depend on your age, whether you’re receiving Social Security Disability Insurance benefits, and – if you’re still working – the size of your employer.
The rules are different if you have Medicare and employer-sponsored coverage than if you have Medicare and COBRA, or Medicare and retiree insurance.
Medicaid may end because there’s a change in your income, household size, disability status, age, residency, or something else. Read every notice from your state Medicaid agency carefully. If you believe the decision to end your coverage was not right, appeal as soon as possible. You usually have 90 days to file an appeal, but if you file an appeal within ten days, you may continue to keep your Medicaid, while the appeal is being decided. When Medicaid ends, other options include your employer plan, your spouse’s or parent’s employer plan, another state health program (if available), a Marketplace plan, or Medicare, if eligible.
To learn more: Quick Guide to Medicaid: TriageCancer.org/Quick-Guide/Medicaid.
Network changes can happen when a hospital, doctor, or other provider ends its contract with your insurance plan. This can happen at any time, even at a time when you have no ability to change your plan. Common reasons for network changes include payment disputes, health care facility mergers, or other changes in ownership. If a provider you are seeing tells you that it will no longer be in-network for your plan, you can:
Confirm that your plan is active before using it. Then:
Remember to review your explanations of benefits for errors, and keep your old plan’s records and insurance ID card. You may need them to address claims for services you received before your old coverage ended.
For more information about navigating health insurance, health care, medical bills, and finances: TriageCancer.org/HealthInsurance & TriageCancer.org/Financial.
Last updated: 09/2026
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