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If I sign up for a Bronze plan during open enrollment, can I bump my coverage up to a higher level several months later if I find out that I need surgery?

After open enrollment ends, you won't be able to change your policy until the next open enrollment period. | Image: Prostock-studio / stock.adobe.com

Q. If I sign up for a Bronze plan during open enrollment, can I bump my coverage up to a higher level several months later if I find out that I need surgery?

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An executive order signed by President Biden has authorized a COVID-related special enrollment period on HealthCare.gov. The SEP will run from February 15 to May 15.

A. No. After open enrollment ends, you won’t be able to change your policy until the next open enrollment period. A 60-day special enrollment window can also be triggered on an individual basis by a qualifying event, but a change in health status is not a qualifying event.

Open enrollment and special enrollment periods triggered by qualifying events apply both on and off-exchange. So regardless of whether you buy your health insurance plan through the exchange or outside the exchange, you won’t have an opportunity to switch to a different plan until the following year (during open enrollment) unless you experience a qualifying event.

And even with a qualifying event, rules that HHS finalized in 2017 limit the ability to switch to a plan at a different metal level outside of open enrollment.

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