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?
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 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.