Can you add your spouse to your health insurance after open enrollment

After BOE ends, changes in coverage will only be allowed for a "qualifying life event" (QLE). The coverage change must be consistent with the QLE and each event requires documentation. Some examples of a QLE are:

• You move outside of your HMO's service area:
  • You may enroll in a health insurance plan authorized for your area. The effective date will be the first day of the pay period after your move.
• You get married or divorced:
  • You may enroll a new spouse within 31 days of your marriage. The effective date of the insurance is the first day of the next pay period after the MI HR Service Center receives notification.
  • In the event of a divorce you must remove a spouse and step-child(ren) from insurance immediately. The effective date of the removal will be the date of the divorce. 
  • Or, you may newly enroll in health coverage if you lose insurance coverage as a result of a divorce.
• Your spouse dies and you are covered under that spouse's insurance plans:
  • You may newly enroll in the State group insurance plans.
• An eligible child is born, adopted, or you gain guardianship of a child:
  • You may add a new dependent to your insurance coverage within 31 days of acquiring that dependent through birth, adoption, or legal guardianship. The effective date will be the date of birth, adoption, or legal guardianship.
• Your spouse begins or ends employment:
  • You and your eligible dependents may enroll in State group insurance coverages if your insurance coverage is lost as a result of a change in your spouse's employment.
  • Or, you may cancel your State group insurance (or opt out) if you enroll in your spouse's plans. 
• Your spouse changes from part-time to full-time (or vice versa), or takes an unpaid leave of absence resulting in a significant change in your coverages:
  • You and your eligible dependents may enroll in State group insurance coverages if coverage is lost or significantly reduced as a result of a change in your spouse's employment status.
  • Or, you may cancel your State group insurance (or opt out) if you enroll in your spouse's plans. 
• There is a significant change in your coverages (or your spouse's coverages) through your spouse's employer plan:
  • You and your eligible dependents may enroll in State group insurance coverages if coverages through your spouse's employer plan are lost, canceled, or significantly changed.
  • Or, you may cancel your State group insurance (or opt out) if you enroll in your spouse's plan. 

Notify the MI HR Service Center of a QLE as soon as possible, but no later than 31 days following the QLE occurring.  Do not wait until you have the official documentation to contact MI HR Service Center. You will be required to provide proof of dependent eligibility. Details about required documentation is available by visiting www.mi.gov/docs4ebd.

Open Enrollment for 2023 plans runs November 1, 2022 to  January 15, 2023. Enroll by December 15, 2022 for coverage that starts January 1, 2023. You have until January 15, 2023 to change plans. Outside of Open Enrollment, you can only change plans if you qualify for a Special Enrollment Period.

If you qualify for a Special Enrollment Period and want to change plans, you may:

• Have a limited number of health plan categories to pick from (instead of all 4)
• Need to select a new plan within the same plan category as your current plan for 2022 or you can change to a different plan category right now for 2023
• Be allowed to change plan categories under certain circumstances

Types of Special Enrollment Periods with limited plan category choices

Enrollees and their dependents (including newly added household members) who qualify for the most common Special Enrollment Period types — like a loss of health insurance, moving to a new home, or a change in household size — will only be able to pick a plan from their current plan category.

For example, someone who’s already enrolled in a Bronze health plan (and wants to change plans) will only be able to select a new plan from the Bronze category.

Circumstances that allow you to change plan categories

It may be possible to change to a plan in a different plan category during a Special Enrollment Period under certain circumstances.

Becoming eligible for cost-sharing reductions

If you become newly eligible for extra savings in the Marketplace called cost-sharing reductions (CSRs) and aren’t already enrolled in a Silver health plan, you can choose a plan in the Silver category to use your cost-sharing reductions.

Silver plans may also be available if you’re eligible for a premium tax credit and can enroll through a Special Enrollment Period based on estimated household income.

Losing cost-sharing reductions

If you’re enrolled in a Silver health plan and lose your cost-sharing reductions, you’ll qualify for a Special Enrollment Period. If you want to change plans, you can enroll in a Bronze, Silver or Gold plan that meets your needs and fits your budget.

New household members

If your household size increases due to marriage, birth, adoption, foster care, or court order, you can choose to add the new dependent to your current plan or add them to their own group and enroll them in any plan for the remainder of the year. Note: This only applies to the new household member. Current enrollees can’t change plans.

If you can’t add new household members to your plan

If your plan’s rules don’t allow you to add new members to your plan, your family can enroll together in a different plan in the same category. If no other plans are available in your current plan category, your family can enroll together in a category that’s one level up or one level down.

An employer offer to help with the cost of coverage

Gaining access to an individual coverage HRA or a QSEHRA from your employer to help with coverage costs doesn’t limit your ability to choose a new plan during a Special Enrollment Period. However, make sure you enroll in a plan that starts by the date your individual coverage HRA or QSEHRA begins, unless your employer offers a later start date.

Special Enrollment Periods for complex situations

Some Special Enrollment Periods, like those due to misrepresentation or plan display error, gaining or maintaining status as a member of a federally recognized tribe or an Alaska Native Claim Settlement Act (ANSCA) Corporation shareholder, or other very rare situations, don’t limit your ability to choose a new plan during a Special Enrollment Period. Learn about Special Enrollment Periods for complex issues.

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