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Replacing ACA Health Insurance in Texas

The question of replacing your ACA insurance comes up in two situations:

  • Replacing your ACA plan with another ACA plan
  • Replacing your ACA plan with another plan outside the ACA

Regarding replacing your ACA plan with another ACA plan is a bit tricky. Because you enroll for ACA coverage during the open enrollment period only. Hence, you are "stuck" with your insurer until the next open enrollment period. You cannot change your insurer because you do not like the services provided or other related reasons. However, you will find a replacement plan if you have a life-changing event that will qualify you for a special enrollment period. This can be when you get laid off from a job that gave health insurance, or you moved to a new zip code, or got married or divorced.

During open enrollment, you may replace an existing ACA plan with the ACA plan of a same or different metal tier. Then you may select the most cost-effective plan within the tier, to serve your medical and financial needs.

On the other hand, replacing your ACA plan with an alternative Texas health insurance plan is straightforward. Cancel your ACA plan at the time when your replacement coverage begins.

Always understand the details before making irreversible changes. Discuss your needs with a state-licensed insurance professional, who can explain how the replacement of a plan may affect you and your family.

How Do I Switch My ACA Insurance to Another?

There are three circumstances where you can switch your ACA insurance for another ACA insurance.

First, you can switch your ACA insurance to another ACA insurance plan and/or carrier during the open enrollment period of that year. This is the time when you can replace an old plan and enroll in a new one.

Alternatively, if you qualify for a special enrollment period, you can switch your plan and replace it with another ACA insurance plan. You qualify for a special enrollment plan when you have had a life-changing event. This could be you having a child, adopting a child, getting married or divorced, or losing your job that gave you health coverage.

The third way is if you obtain group health insurance from an employer. Employer-sponsored health insurance is always compliant with the Affordable Care Act (ACA).

Furthermore, you may be able to switch your ACA insurance to an alternative, non ACA-compliant health insurance plan (Short-term) that may fit your medical and financial needs better. (Always consult with a licensed professional, to fully understand the drawbacks of non-ACA coverage, before committing to the switch.)

To do the switch, all you have to do is cancel your ACA plan when your replacement coverage starts. You can cancel it online, by contacting the Marketplace Call Center at (800) 318-2596, or reaching out directly to your insurer.

How Can I Replace My ACA Insurance?

You can replace your ACA plan with another ACA plan during an open enrollment period or a special enrollment period. Alternatively, you may be able to obtain other (non ACA-compliant) types of health insurance coverage that fit the needs of a large group of Texans.

On the ACA marketplace, you can choose a new plan to replace your existing plan online on your Marketplace account during an open enrollment period. Typically, your existing plan is automatically chosen for you for the next year, but it will not be activated until you pay your first monthly premium. So before paying your premium, you can replace the plan with a new plan.

If you lose your health coverage, you can replace your previous coverage with a new ACA plan during a special enrollment period. You just need to log into your Marketplace account or create an account if you do not have one.

If you want to replace your ACA plan with non-ACA coverage, make sure to cancel your present plan once your newly acquired coverage begins.

Discuss your health insurance needs with a state-licensed insurance professional, who is able to provide advice based on your individual medical and financial needs.

How Can I Replace My ACA Insurance if I Find a Better Deal?

Each individual's "better deal" depends on their personal medical and financial needs. For example, if you expect expensive medical bills due to an ongoing expensive medical treatment, a better deal for you could be the plan with the lowest maximum out-of-pocket (MOOP) amount. Or, if you are a healthy young adult, who mostly cares about preventive services and annual checkups, a lower deductible and copay may be more important to you.

Typically, in order to find a possible better deal, the insured must answer three questions:

  • Does your current Texas ACA health insurance meet your expected medical and financial needs for the next year?
  • Is your plan still being offered as an option in your county on the Texas health marketplace?
  • Are there other health plans that fit your current needs better than your current year's plan?

(Discuss your insurance decisions with licensed insurance professionals, who are the only ones who can legally provide a qualified recommendation based on the assessment of your individual needs).

Suppose you find a better ACA insurance deal than your present ACA plan. In that case, you can only replace your existing ACA plan during an open enrollment period or a special enrollment period. An open enrollment period is a time at the end of the year when you can make ACA insurance decisions which will take effect the following year. This is the time to decide on the metal tier and the underlying plan selection.

A special enrollment period is a time outside the open enrollment period where you are qualified to make ACA insurance decisions. People qualify for the special enrollment period because of life-changing events they experienced. Life-changing events include getting married or divorced, having a child (by birth or by adoption), or losing a job that provides health insurance.

If you find a better deal outside ACA-compliant insurance, you can simply cancel your ACA plan. There are two most efficient ways you can cancel your ACA plan: Either online, through the HealthCare.gov account, or by contacting the Marketplace Call Center at (800) 318-2596.

Can I Switch My ACA Health Insurance to Another non-ACA Company?

Yes, you can switch your ACA insurance to another company that does not provide ACA-compliant coverage. The Texas health insurance market is among a few in the United States that offer a great variety of health coverage options, fitting every demographic and need. Examples of non-ACA health insurance in Texas are: Short-term, Accident, and other Supplemental types.

Switch from your ACA plan by first obtaining new coverage and then canceling your present ACA plan. Make sure that the day your existing ACA plan cancels is the same day your replacement plan will take effect.

Consult a licensed insurance agent to provide you with the most up-to date information on how to go about switching to a non-ACA health insurer in Texas.

What Happens if You Change ACA Insurer Companies?

All ACA-compliant insurance companies provide comprehensive health coverage with essential health benefits, so the level of benefits remains unchanged - no matter which Texas insurer you choose.

The switch to another insurance company may be for different reasons, depending on each person. For example, some people change insurers because of lower premiums and others because their present insurer does not work with their favorite new physician.

When you think of changing ACA insurance companies, you must evaluate all the options available on the local health insurance market, to make the most informed decision. It will be another year before you can make a change again. Speak with a licensed Texas insurance professional to go over your options for the next year.

Can I Change ACA Insurance Companies at Any Time?

No. You cannot change ACA insurance companies at any time. Texas marketplace-obtained health plans can be changed only during an open enrollment period or a special enrollment period.

Employer-sponsored group health plans are offered only from the insurers that the employer selects. If you are allowed to change, it must be done during the open/special enrollment periods and only between the listed insurers.

Discuss your insurance needs with licensed professionals, to get a personalized assessment based on your specific situation.