What is a qualifying event?
A qualifying life event (QLE) is a change in your life circumstances that makes you eligible to change or enroll in a new health plan during the Special Enrollment Period (SEP) is called a qualifying life event (QLE). Without a QLE, you can only enroll in a new health plan during the annual Open Enrollment Period (OEP) from Nov. 1 to Jan. 15. Federal QLEs include marriage, loss of employer coverage, and aging off a parent's plan.
Is having a baby a qualifying life event?
Yes, the birth of a child is a qualifying life event. Your 60-day special enrollment period starts on the day of your child's birth. You'll need to provide a copy of the birth certificate to qualify. Coverage is usually retroactive to the date of birth, but it can start on the first day of the following month if requested.
Neither parent needs existing health coverage to qualify for a Special Enrollment Period. If you're not covered, you can use this opportunity to enroll in a plan for you and your child. If you're already enrolled, you can add the child to your existing plan or enroll them in a new plan at any metal level. Some restrictions may apply to parents with existing plans, so it's best to consult a health plan expert for the latest information.
Is pregnancy a qualifying life event for health coverage?
In Michigan, pregnancy is not considered a qualifying life event.
How to choose a plan
Choosing a health plan for you and your newborn is a significant decision. Our Learning Center offers resources to help you understand different health plans and their terminology. Enrollment specialists at Priority Health can also discuss your options.
Our Learning Center has a wealth of resources to help you understand the different health plans available and the language that is used to describe them. We also have enrollment specialists who can talk with you about the options available at Priority Health.
When shopping for an Individual and family health plan, consider:
- Any chronic health conditions you have
- Prescription drugs you take
- Frequency of doctor or specialist visits
- Importance of keeping the same provider
- Additional benefits like hearing aids or gym memberships
Why choose Priority Health?
Priority Health is a Michigan-based company recognized for quality, customer service, transparency and innovation. Our health plans focus on improving members' health while keeping costs affordable. We've provided high-quality health plans to Michigan residents for over three decades. Our MyPriority® plans help you take control of your health at an affordable price.
Our mobile app allows customers to manage their health plan, view personal information, find doctors, track spending and use tools to save on care costs.
Talk to the experts at Priority Health
Looking to change health plans after the birth of a child? Contact the experts at Priority Health to talk about the right options for your family.
Frequently asked questions
When is open enrollment?
The annual Open Enrollment Period begins on Nov. 1 for health coverage for the following year. It's the first day you can enroll, re-enroll, or change your health plan. Dec. 15 is the last day you can enroll so your coverage begins Jan. 1. If you enroll between Dec. 16 and Jan 15, your coverage begins Feb. 1. After Jan. 15, you can only enroll or change your health coverage if you qualify for a Special Enrollment Period.
What are the other qualifying life events?
- Loss of qualifying health coverage
- COBRA coverage ending
- Marriage
- Adoption
- Foster care placement
- Guardianship
- Moving to a different coverage area
- Gaining U.S. citizenship or qualified immigration status
- Aging off a parent's plan
- Losing eligibility for Medicaid or CHIP
- Death of the policyholder
Is adoption a qualifying life event?
Yes, both adoption and foster care placement are QLEs. The Special Enrollment Period starts on the day of the adoption or placement and lasts for 60 days. You will need to provide your adoption papers, placement orders or other proof of placement to enroll.
A special delivery means a special enrollment
An increase in your household size could mean extra subsidy savings.
Shop with confidence
- Video library
- 5-step guide to shopping
- OEP checklist
- How to compare health plans
- Final step for enrolling
- 5 health plan terms to know
- 6 Affordable Care Act key terms
The right coverage
- Take a quiz to find your plan
- Narrow Network plans
- What's a high-deductible plan?
- Understanding metal levels
- Health coverage for gig workers
- Coverage for immigrants
- Medi-Share health cost-sharing
Prioritize value
- 5 must haves in a plan
- Why choose a MyPriority plan?
- How to save on health coverage
- Chronic condition coverage
- MyPriority plan benefits