Several life events hand you a new health plan, and most of them open a 60-day special-enrollment window to sign up outside the normal open-enrollment period:
If you're losing job-based coverage, you'll usually choose between COBRA — which lets you keep your old plan for a limited time, but you pay the full premium — and a marketplace plan, where subsidies are based on your new income and are often cheaper. Either way, don't let the 60-day clock run out.
Divorce is one of the life events that opens that special-enrollment window — and if you're also working through the divorce itself, free state-by-state divorce calculators can help you estimate child support, alimony, and property division before you meet with an attorney.
Every plan has its own formulary. The same drug can be a low-cost generic on one plan and a higher tier — or require prior authorization, or be left off entirely — on the next. Before your first refill on the new plan, look up each medication you take against that plan's drug list, so a surprise doesn't land at the counter. That's exactly what our Drug Lookup is for.
Medical-necessity criteria differ by insurer — the BMI bar for a weight-loss surgery, the imaging rules before an MRI, the documentation for a sleep-apnea implant. If you have care planned, check it against your new insurer's actual criteria before you schedule, because "approved under my old plan" doesn't carry over. See where you stand with the free tools →
This is the trap people miss most. A prior authorization your old plan approved generally has to be redone from scratch on the new plan — the new insurer wasn't party to the old approval. If you're on a medication or therapy that required a PA, start the new plan's authorization early so there's no gap in your treatment.
Two more quick ones: confirm your doctors are in-network on the new plan, and remember your deductible usually resets when you switch mid-year, so out-of-pocket costs can look different for the rest of the year.
Look up whether your new plan covers your prescriptions, and check any planned procedure against its real criteria — free, anonymous, no signup.
Check my coverageNot necessarily. Each plan sets its own formulary, so a drug that was covered cheaply on your old plan can land on a higher tier, require prior authorization, or be excluded on the new one. Check each medication against the new plan's drug list before your first refill so you're not surprised at the pharmacy.
Yes. Divorce ends coverage under a spouse's employer plan and qualifies you for a special-enrollment period — generally 60 days — to enroll in a marketplace or other plan outside open enrollment. You may also be eligible for COBRA to continue the old plan for a limited time.
Generally no. A prior authorization approved by your old insurer usually has to be requested again on the new plan, because the new insurer didn't make the original decision. If you take a medication or receive a therapy that needed a PA, start the new plan's authorization early to avoid a gap.
It depends on your income. COBRA lets you keep your exact old plan but you pay the full premium, which is often expensive. A marketplace plan bases subsidies on your new (often lower) household income, so it's frequently cheaper — it's worth pricing both within your 60-day window.
Your prescriptions themselves stay valid, but how they're covered can change with the new plan's formulary — different tier, a new prior-authorization requirement, or a quantity limit. Check each medication on the new plan and, if something isn't covered, ask your prescriber about a covered alternative before you run out.
Related: Drug Lookup · Why prior authorizations get denied · Guides & research · all coverage tools