Enrollment Guides Robert Adams Enrollment Guides Robert Adams

Lost Health Insurance?

Lost health insurance? Most people qualify for a Special Enrollment Period. Compare ACA vs. private PPO options, verify your doctors, and start coverage quickly with RKA

Lost Health Insurance? What to Do Next (Step-by-Step) | RKA

Enrollment Guides • Special Enrollment

Lost Health Insurance? What to Do Next

Fast take: Losing coverage is stressful—but you have options. Most people qualify for a Special Enrollment Period (SEP) to enroll in a new plan. We’ll help you compare ACA vs. private PPO options, verify your doctors, and start coverage quickly.

Step 1: Assess your situation

Confirm why and when your coverage ends (job change, hours reduction, divorce, aging off a parent’s plan, etc.). Your reason sets your eligibility window and documentation needs.

Step 2: Talk to a licensed advisor

Health insurance has moving parts—networks, Rx tiers, referrals, and deadlines. A licensed advisor helps you avoid gaps and costly mistakes while matching plans to your providers and budget.

Step 3: Check eligibility for a Special Enrollment Period (SEP)

  • Common QLEs: loss of employer coverage, COBRA ending, move to a new ZIP/state, marriage/divorce, birth/adoption, income changes.
  • Timing: Most SEPs last 60 days from the event. We’ll confirm your exact window and effective date rules.

ACA Marketplace Plans

  • Guaranteed acceptance.
  • Potential income-based subsidies to lower premiums.
  • Networks and deductibles vary—verify your doctors and Rx.

Private Medically Underwritten PPOs

  • Often lower premiums for healthy applicants.
  • Frequent nationwide PPO access—good for travelers.
  • Underwriting applies; we pre-screen and confirm networks first.

Step 4: Consider COBRA vs. switching

COBRA keeps your employer plan temporarily but you pay the full premium (plus admin fee). We’ll run ACA vs. PPO vs. COBRA side-by-side so you can see total annual cost with your expected usage.

Step 5: Budget for healthcare costs

  • Monthly premium and employer/COBRA contribution (if any).
  • Deductible, copays, coinsurance, and maximum out-of-pocket.
  • Prescription costs and prior authorization requirements.

Step 6: Secure new coverage—without gaps

Once we’ve confirmed eligibility and networks, we’ll submit your application, confirm your effective date, and set up online account access and ID cards.

Need help replacing coverage fast?

We’ll confirm your SEP window, verify your doctors and prescriptions, and place coverage quickly so you don’t go uncovered.

Quick FAQs

Will I have a gap between plans?
Not if we align your application date with cutoff rules. Marketplace coverage often begins the 1st of the next month; some PPOs offer 1st or 15th start dates.
Can I switch off COBRA later?
Yes. You can switch during Open Enrollment or if another qualifying event occurs. We’ll time the change to avoid gaps.
Can you verify my doctors before I enroll?
Absolutely. Send your provider list (names & locations) and prescriptions—we’ll verify network participation and Rx tiers first.

For education only; eligibility, plan availability, and dates vary by state and carrier. Always review official plan documents.

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