The Navigator Resource Guide has not been updated for 2025 Open Enrollment. For more current information please visit:
cms.gov/marketplace/in-person-assisters/information-partners.
QUESTION

I signed up for a bronze plan with a high deductible during open enrollment. Now, six months later, I need surgery and would rather be in a different plan with a lower deductible. Can I change plans?

Individuals with coverage | Individual and Marketplace Health Coverage |
ANSWER

No, in general, once you sign up for a plan, you are locked into that coverage for 12 months, or until the next open enrollment period. A change in health status doesn’t make you eligible for a special enrollment period. However, in most states, if your income is below 150 percent of the federal poverty level you may be able to qualify for a special enrollment period and switch to a silver-level plan. Check with your state's Marketplace to see if this special enrollment period is available to you. (45 C.F.R. § 155.420).

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