How To Cancel a Marketplace Plan With or Without Replacement

There are many reasons you might find yourself needing to change or cancel the Health Insurance Marketplace® plan you chose during annual Open Enrollment. Many people want to swap theirs out for another plan, and some choose to opt out of selecting another Marketplace plan entirely, or at least at the time they’re cancelling their current one.

In this section, I provide instructions for how to cancel Marketplace coverage, either for everyone in the household or only select individuals. (Remember that you don’t need to end your coverage if you’re enrolling in a new or different plan during Open Enrollment.)

Finding consumer information on cancelling Marketplace plans

Internet searches are filled with people trying to find information on ending a Marketplace plan without replacement. My goal for the Obamacare? Marketplace? The Exchange: A Comprehensive Guide (COMING SOON!) has always been to answer the questions from consumers that were most searched on the web, and this was definitely in the top 3 when I was completing my research for the project.

My goal for this section is to present this information as clearly and quickly as possible so people can get their coverage sorted out before being charged and paying for a plan that isn’t what they want and that won’t work for them. If you have any questions or are still having trouble after checking out the resources and info presented here, please contact the Marketplace Call Center at 1-800-318-2596 for the most up-to-date information possible. They know everything about the Marketplace and have access to news about changes as soon as possible, often before other agencies or agents/brokers.

Note: It is important that you contact both the Marketplace and your health plan to end coverage.

The date your plan coverage ends depends on whether you’re ending it for everyone or for some people on the application.

In HealthCare.gov states (states with a Federally-facilitated Marketplace (FFM)), you can log into your Marketplace account, select the “terminate coverage” option, and enter the required information. The link provided here details how to terminate Marketplace coverage for Healthcare.gov states.
If you reside in a state with a State-based Marketplace (SBM), click here for the link that will take you to the website for your State-based Marketplace.
If you are unsure if you reside in a FFM State or a SBM State, click here for more information about finding the Marketplace option that applies to you.

How do I cancel my Marketplace plan? | HealthCare.gov

IMPORTANT: Do not just stop paying the premium for your Marketplace health plan as a way to terminate coverage. This will eventually cause your coverage to end, but your insurer might still try to collect from you. In addition, if the government continues to pay premium tax credits (PTCs) on your behalf, you might end up having to repay some or all of that amount to the IRS when reconciling your taxes.
What happens if I want to quit a Marketplace health plan during the year? | KFF

CMS: Know this before terminating/cancelling coverage

It’s important to understand the difference between “terminating” coverage and “cancelling” coverage and it surrounds creating a possible gap in coverage.

TERMINATE coverage

When coverage ends AFTER the coverage effective date, resulting in a period during which you were enrolled in a QHP (qualified health plan).

CANCEL coverage

When coverage ends BEFORE or ON the date your enrollment became effective, resulting in your enrollment NEVER having been effective. This can occur when you end your coverage before the effective date, or when an insurer retroactively cancels your coverage back to the effective date.

In simpler terms, "canceling" is stopping enrollment before it begins, while "terminating" is ending an active insurance policy.

Marketplace policies can be terminated by the consumer at any time, for any reason.

Reasons consumers might terminate their policy include getting a new job with employer-sponsored coverage (ESC), or perhaps becoming eligible for Medicaid or Medicare. Some simply want to end their coverage without providing a reason and this is totally acceptable.

Factors to consider before terminating a Marketplace plan

Exact date your new coverage will begin from your new provider

It’s advised to NOT terminate Marketplace coverage until you know the exact date your new coverage will become effective in order to prevent a gap in coverage OR an overlap in coverage.

Whether or not to terminate coverage for one person vs. the entire household

Decide whether you will be terminating just your coverage, yours and others in the household, or the entire household.
You should not try to change or remove the household contact online unless you are ending coverage for everyone on the plan.
NOTE: It is important to change or remove the household contact by phone to confirm dependents remain on the plan.

Possibility of wait time if need arises to re-enroll

Once coverage is terminated, you will most likely have to wait until the next annual Open Enrollment Period to re-enroll, if needed, leaving you and your household vulnerable to unexpected needs for medical care that may come up while you’re waiting.

Cancel your Marketplace plan | HealthCare.gov

Ending Marketplace coverage for everyone

According to the Centers for Medicare and Medicaid Services (CMS), if you want to end coverage for your entire household (everyone on the plan) or if you’re the only one on the plan, you should follow these steps to terminate coverage:

Log into your Marketplace account.
Select your name in the top right of the screen, and select "My applications & coverage."
Select your application under "Your existing applications."
On the left, select "My plans & programs."
Select the red button "End (Terminate) All Coverage" at the bottom.
Select the date for desired coverage end date (if updating information outside the Open Enrollment Period).
Check the attestation box.
Select the red "Terminate Coverage" button, a red "Terminated" or "Canceled" status should appear above the plan you ended.

You can also end coverage for everyone on the plan over the phone with the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325).

Ending Marketplace coverage for some household members

You can end coverage for only some household members on your Marketplace plan (i.e., a spouse or dependents).

If you are ending coverage for just some household members on the application, in most cases, coverage for these individuals will end immediately. The best way to ensure that you receive your desired coverage end date is by requesting the change by contacting the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889- 4325).

In some cases, coverage will not end immediately, including when the household members staying on the Marketplace plan qualify for a Special Enrollment Period (SEP). For example, if you update your household income after ending coverage for one or more people and the amount of premium tax credits or other cost savings changes, the remaining enrollees may qualify for an SEP.

If a consumer is removed, their last day of coverage will be the last day of the current month. Regardless of the day of the month the consumer removes their coverage, their new coverage effective date will be the first date of the following month.

If you need your Marketplace coverage to end immediately, you can contact the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325) to have the coverage end-date adjusted.

In conclusion

Things to remember:

If you’re ending coverage for everyone on the application, you can have the termination take effect as soon as the day you take action with the Marketplace, or you can set the Marketplace coverage end date to a day in the future (for example, for the day before your new coverage will start).
If you want to end coverage for some, but not all people on a Marketplace application, you can change their status to a non-applicant or remove them from the application entirely if the person is no longer part of your tax household (e.g., in cases of death or divorce). Make sure to contact the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325) on the day the new coverage will begin to confirm the coverage end date for individuals who no longer need Marketplace coverage. Calling the Marketplace Call Center will ensure that you avoid any potential gaps in coverage by making sure coverage ends for the right individual(s) on the desired date(s).
You should not end your Marketplace plan until you know when your new coverage starts.

I hope this section has cleared up some things surrounding ending Marketplace coverage. I wish you all the best in getting your coverage set up the way you need it or ended if you don’t need it. Thank you for learning with me!

From here, you can:

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