My Spouse, Dependent(s) And/Or I Have Had Changes In Medicare, CHIP, Medicaid Or NC Health Choice Eligibility Or Enrollment

Change in Medicare, CHIP or Medicaid Entitlement.

Changes must be requested within 60 days.

Changes are allowed for the following benefits

You can*:

You must provide this supporting documentation:

Health/Rx, Dental, Vision

Drop coverage for self or child(ren) who gain coverage
 
Add coverage for self or child(ren) who lose coverage
 
For loss of Medicaid or CHIP entitlement, may change health coverage from one option to another
 
Add coverage if premium assistance becomes available
Proof of the change in Medicare, CHIP or Medicaid entitlement

Health Care Flexible Spending Account

 
Enroll or increase contributions with loss of eligibility for Medicare, CHIP or Medicaid
 
Drop or decrease contributions if become entitled to Medicare, CHIP or Medicaid

Dependent Care Flexible Spending Account

No change allowed

Life/AD&D

No change allowed

Short Term Disability and Long Term Disability, Critical Events, Hospital Indemnity

No change allowed

 


Loss of Coverage under Medicaid, CHIP or NC Health Choice.

Changes must be requested within 60 days of the loss of coverage.

Changes are allowed for the following benefits

You can*:

You must provide this supporting documentation:

Health, Dental, Vision

Enroll or add health plan coverage for self, spouse and/or child(ren) previously covered by Medicaid, CHIP or NC Health Choice
 
Change from one health plan option to a different option following a loss of eligibility for Medicaid or CHIP
Proof of coverage loss

Health Care Flexible Spending Account

Increase or start contributions

Dependent Care Flexible Spending Account

No change allowed

Life/AD&D

No change allowed

Short Term Disability and Long Term Disability, Critical Events, Hospital Indemnity

No change allowed

 


You or Your Spouse or Dependent Gain Coverage Under Medicare and You Wish to Drop Coverage.

Changes must be requested within 60 days of the gain of coverage.

Changes are allowed for the following benefits

You can*:

You must provide this supporting documentation:

Health/Rx, Dental, Vision

Drop coverage for anyone who gained coverage under Medicare Proof of coverage gain

Health Care Flexible Spending Account

Decrease or stop contributions

Dependent Care Flexible Spending Account

No change allowed

Life/AD&D

No change allowed

Short Term Disability and Long Term Disability, Critical Events, Hospital Indemnity

No change allowed

 


Gain Eligibility Under Medicaid.

Changes must be requested within 60 days of gain of eligibility.

Changes are allowed for the following benefits

You can*:

You must provide this supporting documentation:

Health/Rx, Dental, Vision

Drop coverage for self, spouse and/or child(ren) covered by Medicaid (health coverage only) Proof of coverage gain

Health Care Flexible Spending Account

Decrease or stop contributions

Dependent Care Flexible Spending Account

No change allowed

Life/AD&D

No change allowed

Short Term Disability and Long Term Disability, Critical Events, Hospital Indemnity

No change allowed
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