Upgrade Health Insurance Outside Open Enrollment?

Has anyone heard of anyone making a change to their health insurance plan at work outside open enrollment without a "qualifying event?" A qualifying event is defined as an event that would change your tax status, such as marriage, divorce, additional dependent (child), etc.

I was hospitalized about a month ago and need to seek more acute care. After an exhaustive search, I have found a doctor(s) who is a good fit. The problem is, that it is out-of-network. I would like to upgrade my health insurance plan at work which would partially cover this practitioner. I cannot seem to find anything on the internet where someone discusses their experience trying to upgrade their health insurance (for a good reason, but not according to the IRS).

Any input from personal experience would be greatly appreciated.

sph123, Have you asked your insurance provider to look into this for you?

I did. And they said only if my employer allows it. I ended up opening up a can of worms by asking my employer unfortunately.

So no you can't do it if your employer does not allow it. Employers don't allow it because it is not a "qualifying event" according to the IRS. The other option is supplemental insurance, and no, my employer does not offer this.

And now I have been forced to take a leave of absence or risk getting fired.

sph123, I am sorry to hear this. It does not sound fair.

Thanks, bluekoi. I just hope that my experience can prevent someone else from going through the same thing.

I am not quite sure what you are asking. My jobs always offered several plans for insurance I always bought the most expensive one I could afford for myself, the PPO plan rather than the POS or HMO. Talk to your personnel officer about your company's plan(s). You may have to wait until the next Open Enrollment though (November for next year) to upgrade/buy another plan or buy from the marketplace.

https://www.healthcare.gov/what-if-i...lth-insurance/

https://www.healthcare.gov/glossary/...llment-period/