When your health insurance company leaves or exits the Marketplace, it can feel unsettling. But don’t worry, you have options. Carrier exits happen for different reasons, and when they do, you qualify for an SEP. That means you can shop for a new plan right away, and Ambetter Health can help you make the switch smoothly so you don’t lose coverage.

What Happens When Your Health Insurance Company Leaves the Marketplace

When a health insurance company exits the Marketplace, it means they will no longer sell or renew plans in your state. While that can feel stressful, understanding why it happens (and what that means for your coverage) makes it easier to take your next step.

Why Carriers Leave the Marketplace

Sometimes insurers exit for business decisions, like balancing costs or merging with another company. Other times, shifts or changes in state and federal rules lead carriers to adjust their offerings. These exits are a normal part of how the Marketplace evolves.

How Carrier Exits Affect Your Coverage and Timeline

If your plan is ending, you’ll receive an official notice with your last day of coverage. That notice also explains your SEP, which gives you time to choose a new plan.

It’s important to act before your deadline; waiting too long could leave you with a gap in coverage or fewer choices. 

How Do You Switch to a New Ambetter Health Plan Without a Coverage Gap?

Switching health insurance doesn't have to mean losing protection. When your carrier exits, you’ll get an SEP that lets you choose a new plan in time to keep your coverage continuous.

Here’s what to know:

Your 60-Day Special Enrollment Window

You’ll have 60 days before and 60 days after your plan’s end date to enroll in a new Marketplace plan. Missing this window could leave you uninsured until the next Open Enrollment Period, so it’s important to act quickly.

Timing Matters: Year-End vs. Mid-Year Exits

If your plan ends on December 31, you can shop during the regular Open Enrollment window. But if your plan ends mid-year, your SEP begins right away, giving you time to switch without losing benefits.

Steps to Avoid a Coverage Gap

The easiest way to protect yourself is to enroll in a new Ambetter Health plan before your old coverage ends. That way, your doctor visits, prescriptions and hospital care stay covered without interruption.

Need help switching? Call 844-970-1230 to get personal support with your Ambetter Health enrollment.

How to Choose a New Health Plan

Choosing a new health insurance plan can feel overwhelming, but breaking it into steps makes it easier.

Here's how to compare your options with confidence:

Step 1: Check the Provider Network

Start by confirming your doctors, hospitals and pharmacies are included. If you take prescriptions, make sure they’re covered on the plan’s drug list (also known as a formulary).

Step 2: Understand the Plan Types

Plans like HMOs, PPOs, and EPOs each work differently. Some require referrals, while others give more out-of-network flexibility. Think about how much choice you want in your care.

Step 3: Compare the Total Costs

Look beyond the monthly premium. Review the deductible, copayments, and out-of-pocket maximum to understand your full yearly costs.

Step 4: Use Marketplace Tools to Compare Plans

The Marketplace lets you view plans side-by-side. You can also compare health plans from Ambetter Health to find one that balances costs and benefits.

What Special Factors Should You Consider Before Switching?

Every situation is different. Certain factors may affect how you choose your new plan; make sure to consider your specific needs when choosing a new plan.

• Switching Insurance with Pre-Existing Conditions
  Marketplace plans, including Ambetter Health, cover pre-existing conditions. You won’t be denied coverage when you switch.
• Switching Insurance During Pregnancy or Ongoing Treatment
  If you’re pregnant or receive long-term care, confirm your doctors and prescriptions are included so your treatment continues without interruption.
• Switching to Employer-Sponsored Coverage
  If you qualify for insurance through work, compare it with Marketplace options. Remember, you may no longer qualify for subsidies if you choose an employer plan.
  

Will You Still Qualify for a Premium Subsidy When Switching?

In most cases, yes. If you’re eligible for savings now, you can usually keep them when you switch to a new Marketplace plan.

Here’s what to know:

How Premium Subsidies Work When Switching Plans

Subsidies (premium tax credit) are based on your income and household size, not the insurance company. If you qualify, they can be applied to your new Ambetter Health plan.

How Benchmark Plan Prices Affect Subsidies

Your subsidy amount is tied to the “benchmark” plan in your area, which is the second-lowest-cost Silver plan. If benchmark prices change, your subsidy may also change, even if your income stays the same.

Steps to Update Your Marketplace Application

To make sure your subsidy is applied correctly, update your Marketplace information as soon as you switch:

1. Log in to your Marketplace account.
2. Report any change to your income, household or plan selection.
3. Submit your updates to recalculate your subsidy.
4. Review your eligibility notice to confirm your savings amount.

Is Marketplace Auto-Enrollment a Good Idea?

If you don’t pick a new plan, the Marketplace may automatically place you in one. While that keeps you covered, it’s not always your best option.

How Auto-Enrollment Works

The Marketplace will try to match you with a similar plan from another carrier. This happens automatically if you don’t make an active choice during your SEP.

The Risks of Relying on Auto-Enrollment

Auto-enrolled plans may not include your doctors, prescriptions or preferred costs. By choosing your own Ambetter Health plan, you stay in control and avoid unexpected costs. 

What Are the Best Tips for Switching Health Insurance Smoothly?

Switching health insurance plans may feel like a big task, but a few simple tips can make the process seamless and keep you protected the whole way through.

• Enroll Before your Current Plan Ends — Don’t wait until the last minute. Submitting your new application early ensures your Ambetter Health coverage starts the day your old plan ends, so you won’t face a gap in care.
• Track Key Deadlines and Stay Organized — Your SEP has firm start and end dates. Mark them on your calendar and set reminders so you won’t miss your window to switch. Staying proactive now saves stress later.
• Gather Your Important Information in Advance — Have your income details, household information and list of prescriptions ready before you start comparing plans. This makes the application process faster and ensures you choose coverage that matches your health and budget needs.

Compare Health Plans and Get Covered Today with Ambetter Health

The Marketplace offers many choices, but not all plans are the same. Ambetter Health makes it easy to compare health insurance plans and find one that fits your needs.

Frequently Asked Questions