What to Know about Insurance 

Coverage Cancellation 

What’s a coverage notice?

Individual health insurance is usually sold as a 12-month contract between you and an insurance company. 

At the end of the contract period, the insurance company may send you a notice stating that it’s choosing 

either to discontinue (cancel) or renew the coverage, possibly with some changes. Some of the changes are 

made to meet federal and state requirements. Thousands of people get these notices every year.

Most health plans sold to individuals and families must cover a minimum set of essential health benefits and 

provide certain consumer protections.

What are health insurance companies required to do?

Under the Health Insurance Portability and Accountability Act (HIPAA), a law in place before the Affordable 

Care Act was passed, individual plans are generally “guaranteed renewable” at the end of the 12-month 

contract, although the health insurance company that offers them can increase premiums, increase costsharing, and/or reduce the scope of benefits covered. The health insurance 

company may stop offering the plan entirely if it takes these actions:

n Provide at least 90 days notice in writing to each covered 

individual.

n Offer each covered individual the option to buy any other 

individual plan it offers to individuals in that market.

n Treat all covered individuals the same, regardless of 

health status.

n Follow any additional state requirements.

The only time a health insurance company can cancel your 

coverage without offering you the chance to buy a new 

plan is if it cancels all its health insurance in a state’s 

individual market. If it stops all coverage, it can’t offer 

coverage in that state’s individual market again for 5 

years. It also must notify the state and all policyholders of its 

decision in writing at least 180 days before stopping coverage.
If your health insurance company gives you the option to renew your coverage in a plan that doesn’t include 

the minimum set of essential health benefits and certain consumer protections, it must send you a letter 

notifying you of this option. Your health insurance company may be able to give you this option even if it 

already told you that your plan’s being cancelled.

If you’re concerned your health insurance company isn’t following these requirements, contact your State 

Department of Insurance.

What are health insurance companies not allowed to do?

Health insurance companies can’t market in a way that discourages people with significant health needs 

from enrolling in their plans. A health insurance company might violate this requirement if it provides 

renewal notices that discourage certain enrollees from buying particular products (like individual plans 

that cover a minimum set of essential health benefits and provide certain consumer protections, including 

qualified health plans in the Marketplace).

How can I find health coverage?

You have rights and benefits to help you get the health coverage you need. You have the right to buy any 

other individual plan offered by your health insurance company that you’re eligible for, or by any other insurer 

offering plans either through the Marketplace or outside the Marketplace. Visit HealthCare.gov or 

call the Marketplace Call Center at 1-800-318-2596 for more information. TTY users should call 1-855-889-4325.

All Marketplace health plans cover the same core set of essential health benefits. You can compare plans 

based on price, benefits, and other features before you make a choice.

If you got a cancellation notice from your health insurance company, you have several options:

n Buy one of the plans the company offers in its place. The health insurance company must allow you to 

buy any of its other plans available to you.

n Apply for new coverage through the Marketplace. Visit HealthCare.gov/lower-costs/qualifying-forlower-costs/ to learn more about qualifying for lower costs on monthly premiums and out-of-pocket 

costs based on your income. All Marketplace plans include the new rights and protections.

n Buy a plan outside the Marketplace. Visit HealthCare.gov/apply-and-enroll/income-too-high-for-taxcredit/ to see how you can get covered if you don’t qualify for lower costs based on your income. 

Most plans outside the Marketplace include the new rights and protections.

Additional option if your plan is cancelled: a Catastrophic plan

If your plan has been cancelled and you can’t afford a Marketplace plan to replace it, you can apply for a 

hardship exemption. This may allow you to buy a Catastrophic plan, which is generally available for people 
under 30, and for people who qualify for a hardship exemption. A Catastrophic plan generally requires you 

to pay all of your medical costs up to a certain amount, usually several thousand dollars. These policies 

usually have lower premiums than a comprehensive plan, but cover you only if you need a lot of care. They 

basically protect you from worst-case scenarios. Visit HealthCare.gov/fees-exemptions/ to learn more about 

applying for a hardship exemption. For more information about Catastrophic plans, visit HealthCare.gov/

choose-a-plan/catastrophic-plans/.

How to get a Catastrophic plan

n Call 1-866-837-0677, a special phone number for people whose plans have been cancelled, 

9 a.m. – 7 p.m. (ET) Monday through Friday. The hotline will operate Saturday and Sunday from 

9 a.m. – 5 p.m. through January. Hotline operators can help you understand your options. If you want to 

buy a Catastrophic plan, they can provide information, plan options, and contact numbers.

n Visit HealthCare.gov/catastrophic-plan-information/ to download and fill out an application for a 

hardship exemption. Provide this application to an insurance company selling Catastrophic plans 

to show that you qualify to buy one. Be sure to include a copy of your cancellation notice. The 

insurance company will send the application to the Marketplace. We’ll confirm that you’re eligible for 

a hardship exemption later, but you can buy a Catastrophic plan right now. 

Note: When you fill out the form, be sure to answer that #13 is your reason for applying — that your 

individual policy has been cancelled and you feel you can’t afford coverage in the Marketplace.

n See a list of Catastrophic plans available in your area by visiting HealthCare.gov/catastrophic-planinformation/. The list includes plan and company names and contact information. You can call the 

insurance companies directly to buy a Catastrophic plan.

What if my health insurance company enrolled me in a new plan?

If your plan was cancelled and your health insurance company already enrolled you in a new plan, you can 

still switch to a Marketplace plan or a plan offered outside the Marketplace during Open Enrollment, from 

November 1, 2015 – January 31, 2016. If your plan is cancelled on or after February 1, you generally have 

60 days to enroll in a Marketplace plan or a plan offered outside the Marketplace.

Remember, if you buy a plan through the Marketplace, you may qualify for lower monthly premiums and 

out-of-pocket costs based on your household income and family size. If you buy health insurance outside 

the Marketplace, you won’t get these savings.

You can find out what you might qualify for through the Marketplace before you decide whether to enroll 

in the plan recommended by your health insurance company. You do this by filling out a Marketplace 
application. If you have an individual insurance plan and want to be considered for lower costs, when you 

get to the part of the application asking about any existing coverage, be sure to check the box that says 

“Individual insurance (non-group coverage).” Don’t check the box for other types of coverage unless you 

have that, too. This way, the Marketplace can make sure you get the lowest possible costs.

How can I learn more?

If you got a cancellation notice from your health insurance company and want additional information about 

your options, you can:

n Visit HealthCare.gov. 

n Contact the Marketplace Call Center at 1-800-318-2596. TTY users should call 1-855-889-4325. The call 

center is available 24/7 and a representative can help you complete the entire application process from 

beginning to end with information you provide over the phone, including reviewing your options and 

helping you enroll in a plan. We can also help to answer questions as you apply and enroll on your own. 

n Call 1-866-837-0677. This hotline is dedicated to consumers with cancelled policies. A representative 

will help you find coverage. They can explain the options available for replacing or renewing a cancelled 

plan. You can call from 9 a.m. – 7 p.m. (ET) Monday through Friday. The hotline will operate Saturday and 

Sunday from 9 a.m. – 5 p.m. through January.

CMS Product No. 11756

Revised October 2015