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Can I get out of my work health insurance plan? Consumer Q&A

By on September 7th, 2012
Filed: Advice, Consumers, Employee Benefits, Health Insurance, You

Did you ever have something you desperately wanted to get rid of but couldn’t find a way to do it? -It might even be a good thing, but maybe you’ve reached a point where paying for it just doesn’t make sense anymore. In fact, it could be hurting you financially.

If you bought a house between 2004 and 2008, maybe you can relate. But in rare cases this situation can arise with regards to health insurance too, particularly employer-sponsored health insurance.

Recently on Yahoo Answers we took a question from a young woman in dire straits. She’s employed, but doesn’t earn enough to make ends meet. One of the things hurting her most is the money taken from her paycheck for her employer-based health insurance. If she could just get out of her health insurance plan (she could maybe buy individual coverage on her own), she might make it. Otherwise, she says, she may end up homeless.

The trouble is, her employer says they can’t drop her coverage mid-year. Is that right? Can’t you get out of an employer-based health insurance contract mid-year?

The eHealthInsurance reply was voted Best Answer:

You don’t actually have a ‘contract’ for health insurance, your employer does, but they’re right. They may not be able to drop your coverage before the annual enrollment period. The only cases in which it is allowed is when 1) you leave your job for one reason or another, or 2) when you switch from full-time to part-time work. Since neither of these apply in your case, I’m afraid you’re stuck with health insurance. It’s a strange thing to say: ‘stuck with health insurance,’ but it really sounds like you’re in a tough spot.

Best wishes.

Image from Flickr user DorkyMum


About Douglas Dalrymple

Doug Dalrymple is a member of the communications team at eHealth, Inc. and has worked in the health insurance and technology industries for fifteen years. He works on communications strategy, content creation and management, project management, and corporate messaging.

2 Comments Add Your Comment

Lorraine on Thursday, May 23 @ 7:36 am

I am in this same situation where I am stuck with my company health insurance and didn’t even want it to begin with but since you have to opt out within a certain period of time or you are automatically signed on. I was unable to even look at the plan from my provided sites and the next thing I know the deductions are taken out of my paycheck. I am still covered by my husbands insurance but now have yet another deduction from my paycheck. I asked if I could cancel coverage and was told not until next January. Well, went to the doctors the other day and had to use my insurance since it is now my primary ins. They rejected my claim stating that it was pre-existing. So now I have to pay for this insurance that I can’t even use because everything is going to be pre-existing! Total bunch of BS.

Sheila Jewell on Saturday, February 21 @ 2:49 pm

I have a problem with my employer. They offer a self funded health insurance plan thru United Healthcare which I enrolled myself and my transgender son in, (who is 19). I wasn’t even aware of what “self funded” was and did not find out until Dec. after I called UHC to see if they covered GRS. However, once the rep told me the plan was “self funded” which meant it doesn’t have to follow state mandates for coverage, I was upset. I asked my HR Rep at work to contact Corporate & expain the situation and ask if they could please either add GRS to the policy or have him removed, since this insurance does not benefit him, as it will not cover any of his hormone treatment or surgery. The HR Rep locally said she contacted the corporate office (of my employer) located in TN, and they refused to add on GRS (gender reassignment surgery) to the policy and said they don’t have to since it’s self funded.. I understand that, and was hoping they could take him off of my plan, but they won’t remove him & I’m still paying for him to be on this plan. I want to purchase individual policy for him outside of work and can’t do this unless they remove him from the plan as this causes issues with insurances. If you have any advice or point me in the right direction as to how I can get help, please let me know. I’m located in Boston, MA.. Thanks, Sheila

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