We’ve had a few applicants say, “I was approved for the wrong plan. There must have been a mistake!” Often, when this happens it is not due to a processing error, but rather is the result of the decision of an underwriter. It’s possible that this customer didn’t qualify for the plan they requested. Rather than simply denying the application, the underwriter gives the applicant the option to get individual health insurance coverage on a different plan. 

Why does this happen?
This usually happens when a customer applies for a plan that has rich coverage in an area where the customer has historically had high usage of healthcare. For example, if an applicant was getting $450 worth of prescription drugs a month, they would most likely be denied coverage on an individual and family plan. However, if this client was generally healthy and the RX usage was the only big issue, an underwriter might offer the client coverage under the $50 Copayment Plan which doesn’t cover prescriptions. In such cases the applicant is usually disappointed that she is unable to lower her monthly prescription drug bills, but she is grateful that she can at least get covered on some type of medical insurance plan. 

Can I switch plans?
In such cases where an applicant is denied coverage on the plan he selected and offered another plan, this customer cannot “switch” plans.   

How do I know if I was “moved to a different plan”?
This is important to know because if there was a processing error, you can switch to another plan, but if you’ve been moved to another plan by an underwriter on purpose, then you can not change plans. To find out if you have been moved, you will need to Sign In to your online application. Once you’re in your account, if it says “moved to different plan,” this means that you did not qualify for the one you selected. If you want to contest this decision, there should be instructions on the KP notification. If it does not say “moved to a different plan,” it could have been a mistake. In this case, you will need to use the Change Plans Form or contact Member Services to switch plans.