What is Open Enrollment Period for Health Insurance?

You may have heard about Open Enrollment, but it's time to understand what it is.
What is Open Enrollment Period for Health Insurance?

Fall signifies several key events, like football season, the start of the holiday season, and open enrollment season. Open enrollment is an important time of year for anyone who needs to sign up for health coverage. By knowing what to expect from open enrollment, you can prepare yourself to find a health insurance plan that meets your needs.

What Is the Open Enrollment Period?

The open enrollment period is the time of the year when you can sign up for a new health plan. This particularly applies to health insurance plans purchased through the Health Insurance Marketplace created by the Affordable Care Act, but other insurance programs have enrollment periods as well.

If you want to signup for a new plan or switch to a different plan, open enrollment is the time to do so. If you want to keep your current Obamacare plan, you may be automatically enrolled, but you should still use the open enrollment period to update your application and review your current plan’s offerings.

What Happens During the Open Enrollment Period?

During the annual open enrollment period, you have the opportunity to shop and sign up for a healthcare plan. Open enrollment is the chance to study your options and discover which plans fit your lifestyle best. You can explore the Obamacare plans that are available to you in several ways.

The most convenient way to find health insurance is to look online. A reputable health insurance comparison website will instantly show you what options are available in your area. Your other online option is to check through the health insurance marketplace.

A simple phone call with an experienced agent, broker or navigator can also give you the help you need. They will be able to answer all of your questions in real time and help guide you along the way. Call (858) 239-2886 for help finding the right plan for you. If you are more comfortable with talking face to face, you can also schedule an in-person appointment with your health insurance representative.

Once you have considered the options that are available to you, it is time to apply for coverage. You can select a plan and fill out the coverage application. If you qualify for government subsidies to help cover the cost of your plan, you can select how much of your allotment you would like to apply toward your premiums each month. Applications can be made in the following ways:

  • On the federal healthcare website or your state’s website.
  • Over the phone.
  • By mail.
  • With the help of an agent or a broker. Fees and premiums are not higher if you opt for this service.

When Is Open Enrollment?

To sign up for an Obamacare plan through the federal Marketplace or your state’s exchange, the enrollment period is typically November 1 through January 15. Affordable Care Act plans selected during this period go into effect on February 1. However, these deadlines can vary by state, so it is important that you check your state’s specific deadlines.

This enrollment period also applies to individual plans that are offered outside of the Marketplace but still meet the Affordable Care Act’s guidelines for essential minimum coverage. If you do not qualify for subsidies, you may want to consider a plan outside the Marketplace. Other types of plans have different enrollment periods:

  • Medicare: October 15-December 7.
  • Medicaid: Enrollment is year-round.
  • Employer-sponsored plans: Usually in the fall, but exact dates vary among employers.

Are There Exceptions to the Open Enrollment Period?

If you have a major life event during the year, you will be able to sign up for a plan within a set time period after that event. For Obamacare plans, this period is 60 days, but some separate insurance plans offer shorter windows. This is called a Special Enrollment Period. To qualify, you must have a major life change, such as any of the following Qualifying Life Events:

  • Losing coverage on your parents’ plan when you turn 26 years of age.
  • Getting married.
  • Getting divorced.
  • Having a baby.
  • Adopting a child.
  • Losing a job.
  • Moving to a new place.
  • Being released from jail or prison.

What If I Miss Open Enrollment?

It is important to sign up during open enrollment or you risk missing out on health insurance coverage. Not only will you be uninsured, but depending on your state, you could also face penalties for not carrying health insurance. Some states have put in place health insurance mandates in recent years, and missing open enrollment could put you at risk for paying the fines that come with not having insurance. Even if you do not live in a state with a health insurance mandate, going without health insurance could be risky.

If you do miss the enrollment window, you may qualify for a special enrollment period that would give you the opportunity to sign up for insurance. If not, consider one of the following options:

  • Sign up for short-term or catastrophic coverage. You can still be fined for not having insurance, depending on your state, but you may be covered if something major happens to you or your family members.
  • Look into whether you qualify for Medicaid.

If you miss out on signing up for a Marketplace plan during Open Enrollment, you can still qualify for one next year, or compare your options in the private sector which may surprise you. However, health coverage is important for keeping you protected against unforeseen circumstances, so be sure to sign up on time and avoid any headaches.

Start Preparing for Open Enrollment

Knowing when open enrollment is and understanding how it works helps you get a step ahead. By exploring your options and researching plans before the open enrollment period starts, you can make sure you find the right health insurance coverage without missing your chance to sign up.

Comparing health insurance plans and finding the right one for you can be tricky. Fortunately, Coverage Guru makes it easy, allowing you to generate quotes and compare health insurance plans both during the open enrollment period and before it even starts. Start comparing plans today!

Frequently Asked Questions

What Is the Purpose of Open Enrollment?

The presence of an open enrollment period helps to regulate the health insurance market and keep prices low for all participants. Reducing enrollment in health insurance plans to a specified period prevents consumers from buying health plans only when they are sick. If individuals were able to sign up for a health insurance plan whenever, insurance companies would spend more money on care and monthly premiums would skyrocket.

What Is the Difference Between Open and Annual Enrollment?

Open enrollment is the time when individuals without health insurance plans can explore new plans and sign up for one that works. Annual enrollment is more important to individuals who are already covered under an employer-sponsored, or other health insurance plan. Annual enrollment allows participants to make changes in their coverage or add new members without issue.

What Types of Insurance Use Open Enrollment?

Most types of comprehensive insurance use an open enrollment period. Healthcare marketplace plans, Medicare, employers, and private insurers all provide an open enrollment period, although they each follow different dates. Following an open enrollment period allows these insurers to keep their rates low for members by preventing anyone from signing up for insurance at any time.

What Types of Insurance Don’t Use Open Enrollment?

Less-comprehensive insurance plans do not use an open enrollment period. For example, you can sign up for a dental or vision plan at any point during the year. Plans that are used more for providing urgent or situational coverage also do not use open enrollment.

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