The Open Enrollment Period (OEP) is a yearly window when individuals can enroll in Affordable Care Act (ACA) plans. Generally, it runs from November 1 to January 15, but some states set different dates.

The OEP is an important time of year for uninsured people and those with existing health insurance. It provides an opportunity to review your insurance needs and take actions like:

Enrolling in a health plan
Renewing your existing plan
Changing to a different plan
Updating your plan

However, not all health insurance changes are allowed during the OEP. It’s not a time to sign up for Medicare, for instance. Read on to learn more about how the OEP works and whether it’s a period you can use.

How Does The Open Enrollment Period (OEP) Work?

Generally, the OEP is the only time a person can enroll in an ACA health plan during the year, unless they experience a qualifying life event that allows them to register outside of the OEP, such as getting married or losing employer-based health insurance.

ACA plans are sold through the federal Health Insurance Marketplace or state-run Marketplaces, as well as through insurance companies, individual agents, and brokers.

When Is OEP?

The OEP generally runs from November 1 to January 15. However, the exact dates can vary from year to year based on rules set by the federal government.

Some states also set different date ranges for the OEP, so the window may start earlier or end later. To learn about OEP dates in your area, contact your state’s Department of Insurance or a licensed insurance agent for more help.

What Types of Healthcare Plans Are Available?

During the OEP, consumers can sign up for various ACA-compliant individual or family health insurance plans. ACA-compliant means the plan follows rules set by the ACA, such as covering people with pre-existing conditions and including essential health benefits.

ACA plans are available in 4 metal levels:

Bronze
Silver
Gold
Platinum

These levels describe how the insurer and plan member share healthcare costs. It does not indicate quality of care. Lower metal levels typically result in lower monthly premiums but higher care costs, while higher metal levels have higher premiums but lower costs when you get care.

Consumers also have a choice of various network types, including Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Exclusive Provider Organizations (EPOs). The network type affects the providers and facilities a plan member can use.

Who Can Participate In OEP?

Consumers can participate in the OEP if they need health insurance coverage and meet the following eligibility requirements:

Live in the United States: People considered U.S. residents for tax purposes meet this requirement.
Be a U.S. citizen, national, or lawfully present immigrant: Eligible immigration statuses include Green Card holders and refugees.
Not be incarcerated: People serving time in prison or jail become eligible when they’re released.
Not have Medicare coverage: People cannot enroll in a Marketplace plan if they already have Medicare.

What You Can Do During Open Enrollment

Open enrollment for ACA health plans is a time to make a variety of changes, including:

Enrolling in Marketplace coverage: New consumers, including currently uninsured people, can enroll in a plan during the OEP.
Renewing your existing plan: Returning consumers satisfied with their current plan can renew it for another year, so long as it’s still available.
Changing to a different plan: Consumers can switch to another health insurance plan for any reason.
Updating your plan: The OEP offers an opportunity to update income and family information, which is used to calculate subsidies for the next year.

What You Cannot Do During Open Enrollment

Some actions cannot be performed during the OEP, including:

Enrolling in a Marketplace dental plan without buying a health plan. Marketplace rules state that dental plans are only available to people who already have or are buying a health plan.
Enrolling in a plan when you are not eligible. Not all plans are available in all counties, even during the OEP.
Enrolling in plans not covered by the OEP. Some kinds of insurance are unavailable during the OEP but can be purchased at other times.

What Kinds Of Insurance Are Not Available During OEP?

The OEP for ACA health plans, like those sold in the Marketplace, does not apply to all types of health insurance. Here’s a look at some common plan types that do not fall under the OEP, which means you can enroll in them at any time of the year instead of waiting for the OEP.

Short-Term Health Insurance

Short-term health insurance is temporary, limited coverage for people without health insurance. They generally can last up to 364 days, though some plans allow policyholders to renew for up to 36 months of coverage.

These plans are not considered qualified health plans under the ACA, which means they do not need to meet the ACA’s requirements for comprehensive coverage. Eligible consumers can enroll in a short-term health plan at any other time of year.

Medicaid

Medicaid is a government program that provides health insurance to certain people with low incomes, including families, pregnant people, people with disabilities, and seniors.

The program is designed to make healthcare more accessible, so it does not use a set open enrollment period. Eligible people can apply for Medicaid at any time of year.

Medicare

Medicare is a government program that provides health insurance to people 65 and older, as well as people with disabilities, End-Stage Renal Disease, and ALS. It does not use the ACA’s OEP. That’s because Medicare has its own enrollment periods.

Medicare offers an Initial Enrollment Period for newly eligible beneficiaries and an Annual Enrollment Period for current beneficiaries that runs from October 15 through December 7 each year.

Dental and Vision

Dental and vision plans are optional insurance that supplement a person’s existing health insurance plan. There are stand-alone dental plans in the Marketplace, but they do not have their own OEP. However, note that they can only be purchased if you already have a qualifying health plan or if you are buying an ACA-compliant plan at the same time.

Depending on your existing coverage, this may mean that dental and vision insurance may still be tied to the OEP. But if you already have qualifying health coverage through private insurance or an employer-sponsored health plan, you can purchase dental and vision plans year-round.

Is OEP The Only Time To Enroll In Health Insurance?

The OEP is typically the only time each year when consumers can enroll in ACA plans. However, some people are eligible for a Special Enrollment Period to enroll in coverage outside of the OEP. A Special Enrollment Period is triggered by various life events, such as:

Losing other health coverage
Getting married
Having a baby
Moving to a new ZIP code
Leaving jail or prison

During their Special Enrollment Period, consumers can enroll in or change ACA health plans, including adding a spouse or dependent to their existing coverage. Certain restrictions may apply, such as needing to select a new plan in the same tier as the old plan.

How To Prepare For OEP

If you plan to enroll in or change coverage during the next OEP, try the following tips to prepare for a successful application process.

Confirm the OEP dates: The time frame can vary slightly depending on the year and your state.
Review your current plan: Assess whether or not the plan’s costs and coverages still meet your needs.
Research available plans: If you plan to switch plans during the OEP, compare other plans for sale in your area.
Gather documentation: Be ready to provide your Social Security Number, estimated household income, and details about any other health insurance you have.
Get professional help: Consider talking to a trusted agent for help comparing plans and preparing to enroll.

How To Enroll in OEP

Access the Marketplace. Many states use the Healthcare.gov platform, but some run their own Marketplaces. Consumers can also apply by phone, on paper, or through a trusted agent or broker.
Select a health insurance plan. Browse plans and estimated prices, and choose the right option for your needs. Working with an agent or broker can also help you narrow your options.
Complete the application forms. Start the application, and be ready to provide information about your annual income and family size.
Activate the coverage. Pay the first premium to complete the enrollment process.

What If You Miss Open Enrollment?

Depending on their circumstances, people who miss the OEP may be eligible to enroll later in the year. For example, certain life changes can trigger a Special Enrollment Period to enroll in or change coverage.

Other health insurance options may be available to people who miss the OEP and are not eligible for a SEP. Look into government plans like Medicaid or consider enrolling in a short-term plan to bridge the gap until the next OEP.

In some states, uninsured people may be penalized when they file their tax returns. For example, an adult who is uninsured all year in California could pay $900 or more. Beyond any penalties applied by their state, uninsured people also face potentially high healthcare bills if they get sick or injured and must pay for care entirely out of pocket.

Putting It All Together

For people who do not have health insurance or who want a plan that better suits their needs, the Open Enrollment Period is an opportunity to sign up for an ACA health plan.

Other types of health insurance, like Medicare and employer-sponsored plans, have their own open enrollment periods. Some options, including Medicaid, do not use open enrollment and are available year-round.

For help choosing a suitable health insurance option and to learn when you can enroll, work with a trusted agent or licensed broker.

Frequently Asked Questions

The OEP for Marketplace coverage does not apply to employer-sponsored health plans. These plans are offered by companies to their employees as a workplace benefit. The time frame to enroll varies from one company to another.

Often, open enrollment for employer-sponsored plans takes place during the fall. The enrollment window typically lasts at least two to four weeks, depending on the company.

The eligibility for enrollment periods also varies from company to company. Some companies extend health insurance to part-time employees, while others do not. Eligible dependents may include a spouse, domestic partner, or children.

A common myth is that insured people do not need to do anything during the OEP. The truth is that everyone should review their plan each year to ensure it’s still a good fit and switch if necessary.

Another common misconception is that open enrollment is complicated. In fact, there are many resources to help consumers choose and enroll in plans, including benefits navigators and insurance agents.

Since navigating health insurance in a second language can be challenging, Marketplace shoppers have the right to get no-cost assistance in their own language. The Marketplace Call Center offers interpreters for languages like Spanish, Chinese, and Tagalog.

People with disabilities also have the option to request open enrollment information in an accessible format, such as audio, braille, or large print.

Guide to Health Insurance Open Enrollment

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