Health Insurance

Guide to Health Insurance Open Enrollment

It’s important to know when your open enrollment period is, as you may be required to switch health plans or renew them.

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If you’re in need of health insurance, you may need to participate in an open enrollment period in order to obtain it. It’s important to know when your open enrollment period is, and what to expect during that period.

What Is Open Enrollment?

Open enrollment is a window of time in the year where you can sign up, end, or change your health insurance plan. There are different open enrollment periods for those who are looking for individual health insurance and Medicare plans.

For Medicare applicants, open enrollment is between October 15 to December 7.

Health Insurance Marketplace plans and individual plans open from November 1 to December 15.

Health Insurance Marketplace

The health insurance marketplace, also known as the “marketplace” or “exchange”, is a place (online and in-person) for individuals to purchase private health insurance for themselves. The marketplace may offer ACA-compliant health insurance plans and income-based subsidies to make an individual’s health coverage more affordable. In the marketplace, you may compare plans with various health insurance companies to see which is the most suitable and affordable for you and your family.

Outside of the open enrollment period, you may not be able to use the health insurance marketplace unless you qualify for a special enrollment period.

Employer-sponsored Insurance

Health insurance offered by your employer is known as an employer-sponsored health insurance plan. Your employer may choose to change health plans at any time of the year.

The difference between an employer-sponsored health plan and the health insurance marketplace is that your employer offers only a select few health plans that you may choose from. However, your employer pays a part of your health premiums. With a health insurance marketplace plan, you may have to pay the entire health insurance premium.

Why Does Open Enrollment Exist?

Open enrollment exists to discourage adverse selection. Without open enrollment, individuals may choose to only get health insurance when they need it most. For example, only purchasing health insurance when you’re sick.

Adverse selection is bad because if only sick people purchase health insurance, health insurance companies may not be able to afford to pay everyone’s claims. If adverse selection were to happen, there would be fewer and more expensive health plans as well.

In order for health insurance companies to stay in business, they need enough premiums to pay for claims. To prevent health insurance companies from going out of business, the Affordable Care Act made it mandatory for everyone to have health insurance.

When Is The Health Insurance Open Enrollment Period?

The annual open enrollment period for 2023 is open between November 1 to December 15, 2022. Your new plan for 2023 may begin on January 1, 2023.

How Long Is Open Enrollment?

Open enrollment for individual plans lasts for 45 days, beginning on November 1 through December 15.

If you have a health plan through your employer, the open enrollment period may be two-to-4 weeks.

Depending on your employer, the dates may vary for when your open enrollment is. You may clarify the dates with your Human Resources department.

When Is The Medicare Open Enrollment Period?

Medicare’s open enrollment period opens on October 15 and ends on December 7. You may join or switch over to a new health plan at any point during this period.

If you missed your initial enrollment period for Medicare, you may qualify for a special enrollment period. Bear in mind that you may be penalized up to 10% of future premiums for the years you were not signed up for Medicare after the age of 65.

Is There Open Enrollment for Dental or Vision Insurance?

There is no open enrollment for dental and vision insurance. Therefore, you may purchase, cancel, or change your dental and vision insurance year-round.

To enroll in dental or vision insurance, you may apply online, in person, or through the phone with a health insurance provider.

What Types of Insurance Do Not Have Open Enrollment?

There are health insurance plans that do not have an open enrollment period. You may apply for these types of insurance at any time of the year, if applicable:

Short-term Health Insurance

Short-term health insurance provides temporary and emergency coverage for those who change jobs, are waiting for the annual enrollment period to enroll again, and for other individuals who may have a gap in their health insurance.

When enrolling in a short-term health plan, you may choose the type of plan and how much your deductible is. Deductibles may range from $2,500 to $15,000.

Medicaid

Medicaid is a federal health program for low-income families and individuals. You may enroll in Medicaid through the health insurance marketplace or with your state’s Medicaid agency.

When applying, the state may look at your age, income level, if you’re pregnant or disabled, and the number of people in your family.

CHIP

Children’s Health Insurance Program (CHIP) is a federal and state healthcare program designed to provide children with routine check-ups, dental care, and immunizations.

You may enroll a child in CHIP through the health insurance marketplace or through your state’s Medicaid agency.

Travel Insurance

Travel insurance pays for emergency medical events during a trip, such as prescriptions, ambulance services, and hospital charges. Travel insurance may be purchased as a medical standalone plan or as part of a travel insurance package.

Are There Exceptions To Open Enrollment?

In the case that you missed the window to sign up for health insurance during open enrollment, you may still have the chance to enroll if you qualify for a special enrollment period.

What Is a Special Enrollment Period?

A special enrollment period (SEP) allows individuals to apply for health insurance outside of the annual enrollment period. To qualify for special enrollment, you may have to meet certain qualifying life events.

With qualifying life events happening outside of the normal enrollment period, insurers may allow you to change your health plan to ensure that you’re protected. Certain changes may lead you to be disqualified from your current health plan. You may qualify for a special enrollment and can apply within 30 to 60 days of the event if you experience:

  • Changes in your household
  • Changes in your employment and finances
  • Changes in location
  • Changes in age
  • Changes in your current health insurance