Jessica Fox Last Updated On: August 14, 2023

Everything You Need to Know For Open Enrollment Health Insurance

You’re living in the US and you’re trying to get a handle on health insurance. You’re hearing a lot of terms being thrown around, like ACA, COBRA, and CHIP. You’re getting confused and frustrated. 

Fair enough. 

Now take a deep breath. While all these terms are important to know about, the first and most crucial concept with which you should become familiar is that of open enrollment. The reason is simple: it’s during this time that you can actually access many types of health insurance. 

What Is Health Insurance Open Enrollment?

Open enrollment for health insurance is a certain period in which you can enroll in or make changes to your healthcare plan. The length of the enrollment period varies by state and insurance type but typically occurs from November 1 to December 15 for plans effective on the following January 1.

You can make changes to your current healthcare plan or enroll in a new plan during this period for the following types of health insurance:

  • Medicare
  • Health insurance from your employer
  • Individual market health insurance (that you purchase yourself)

If you miss open enrollment, you generally have to wait until the next open enrollment. Bummer, right? Well, don’t lose hope: there may be a loophole. Just keep reading.

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The Benefits of Open Enrollment Health Insurance

While it might be frustrating to be limited to six weeks each year to change or enroll in health insurance plans, there are a few key benefits to this system.
  • You have the opportunity to change your plan every year until you find one that works for you or your changing situation.
  • If you’re eligible for health insurance, the plan can’t deny you during open enrollment.
  • It ensures you get health insurance coverage in a timely manner—typically by January 1 of the following year if you enrolled in October to December.

Special Enrollment: Enroll in Health Insurance Now

Here’s that loophole we spoke of earlier. If you did miss open enrollment, there are certain qualifying life events that allow special enrollment outside of the open enrollment period. Some of these qualifying life events include:

  • Losing health insurance unexpectedly or involuntarily, such as losing your job, expired Consolidated Omnibus Budget Reconciliation Act (COBRA) insurance, a divorce, and more
  • Moving out of your current health insurance plan’s service area
  • Getting married
  • A new baby or an adopted child
  • You no longer qualify for a parent’s plan due to age

While this list isn’t exhaustive, it shows the type of qualifying events that would require you to unexpectedly be out of health insurance and require new coverage. It’s important to note that cancelling your own health insurance or not paying premiums and voiding the policy wouldn’t make the cut for special enrollment.

Special enrollment generally lasts for 60 days after the qualifying event, which gives you time to shop for a new plan, compare plans, and enroll. The good news is you have access to the same plans you would during open enrollment.

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When Health Insurance Open Enrollment Doesn’t Apply?

Open enrollment doesn’t apply to all types of health insurance, so it’s important to know what you’re looking for.

The following categories don’t have an open enrollment period:

  • Medicaid
  • CHIP (Children’s Health Insurance Program)
  • Travel insurance
  • Short-term health plans
  • Supplemental insurance policies for individual plans

If any of these types of health insurance are what you’re looking for, you’re in luck: You don’t have to wait for open enrollment or special enrollment to enroll in these plans.

How to Enroll For Health Insurance Outside of These Periods?

If you missed the open enrollment period but don’t qualify for special enrollment, you may want to consider choosing a short-term health plan. This allows you to get the health insurance you need until the next open enrollment period. While it may be more expensive than long-term plans, at least you’ll have health insurance coverage in the meantime and won’t have to pay-out-of-pocket for potentially financially devastating medical emergencies.

Final Thoughts on Health Insurance Open Enrollment

Health insurance open enrollment is designed to encourage people to enroll in healthcare insurance before they need it, so that everyone has affordable coverage if something happens. Whether you are looking to enroll in a new healthcare plan, looking to opt-out of an employer’s healthcare plan, or simply need to make changes to your current plan, open enrollment is the time to do so. 

Make sure you know the open enrollment dates that apply to you so that you don’t have to wait until the following year for your healthcare coverage needs.

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Open enrollment for health insurance is a specific period in which you’re able to enrol in a health insurance plan or make changes to your existing one. It applies to Medicare, private health insurance, and employer-provided health insurance.
It varies by state and type of insurance, but generally open enrollment lasts six weeks from November to mid-December, for insurance plans taking effect January 1st of the following year.
There is a special enrollment period for health insurance option that will allow application but there are certain qualifications which must be met. Like marriage, birth of a child, job change or a move.

Special enrollment is designed for those who’ve experienced a qualifying life event that interrupts their health insurance coverage and causes them to need a change in health insurance. This includes a divorce, job loss, a new child, aging out of a current plan, and more.

Contact your current insurance provider or your potential new provider to find out if you qualify for special enrollment. Or, contact us for a free quote and we’ll help you find the best provider for you.

The open enrollment for health insurance is from November 1 to Dec 15th in 37 states. Fifteen states have extended their enrollment period to January 31st for coverage in 2022.



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