Open enrollment is a period of time each year when you can sign up for health insurance. If you don’t sign up for health insurance during open enrollment, you probably can’t sign up for health insurance until the next open enrollment period, unless you experience a qualifying event.
If you’re eligible and apply for health insurance during open enrollment, the health plan must insure you. The company is not allowed to use underwriting or require evidence of insurability, both of which could make it harder for you to get health insurance.
What Health Insurance Sources Use Open Enrollment Periods?
Open enrollment periods are common and in place for:
When Is Open Enrollment?
The time of year for open enrollment depends on the health care plan you choose:
- Medicare open enrollment runs from October 15 to December 7 each year. Note that this does NOT apply to Medigap plans, which don’t have an annual open enrollment period. Medigap plans are only available without medical underwriting during your initial enrollment period, or during one of the very limited special enrollment periods that apply to those plans.
- Job-based health insurance open enrollment periods are set by your employer and can happen at any time of the year. However, it’s usually in autumn so the new coverage begins on January 1 of the next year.
- Open enrollment in the individual market (on and off-exchange) has varied considerably over the last few years. Starting with 2018 coverage, the open enrollment schedule has settled at November 1 to December 15, with all plans effective January 1 of the coming year. So open enrollment for 2018 coverage began November 1, 2017 and ended December 15, 2017 (with extensions in ten states that operate their own exchanges). This is the same time frame that is scheduled to be used for future years as well. Open enrollment for 2018 marked the first time that enrollment ended before the start of the new year, and plan selections cannot be made after the year begins (prior to 2014, enrollment was available year-round in the individual market, but in most states insurers determined eligibility based on applicants’ medical history, which meant people with pre-existing conditions could be denied coverage; that no longer happens, thanks to the ACA). Learn more about open enrollment in the individual market.
Special Enrollment Is the Exception to Open Enrollment
Insurance plans that use an open enrollment system also have an exception that allows you to enroll outside of open enrollment under extenuating circumstances, frequently called life events. Known as a special enrollment period, this exception allows you to sign up for health insurance if you lost your other health insurance because you:
- lost your job
- got divorced or married
- became a widow or widower
- aged off of a parent’s plan
- let COBRA insurance expired
- have a new baby
You won’t be eligible for a special enrollment period if you lost your other health insurance because you didn’t pay the monthly premiums, though, or if you voluntarily canceled your prior coverage.
Note that although qualifying events and special enrollment periods in the individual market are similar to those that have long existed for employer-sponsored plans, they are not identical. Here’s a guide that pertains specifically to special enrollment periods in the individual market, on and off-exchange.
What Types of Health Insurance Don’t Use Open Enrollment?
Most health insurers in the United States use some sort of open enrollment program that limits sign-ups to a particular time each year. Here are some exceptions:
- Medicaid, the state-based health insurance, doesn’t limit enrollments to an open enrollment period. If you qualify for Medicaid, you can enroll at any time.
- CHIP, the U.S. government’s Children’s Health Insurance Program, doesn’t limit enrollments to a particular time, either.
- Travel insurance isn’t subject to open enrollment restrictions, either. Due to the short-term nature of travel insurance policies, they’re not usually subject to open enrollment. However, some travel insurance companies restrict your ability to purchase a travel insurance policy to the period of time immediately after you book your travel.
- Short-term health insurance doesn’t use open enrollment periods either. Like travel insurance, short-term insurance isn’t regulated by the ACA, and plans are available year-round in states that allow them. A new rulein 2017 limited short-term plans to no more than three months in duration, but that rule is expected to be reversed under new regulations that are under review by the federal government (the previous rules allowed short-term plans to exist for up to 364 days; those guidelines might be reinstated, or there might be a new rule altogether, but the three-month limit is almost certainly going to be eliminated).
- In some cases, supplemental insurance products. Supplemental insurance plans sold to individuals are available year-round. But if your employer offers supplemental insurance, your opportunity to enroll will likely be limited to your employer’s overall open enrollment period.
More Open Enrollment Opportunities
Most employers allow you to sign up for or change other job-based benefits during open enrollment, also. Generally, you’re only allowed to make these changes during open enrollment. For example, you may be able to: