What is open enrollment for health insurance?
Health insurance open enrollment is when you can get, change, or stop your health insurance coverage. Most health insurers have an annual open enrollment period during a specific timeframe, so there's no need to look for an "open enrollment health insurance" policy. Simply confirm when your insurer's open enrollment period is before you try to make a change. If you already have health insurance, you may also be allowed to change your coverage outside of open enrollment if you experience a qualifying life event.
How does open enrollment work?
Open enrollment works by allowing you to get, switch, or end your health insurance coverage — typically via an online portal or forms provided by your insurer or employer. Open enrollment can typically be used in two ways, depending on if you already have health insurance:
- If you don't already have health insurance, you can choose to get health insurance during the open enrollment period for the plan you want.
- If you already have health insurance, you can choose to change your plan or end your coverage during open enrollment. If you end your coverage and plan to get a new policy through a different insurer, you'll need to sign up for the new coverage during your new insurer's open enrollment period or after a qualifying life event. Note that open enrollment period dates may differ by insurer.
Weigh your health insurance options carefully before open enrollment begins. Starting early can leave you time to find answers to any questions you have throughout the enrollment process.
When is health insurance open enrollment?
Health insurance open enrollment dates usually occur in the fall before the year that you need coverage, and they vary based on the type of health insurance you want.
For government Marketplace plans under the Affordable Care Act, open enrollment is typically November to mid-December — check the exact dates at Healthcare.gov.
For employer-sponsored health insurance, open enrollment dates are set by the insurer. They usually occur in the fall, but you should check with your employer for the exact dates.
Medicaid signup doesn't have date limitations. However, you should confirm that you'll qualify for Medicaid before counting on getting it. If you plan to get Medicaid in February and end up not qualifying, the open enrollment periods for other plans will likely be closed and you may not be able to get full coverage until the following year.
How to get health insurance after open enrollment
If you experience a qualifying life event (QLE), you can get health insurance after open enrollment. For example, if you have health insurance through your employer and you change jobs (a common QLE), you'll likely be allowed to end your health insurance coverage through your old employer and get a policy via your new employer (as long as your new employer offers health insurance as a benefit).
If you don't experience a qualifying life event, there are short-term coverage options you can get until open enrollment begins — however, coverage from these plans is limited compared to a standard policy.
What is a qualifying event for health insurance?
Qualifying life events (QLEs) make you eligible for special enrollment in health insurance — they're your best option for getting standard health insurance outside of open enrollment. All government Marketplace plans allow the same four types of QLEs, as defined by HealthCare.gov. You may qualify for special enrollment if you experience one of these qualifying life events outside of the open enrollment period:
Losing your existing health insurance
You can sign up for a new policy if you lose an existing job-based, individual, or student health insurance policy. This also applies if you lose eligibility for Medicare, Medicaid, or Children's Health Insurance Program (CHIP) coverage, or when you turn 26 and are no longer covered under your parent's healthcare plan.
Adding or removing people in your household
If you get married or divorced, have a baby, adopt a child, or have a death in your household, you're qualified to get a new health insurance policy or change your coverage.
For the Marketplace, if you move to a new ZIP code or county, you can qualify for special enrollment. This includes students who move away to college (or return home from living at school) and seasonal workers moving for a job. It also applies to people moving out of transitional housing. The exact requirements for moving may be different for non-Marketplace plans.
Other qualifying events
For the Marketplace, this may include changes in your income that affect the coverage you qualify for, such as a massive increase or decrease in income. If you're released from a period of incarceration, you can apply for coverage. You can also qualify if you become a U.S. citizen or gain membership in a federally recognized tribe.
For Marketplace plans, you'll have 60 days to make a change to your health insurance, starting on the date of your QLE. Employer-provided health insurance plans have their own QLE definitions and special enrollment timeframes, but they tend to be similar. Check with your employer to understand their exact requirements for qualifying life events.
If you just a got a job with an employer that offers health insurance as a benefit, you can typically get a policy when you start work — you won't have to wait for the open enrollment period.
What happens if I miss open enrollment at work and don't qualify for special enrollment?
First, check if you're still within the open enrollment period for government Marketplace plans. Your employer's open enrollment period may be different from the Marketplace's, and you could apply for individual or family health insurance through the Marketplace instead.
If you miss both your employer's and the Marketplace's open enrollment period and you aren't experiencing a qualifying life event, you can opt for short-term health insurance. This can provide some level of coverage for specific incidents until you can get standard health insurance during open or special enrollment.