What Is Open Enrollment?
Open enrollment is the period during which people can purchase health insurance for the upcoming year. If you don’t sign up for health insurance during open enrollment, there’s a possibility that you won’t be able to sign up for health insurance until the next open enrollment period, unless you experience a qualifying event. Need help selecting the best health insurance plan for you and your family?
There are 4 basic types of qualifying life events. (The following are examples, not a full list.)
Loss of health coverage
- Losing existing health coverage, including job-based, individual, and student plans
- Losing eligibility for Medicare, Medicaid, or CHIP
- Turning 26 and losing coverage through a parent’s plan
Changes in household
- Getting married or divorced
- Having a baby or adopting a child
- Death in the family
- Changes in residence
Moving to a different ZIP code or county
- A student moving to or from the place they attend school
- A seasonal worker moving to or from the place they both live and work
- Moving to or from a shelter or other transitional housing
- Other qualifying events
Changes in your income that affect the coverage you qualify for
- Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
- Becoming a U.S. citizen
- Leaving incarceration (jail or prison)
- AmeriCorps members starting or ending their service
During open enrollment, employers and companies may make changes to the offered health insurance benefits for their employees.
Open Enrollment Dates For 2021 Coverage
Open enrollment for ACA-compliant 2021 coverage will run from November 1, 2020 to December 15, 2020 in all states that use HealthCare.gov, and in some of the states that run their own exchanges. This enrollment schedule applies both on and off-exchange. California, Colorado, and DC have permanently extended their open enrollment periods, listed below:
- California: November 1 to January 31
- Colorado: November 1 to January 15
- District of Columbia: November 1 to January 31
For open enrollment 2020, there are 13 fully state-run health insurance exchanges. In fall 2020, Pennsylvania and New Jersey will be joining the list – bringing the total number of fully state-run exchanges to 15.
All fully state-run exchanges (ie, those that use their own enrollment platforms, instead of HealthCare.gov) have the option to extend open enrollment past December 15th. In the past, many state-run exchanges have extended by at least a week.
Pennsylvania has already committed to an extended open enrollment period for 2021 coverage, which will run from November 1, 2020 to January 15, 2021.
Nevada has also committed to an extended open enrollment period for 2021 coverage, which will run from November 1, 2020 to January 15, 2021.
Medicare Open Enrollment Dates For 2021 Coverage
- The Medicare Advantage open enrollment is January 1 – March 31.
- Open enrollment for Medicare part A/B is from January 1 – March 31.
- Medicare open enrollment is from October 15, 2020 through December 7, 2020.
What’s Special Enrollment? Are There Exceptions?
Regardless of whether you purchase insurance through the exchange or off-exchange, the annual Obamacare open enrollment window applies, which is why it’s very important to pay close attention to the enrollment deadlines.
You cannot enroll outside of open enrollment unless you have a qualifying event. And the rules for special enrollment periods are stricter than they used to be. In most cases, you’re required to have already had coverage prior to the qualifying event in order to sign up for a new plan as a result of the qualifying event (for example, if you move to a new area, it’s only a qualifying event—allowing you to sign up for a plan in your new area—if you already had coverage in your previous location). The restrictions on special enrollment periods make it more important than ever for people to sign up during open enrollment, when those restrictions don’t apply.
Does The Open Enrollment Period Matter If I Already Have Insurance?
Yes, even if you are already insured and happy with your plan, there are a few things to pay attention to during open enrollment season. During open enrollment season, make sure you note how much your premium will change in the coming year and if this is still feasible for you and your family. Additionally, some benefits of your plan or coverage details may change in the coming year. Make sure that you are aware of these changes before open enrollment period ends, as most states will not let you make changes to your plan after mid-December.
What If I Get Coverage From My Employer?
If you are hired as an employee at a new job, you do not need to wait until the open enrollment period to get covered by their health insurance. The open enrollment period employer health insurance may overlap with the regular open enrollment period, or it may be a few weeks earlier. Check with your employer to find out when their open enrollment period will be and if they are making any changes to the plan in the coming year.
