Open Enrollment is a time period during which you are eligible to sign up for a health insurance plan. If you fail to sign up for health insurance during the open enrollment, then you will not be able to sign up for a health plan until the next open enrollment period, with the only exception that you experience a qualifying event. If you are eligible for a health plan, and you apply for health insurance during the open enrollment, then the insurance company should provide you the plan and the company is not allowed to use underwriting or require proof of insurability because both these options will make it difficult for you to obtain health insurance. Open enrollment periods are commonly in place for health plans like Medicare, Job-based health insurance, and Individual market health insurance plans. Enrollment windows apply for ACA compliant plans that are available in the health insurance exchanges and outside the exchanges.
Open Enrollment Period of Diverse Health Plans
Open enrollment period varies from one health plan to others, and so depending upon the plan you chose, it will have its open enrollment period:
Medicare – If you are choosing a Medicare plan, then open enrollment of Medicare plans runs from October 15 to December 7 each year. However, you should be aware that Medigap plans do not have an annual open enrollment period and you can avail of these plans during your initial enrollment period or during the very limited special enrollment periods that apply to those plans.
Job-based Health Insurance Plans – If you have employer-sponsored health plans, then the open enrollment period for such plans are set by your employer and they can set at any time of the year. However, generally, the open enrollment period of those plans is in autumn and the new coverage initiates from January 1 of the next year.
Individual plans available on and off the exchange – Individual plans open enrollment period, starting with 2018 coverage has been fixed from November 1 to December 15, with all plans being effective from January 1 of the coming year. Beyond this period, you are not able to enrol for any plan.
Special Enrollment Period
The special enrollment period is the exception to open enrollment that allows you to enroll outside the open enrollment period. People are allowed to enroll in this period due to life events or extenuating circumstances. You are allowed to sign-up for health insurance plan if you lost your health insurance due to the any of the below-given reasons:
- Loss of job
- Relocated to a new place
- Got married
- Loss your Spouse
- Loss coverage under your parent’s plan
- COBRA insurance expire
- Deliver a baby
You need to know that you will not be eligible for a special enrollment period if you lost your coverage because of not paying the monthly premium or if you voluntarily canceled your previous coverage.
Health Insurance Plans that Don’t have Open Enrollment Period
Some of the health insurance plans in the United States don’t have an open enrollment period to limit sign-ups to a particular time each year. Examples of such plans are:
Medicaid – If you are eligible for Medicaid plans, then you can enroll for this plan at any time of the year.
Travel Insurance – Since travel insurance is issued for a short time-frame, these plans are not subjected to the open enrollment period. However, some travel insurance companies allow you to purchase travel insurance immediately after you book your travel and not later on.
CHIP – The U.S. government’s Children’s Health Insurance Program also doesn’t come with an open enrollment period.
Supplemental Insurance Plan – Individuals are allowed to buy supplemental health plans all through the year. However, if the supplemental plans are offered by your employer, then you will likely be limited to your employer’s open enrollment period.
Short-term Health Plans – Since short-term plans are not regulated by the ACA and are available for only a short duration, so these plans don’t have an open enrollment period.
Other Opportunities during Open Enrollment
Besides enrolling for a new health plan during the open enrollment period, you are also allowed to sign up for or change other job-based benefits during this open enrollment for your employer-sponsored plan. You also have an opportunity to set up a flexible spending account or a health saving account during open enrollment. During this period, you can also adjust the amount of life insurance, disability insurance, dental insurance, vision insurance, and supplemental insurance benefits.