How Does Open Enrollment Work?
The gist
Open Enrollment is a specific time frame where you can make certain modifications to your existing health coverage or get covered if you lack health insurance.
For Affordable Care Act (ACA) plans, the Open Enrollment Period typically runs from Nov. 1 to Jan. 15 (though some states have extended enrollment deadlines).
While you can enroll in a new policy during Open Enrollment, you can also use it to modify your existing coverage. Depending on your carrier and the options available, you may be able to change coverage levels, update your Health Savings Account contributions, and more.
What happens if you miss Open Enrollment? You may qualify for a Special Enrollment Period to get health insurance throughout the year.
In this article
It’s critical to have a comprehensive health insurance plan. From regular checkups to specialist visits to emergency room trips, a health policy can help offset a lot of your out-of-pocket expenses — which could save you thousands on medical care! And if you lack coverage or need to make changes to your existing plan, it’s important to be prepared for Open Enrollment Period. Open Enrollment is the annual period during which you can get covered or replace your current plan, and it runs from Nov. 1 to Jan. 15 in most states.
In this article, we’ll answer some of our most frequently asked questions about Open Enrollment so that when it begins, you’re ready to find the best insurance plan for you!
Question 1: How does Open Enrollment work?
Put simply, the Open Enrollment Period is a pre-set window of time where you can get health insurance or replace or modify your current plan. For example, you can change your coverage levels and contribution amounts, add beneficiaries, and more. You can also enroll in an entirely new policy.
Just remember that Open Enrollment is often the only time of year when you don’t need any extenuating circumstances to get health insurance. In other words, if you miss Open Enrollment, it’s possible that you won’t get another chance to get coverage until next year’s Open Enrollment.
Question 2: When is Open Enrollment?
For most states, Open Enrollment runs from Nov. 1 to Jan. 15 (although some states have extended deadlines). The reason some states have a slightly different Open Enrollment Period is because they operate their own exchanges rather than using the federal marketplace. Here are the dates to keep in mind for states with different start dates and/or deadlines:
Idaho: October 15, 2024 to December 15, 2024
California, Washington D.C., New Jersey, New York, Rhode Island: November 1, 2024 to January 31, 2025
Massachusetts: November 1, 2024 to January 23, 2025
Pennsylvania: November 1, 2024 to January 19, 2025
Question 3: What do you need to know before the OEP?
First and foremost, mark your calendar for Nov. 1 so you don’t miss Open Enrollment (whether or not you currently have coverage!).
If you’re currently uninsured, learning about the different health insurance plan types can help you determine what level of coverage is best for you so that when Open Enrollment comes around, shopping for insurance is a breeze.
If you currently have insurance, prepare to re-shop! Even if you’re satisfied with your current coverage, it’s possible that your monthly premium cost will increase or the coverage could change in the coming year. That means you might end up paying more for the same coverage, or your current plan may stop covering your preferred doctors or medications.
Similarly, you or your household’s needs may have changed — for instance, if you had a baby or developed a new health condition, you may want to look for new coverage that better addresses those needs.
If you’re shopping for an ACA plan, Stride is the simplest way to find the right coverage for your unique needs (more on that in a moment).
Question 4: What happens if you miss Open Enrollment?
If you miss your company’s Open Enrollment, you might qualify for a Special Enrollment Period. To apply for a Speical Enrollment Period, you must first experience a qualifying life event. The most common qualifying life events are:
Loss of employer-provided coverage
Loss of coverage on parents’ plan when you turn 26
Birth or adoption of a child
Marriage or divorce
A death among the family members who are covered by your plan
Moving to a new ZIP code or county
Gaining U.S. citizenship
Leaving incarceration
When you apply for your Speical Enrollment Period, you may need to provide certain documentation (like a birth or death certificate), so make sure you have that handy. During the Speical Enrollment Period, you have all of the same privileges as during the Open Enrollment Period, so if you want to add beneficiaries, update your coverage level, or change your HSA contributions, this is your chance to do so.
Once you’ve been granted a Speical Enrollment Period, you only have 60 days to enroll in a new health policy or make changes to your existing plan, so don’t delay! If you miss your Speical Enrollment Period, you will have to wait until the following Open Enrollment Period, so you’ll want to enroll as soon as possible.
Which brings us to our final question:
Question 5: What’s the best way to get a new health insurance plan?
If you’re looking for marketplace insurance, Stride is a partner of HealthCare.gov — and the simplest way to find the right plan. All you have to do is enter your ZIP code, provide some basic information about your health needs, and we’ll do the rest. We’ll recommend the best plans for you in five minutes or less. Then just narrow down your options with filters and side-by-side comparisons, pick your favorite, and follow the prompts to submit your application.
