Open enrollment is when you can assess your current health insurance plan and either change what you have, cancel it, or enroll in a new one. Health and financial needs change over time, so take the time to ensure your benefits change with you.
With a better idea of how open enrollment works, you can make educated decisions for the health and well-being of you and your family.
Here’s what you need to know about the open enrollment period (OEP).
How does open enrollment work?
Every year, most types of insurance will have open enrollment periods that last several weeks – usually from November 1 to January 15. The time frame may differ for states with their own health marketplaces.
There are a few ways you can sign up for coverage:
- Through your employer
- Via Medicare (if you are of retirement age)
- Through the government healthcare marketplace (Healthcare.gov)
- Directly through an insurance company
- By working with a health insurance broker
During open enrollment, you can:
- Sign up for a new health insurance plan, or other forms of coverage like dental, vision, or life insurance
- Make changes to your existing plan if you need to increase coverage amounts or add family members and dependents
- Sign up for or make changes to your flexible spending account (FSA) or health savings account (HSA)
Does open enrollment differ by state?
What is open enrollment like for other states? For most states, OEP for 2024 health plans starts November 1, 2023, and ends January 15, 2024.1 This gives you just around 11 weeks to sign up. However, if you want coverage beginning January 1, 2024, you’ll need to enroll by December 15, 2023. If you enroll between December 16, 2023, and January 15, 2024, your coverage will begin February 1, 2024 instead.
Not all states have these same deadlines as they manage their own health marketplaces. In the case you live in any of the following states, you’ll want to ensure you enroll by the deadlines below:
- California: November 1 – January 31
- Massachusetts: November 1 – January 23
- New Jersey: November 1 – January 31
- New York: November 16 – January 31
- Rhode Island: November 1 – January 31
- Washington, D.C.: November 1 – January 31
Which insurance providers use open enrollment?
Most insurance providers have an open enrollment period. However, when you receive employer-sponsored insurance, the open enrollment window may vary and occur anytime throughout the year.
It’s common for employers to schedule enrollment for the fall so that coverage can begin at the start of the new year. Some employers may choose to start enrollment at the beginning of the fiscal year. If you know you’re enrolling through your employer, ask about your employer’s enrollment window.
Plans that don’t use open enrollment
Programs like Medicaid, Children’s Health Insurance Program (CHIP), and short-term health insurance are the exceptions when it comes to open enrollment periods. You can enroll any time of the year if you meet the qualifications.
One of these options could help you find health insurance if you are underemployed or unemployed.
Types of insurance plans
What kind of insurance plans can you expect to choose between during open enrollment?
Insurance plan by metal tier
Health insurance companies often organize their plans by metal tiers: bronze, silver, gold, and platinum. Each tier represents different price points and coverage amounts. The more you pay each month, the more medical care your insurer will cover.
If you have multiple health conditions, plan on going to the doctor frequently, or paid full price for several doctor visits and prescriptions this past year, shop around in a gold or platinum metal tier. Even though you pay more upfront, your insurer will cover more of your medical bills, which could save you money in the long run.
If you’ve been paying for an expensive plan but rarely use it or don’t have many medical costs, consider bronze and silver plans. These have higher deductibles, so you’ll owe more when you visit the doctor. However, your medical costs could balance out with your less-expensive monthly premiums.
Insurance plan by care level
Some insurance providers will offer plans by care level. Here are the most common types:
| Type of plan | Summary |
|---|---|
| Health maintenance organization (HMO) | Requires you to select a primary care physician (PCP) who will refer you to in-network specialists or diagnostic services. Out-of-network costs will not be covered. |
| Preferred provider organization (PPO) | No referrals are required. You will be responsible for choosing care from your plan’s preferred network of providers. Out-of-network care will be partially covered. |
| Exclusive provider organization (EPO) | No referrals are required. You will be responsible for choosing care from your plan’s preferred network of providers. Out-of-network care will not be covered. |
| Point of service plan (POS) | POS plans are similar to HMOs in that you select a PCP, who will refer you to in-network specialists. Unlike HMOs, you can go out of network, and those costs will be partially covered. |
| High-deductible health plan (HDHP) or HSA-eligible plan | A higher deductible than a traditional plan with a lower premium. This plan can also be combined with a tax-free health savings account (HSA). |
Important open enrollment dates
Employer-sponsored insurance: Your employer will choose your OEP, but it only happens once a year, typically in the fall. You’ll need to confirm the dates with your employer.
October 15 – December 7: Medicare open enrollment takes place. You become eligible to enroll three months before you turn 65.
November 1: The first day you can enroll in individual insurance via the marketplace. These dates can vary by state.
December 15: The last day you can enroll in a marketplace plan that begins coverage on January 1.
January 1: The day coverage starts for those who enrolled by December 15.
January 15: The last day of open enrollment. Those who enroll by this day will have coverage beginning February 1. If you don’t enroll by this day, you may need to look into whether or not you qualify for a special enrollment period (SEP).
February 1: Coverage begins for those who enrolled by January 15.
How to prepare for open enrollment
Spending time each open enrollment to pick your optimal plan can save you thousands of dollars on care. Here’s what you need to do:
✓ Know your important open enrollment dates
✓ Have a list of your doctors and medications ready so you can stay in-network if necessary
✓ Evaluate your current and upcoming healthcare needs
✓ Brush up on your health insurance terminology beforehand (monthly premium, copay, deductible, etc.)
✓ Start researching plans and providers a few weeks before the deadline
✓ Review your current health plan details to see if anything has changed
✓ Examine available options through your employer or marketplace
✓ Compare any costs, including premiums, copays, and deductibles
What happens if you miss open enrollment?
If you don’t buy health insurance during OEP, you will likely not be able to purchase health insurance until OEP the following year – unless you experience a qualifying life event, like having a baby, getting married, or moving.
In that case, you may be eligible for the special enrollment period. While these qualifying events vary in nature, most have one thing in common: you need health insurance before the qualifying event to be eligible to enroll.
If you missed the OEP and already have insurance through your employer or an individual plan, your coverage may automatically renew or continue into the following year. You may not be able to change that coverage until the next OEP.
If you missed OEP and do not have an existing plan, you may be able to enroll in your spouse’s health plan, use the special enrollment period, or have to go without coverage for the following year.
The Affordable Care Act no longer penalizes people for not having health insurance. If you do find yourself without health insurance next year, keep in mind these tips for negotiating medical bills and which medical expenses are tax deductible.
What steps to take if you miss open enrollment?
So, what do you do if you miss OEP?
- Confirm you did miss the enrollment dates. Enrollment dates differ depending on where you get your insurance. If it’s with your employer, ask them about the enrollment window. If you enroll in insurance via the marketplace, you have until January 15.
- Find out if you qualify for special enrollment. Ask your HR team about other options if you receive insurance through your employer. They will inform you about any terms and requirements for qualifying for special enrollment. Research qualifying life events that may allow you to utilize SEP and enroll in a plan within 30 or 60 days of your qualifying life event.
- Research other coverage options. If you cannot enroll in your spouse’s plan, you may be able to explore short-term health insurance, Medicaid, or CHIP. These options do not have specific enrollment windows, but they do have specific qualifications you must meet.
As open enrollment approaches, get acquainted with available plans, evaluate how you used your previous plan, and anticipate any new or upcoming needs you may have this coming year. Healthcare can be complex, but you’re already on the right track by starting your research now.
When you’re going through the open enrollment process, try to find a plan with a health savings account if it makes sense for you.