You’ve probably heard the term “Open Enrollment.” But what exactly is Open Enrollment and why should you care? Here’s a short guide to the most common questions about Open Enrollment.
TLDR: The one time of year you can buy or change your health insurance!
What is Open Enrollment?
The Open Enrollment Period, more commonly known as OEP, is the one time of year that you can buy or change your health insurance. If you don’t buy health insurance during OEP, you will not be able to purchase until OEP the following year unless you experience a qualifying life event. If you already have health insurance, this still applies to you! This is the one time of year you can change your plan.
Who Does Open Enrollment Apply To?
Americans ages 18 to 64 will need to purchase their own health insurance if they don’t already have coverage from an employer, a spouse or parent’s employer, TRICARE, the VA, or Medicare.
When is Open Enrollment?
For most, Open Enrollment begins on November 1, 2022, and ends on January 15, 2023 in most states.
Open Enrollment used to end on December 15 in most states, but the Biden administration added a one-month extension which will continue to be used going forward. This applies to the 33 states that use HealthCare.gov. The other 17 states and DC are free to follow that same schedule or set their own schedule.
In most states, December 15 is the deadline to get a plan that takes effect January 1; enrollments completed in the latter half of December and the first half of January take effect February 1 instead.
What are the Open Enrollment Deadlines for State-Run Exchanges?
The states that run their own exchanges can set their own enrollment deadline, as long as it’s not earlier than December 15. For 2023 coverage, as was the case for 2022 coverage, there are 18 fully state-run exchanges that have the option to set their own open enrollment schedules.
Most of these state-run exchanges choose to follow the same November 1 – January 15 schedule that HealthCare.gov uses. But some have opted for different schedules. Here are the open enrollment windows that the state-run exchanges are using for 2023 coverage:
California: November 1 to January 31 (renewals begin October 1)
Colorado: November 1 to January 15
Connecticut: November 1 to January 15
District of Columbia: November 1 to January 31 (uninsured residents can enroll anytime through the end of the COVID public health emergency)
Idaho: October 15 to December 15 (note that this deadline is before the end of the year)
Kentucky: November 1 to January 15
Maine: November 1 to January 15
Maryland: November 1 to December 15 (this deadline is before the end of the year, but MD does tend to issue last-minute extensions)
Massachusetts: November 1 to January 23
Minnesota: November 1 to January 15
Nevada: November 1 to January 15
New Jersey: November 1 to January 31
New Mexico: November 1 to January 15
New York: November 16 to January 31 (enrollment starts later; enrollment also open throughout COVID public health emergency)
Pennsylvania: November 1 to January 15
Rhode Island: November 1 to January 31
Vermont: November 1 to January 15
Washington: November 1 to January 15
Why Does Open Enrollment Exist?
In a word: stability. If Open Enrollment didn’t exist, when would you buy health insurance? Most likely when you got sick or injured, right? Well, OEP restricts when you can buy health insurance in order to maintain a needed balance for health insurance companies. By constraining the time period in which you can purchase health insurance, the amount of money going into and coming out of insurance companies’ pockets remains relatively balanced. This allows insurance companies to maintain a balanced pool of sick and healthy people, keeping the marketplaces stable.
The amount individuals pay in premiums works to counteract the money insurance companies are paying out towards claims. If people could sign up for insurance at any point, this balance wouldn’t exist and would cause an unhealthy disruption within the health insurance industry.
What If I Already Have A Plan From Last Year?
If you purchased health insurance last year, you’ll be automatically re-enrolled for that plan next year. Sounds pretty good, right? Beware—people who don’t switch plans oftentimes see their monthly health payments increase, their prescriptions might no longer be covered, and their doctors might no longer accept their old plan. Many people choose to cancel their current plan and switch to a new plan to either save money or get coverage that better fits their life!
What Can I Expect For Open Enrollment?
New tax credits are making health insurance more affordable.
President Biden signed the American Rescue Plan Act of 2021 (ARP) into law on March 11th, 2021. This law increases eligibility for tax credits that reduce health insurance premiums. After applying these tax credits, four out of five people will be able to find a plan for $10 or less/month, and over half will be able to find a Silver plan for $10 or less.
You can upgrade your plan for less.
Don’t let your old plan automatically re-enroll without research. One in four of those with marketplace plans will be able to upgrade to a plan with lower out-of-pocket costs.
You will still get just as much value from your plan.
Plans will continue to cover all the essential health benefits you’d look for in a health plan. Plans are required to continue covering things like emergency services, preventative care, prescription drugs, and more.
Where Can I Get Health Insurance?
Visit healthcare.gov. Create an account and read their guides about your eligibility, how to get ready to apply, and how to compare the plans available to you.
