What is open enrollment?
An open enrollment period is a window of time that happens once a year — typically in the fall — when you can sign up for health insurance, adjust your current plan or cancel your plan. It’s usually limited to a few weeks. If you miss it, you may have to wait until the next open enrollment period to make any changes.
What types of insurance use open enrollment?
If you get health insurance through your job, through Medicare, or through the Affordable Care Act (ACA) marketplace, you will have an open enrollment period. For ACA plans, state-based markets may have open enrollment periods that differ from federal-based marketplaces, as well as special enrollment periods. Visit your state health insurance website to find state-based open enrollment and special enrollment period dates.
Tips on making the most of open enrollment
Before you choose a health insurance plan, you may want to think about the following:
- How much did you spend on health care last year (what was your premium, your deductible and your out-of-pocket costs)?
- Did the amount you/your family spent line up with your health care needs?
- Is your doctor/clinic in network?
- Are your medications covered?
When is open enrollment if I get health insurance through my work?
If you get health insurance through work, your employer sets the open enrollment period. It’s typically in the fall so that your benefits can start at the beginning of the calendar year. Choosing a health care plan for the year ahead is an important decision during open enrollment. Take some time to explore your options to help you decide what coverage is best for you before you enroll.
When is Medicare enrollment?
Turning 65 or retiring in the near future? It could be time to choose your Medicare coverage. There are a number of different Medicare enrollment periods. One key Medicare enrollment period for changing your coverage is called the Annual Enrollment Period (AEP). This happens from October 15 to December 7 every year. During AEP, you can join, switch or drop a plan. If you don’t make any changes during AEP, your current plan will automatically renew the next year.
Is there an open enrollment period for Medicaid?
Medicaid, a federal program, was designed to help people with limited income get access to health coverage. There is no open enrollment period for Medicaid programs, including the Children’s Health Insurance Program (CHIP).
In some states, Medicaid covers all low-income adults below a certain income level. In all states, Medicaid provides health coverage to:
- Low-income families and children
- Pregnant women
- The elderly
- People with disabilities
To apply, contact your state agency that manages the Medicaid program. For questions, or to see what health plans UnitedHealthcare Community Plan offers in your area, you can use the search tool at UHCCommunityPlan.com.
When is open enrollment for a Dual Eligible Special Needs Plan?
If you have both Medicaid and Medicare benefits, you could be eligible for a Dual Special Needs Plan, or D-SNP. Those who qualify for this type of Medicare Advantage plan can switch to a new plan at any point during the year, not just during open enrollment.
Can I make changes outside of the open enrollment period? What is a qualifying life event?
Typically, once you’ve made your benefit elections, you have to wait to make changes until the next open enrollment period. Not always, though. You may have heard the term, qualifying life events. These are life events that let you make changes to your benefits outside of the open enrollment period.
What if I missed the deadline for open enrollment?
If you need coverage during a time when annual open enrollment isn’t available and you have not experienced a Qualifying Life Event, you can buy short term health insurance. Short term health insurance can fill health care needs for short amounts of time.