It’s official. On November 1, the open enrollment period — the time each year when you can purchase or make changes to a health insurance policy — began. If you already have a policy, your insurer might’ve sent you a letter or another notification that you need to take action during this period to maintain your coverage. And if you don’t have a policy yet, this is the time of year when you can sign up for one under the Affordable Care Act (ACA).
Open enrollment is one of the few annual opportunities you have to make changes to your health insurance policy. For some, open enrollment is a time of significant change. For others, it might just mean confirming a current policy is working well and carrying that same coverage into the following year. It’s a busy but important time of year, and there’s a lot you might need to take care of. To get started, learn more about what open enrollment is and how you can make the most of this annual opportunity.
What Is Open Enrollment?
Open enrollment is the period of time every year when people can make changes to their health insurance policy, renew their policy or select a new policy. Open enrollment usually lasts for about a month. Aside from special circumstances, open enrollment is the only time annually when people can make changes to their health insurance.
Outside of open enrollment, it’s possible to make changes to a policy during special enrollment periods. These are personal enrollment opportunities based on changing life circumstances. Examples of situations that allow for a special enrollment period are losing a job that provided health insurance or giving birth to a child who you need to add to your existing policy.
Regarding the Health Insurance Marketplace, a nationwide resource where you can purchase a policy online, the open enrollment period runs annually from November 1 to December 15. However, the November 2021 period has been extended an extra month to end on January 15, 2022, for coverage in 2022. Even if you haven’t had a change in life circumstances, if you’ve purchased an insurance policy through the Health Insurance Marketplace, you must update your application during the open enrollment period. This allows you to continue receiving health insurance coverage as of January 1 of the upcoming year.
Medicare has several open enrollment periods throughout the year for different types of coverage. The open enrollment period for job-based insurance plans may vary, but it’s usually close to the end of the year, often in November and December. Whether they stem from your use of the Marketplace or not, most changes made during open enrollment periods take effect on January 1.
What Types of Health Insurance Use Open Enrollment?
Open enrollment periods are used for three main types of health insurance, including Medicare, insurance policies purchased through the Health Insurance Marketplace, and insurance provided through your workplace. In all three circumstances, you must meet certain criteria to continue receiving coverage. In insurance, meeting these standards is referred to as eligibility.
To be eligible for Medicare, a person must be 65 or older, receive benefits from Social Security or the Railroad Retirement Board, or have a serious health condition like kidney failure. Anyone who’s not offered full health insurance coverage from another organization is eligible to receive health insurance through the Marketplace. However, the amount of monthly premium subsidy that you can receive to cover part of the cost depends on your current income. Job-based health insurance depends on continuous employment in a role that has enough weekly hours to qualify an employee for health insurance coverage.
What Is the Purpose of Open Enrollment?
A lot in your life can change in a year, and open enrollment ensures that you’re still eligible for certain types of healthcare coverage. Open enrollment allows you to make sure you have the best plan for your current circumstances. The process also keeps people from switching policies numerous times throughout the year or waiting until they get sick to start the process of purchasing coverage.
Family situations and finances change, so it’s wise to use open enrollment as an opportunity to take stock of your healthcare needs. For example, suppose two parents with two children both have job-based insurance. One parent’s insurance has cheaper monthly premiums but no dental care. The other parent’s insurance is more expensive but includes dental care. Both children will need some extensive dental work in the upcoming year. The family could use open enrollment to see whether the increased cost of the second parent’s insurance is cheaper than paying out-of-pocket for these procedures.
How to Select or Change Your Health Insurance
To change your health insurance coverage through the Marketplace during the open enrollment period, fill out a new application on healthcare.gov. You’ll need to create an account on the site to do so. At the end of the application process, you’ll see all available options for the types of coverage and plans you’re eligible for. This is also the same course of action you’ll take if you’re selecting a plan from the Health Insurance Marketplace for the first time. You can then review the different options and use the comparison tool to determine which plan is right for you.
Outside of open enrollment, policyholders can only make changes in the Marketplace if they have a circumstance that triggers a special enrollment opportunity. To report this change, sign in to your Marketplace account and select the appropriate year under “Your Existing Applications.” Then, press “Report a Life Event” and follow the instructions on the screen.
To cancel coverage from the Health Insurance Marketplace altogether, click “My Plans and Programs.” Then, click “End (Terminate) All Coverage.” You’ll have the option to choose from available dates when the coverage officially ends. You’ll also want to make sure that the end date doesn’t leave any gaps between coverage from the Marketplace and coverage from a new policy.
If you want to change Medicare coverage, a great first step is calling 1-800-Medicare. You may have more flexibility to make changes when you’re on Medicare — it’s sometimes possible to do so outside of an open enrollment period.
The process for making changes to job-based health insurance isn’t standardized the way these other options are. You may need to call an 800 number, access an online portal or speak to an on-site benefits manager at your office. Contact your employer’s human resources department to learn more about what the process looks like for you.
How to Renew Health Insurance Coverage
You can renew coverage on the Health Insurance Marketplace by updating your application each year during open enrollment. At the end of the application process, you’ll see how much of a subsidy you qualify for and which plans are available. You may elect to keep the same policy for the next year or choose a new policy to fit your needs. Your insurer might also decide to discontinue your current plan, and you can choose a new type of coverage from your current insurer or switch to another company’s policy.
Many types of Medicare-related coverage automatically renew on their own without any action from policyholders. However, open enrollment is an excellent time to review your current coverage and medical needs. Other plans could provide you more adequate coverage.
In many circumstances, job-based health insurance will also renew on its own, but it’s important to avoid making this assumption about your employer’s insurance. Always ask to be sure you’re not compromising your coverage. Open enrollment is primarily a time when all employees have the opportunity to make changes to their plans if necessary.
Medical expenses can arise when you least expect them to, and the right insurance policy can help you maintain better financial security. Open enrollment isn’t a chore but rather an annual opportunity to make sure your health insurance costs and policy provisions still fit your and your household’s current needs.
