When is Health Insurance Open Enrollment?

Contributor, Benzinga

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If you’re getting health insurance through an employer, open enrollment is typically at the end of each year. When is open enrollment for health insurance if you’re buying it on your own? In the past, it’s been from Nov. 1 to Dec. 15, with coverage starting the following Jan. 1. The Department of Health and Human Services has proposed extending that period to Nov. 1 to Jan. 15. Learn more about open enrollment for health insurance. 

Key Health Insurance Open Enrollment Dates for 2022 Coverage

  • Open enrollment has typically been from Nov. 1 to Dec. 15.
  • Some states have longer enrollment periods.
  • Some states still have open enrollment for 2021 open, including California, Connecticut, Minnesota, New Jersey, New York and Vermont as well as Washington, D.C.
  • The Department of Health and Human Services has proposed extending open enrollment to end Jan. 15 

What is Open Enrollment for Health Insurance?

Open enrollment is an annual time when you can start, stop or change your health insurance. Employers typically have open enrollment annually for health insurance and other benefits. If you’re buying it on your own, then your state’s Health Insurance Marketplace will also have an annual open enrollment. 

How to Sign Up During Open Enrollment

It can be confusing to know how to get health insurance. During the open enrollment period, you can enroll in a health insurance plan through the Marketplace. The Marketplace is a service that can help you find, compare and enroll in affordable health insurance plans. 

To enroll in a health plan using the Marketplace, you must:

  • Live in the United States
  • Be either a U.S. citizen or national

You are not eligible for a health insurance plan through the Marketplace if you: 

  • Are incarcerated
  • Have Medicare coverage

Most people use the Marketplace to find affordable health insurance. It’s operated by the federal government for most states, although other states run their own Marketplace.

You can enroll in a plan during open enrollment in a few different ways:

No matter which way you choose to enroll, you must submit information about your household and income. This information will be used to determine the types of plans you are eligible for. You may be eligible for premium tax credits and other savings to make your plan more affordable. You may also qualify for coverage through Medicaid and/or the Children’s Health Insurance Program (CHIP) in your state.

If you own a small business, you may be eligible for the Small Business Health Options Program (SHOP). This program can allow you to offer affordable health insurance coverage to your employees. 

If you are already enrolled in your employer’s health insurance program, you should speak with your employer about continuing coverage. Your employer will be responsible for signing you up for coverage under an employer-sponsored health plan.

What Happens if You Don’t Sign Up During Open Enrollment?

If you don’t sign up for a health insurance plan during the open enrollment period, you may not be able to receive coverage for the upcoming year. In some cases, your state may extend the enrollment deadline. It’s important to check with your state to see what other options you may have. In most states, if you miss the open enrollment period, you’re at risk of being uninsured in the upcoming year. 

If your circumstances change at any point throughout the year, you may be able to purchase a new health insurance plan. This is called a special enrollment period. You may also be eligible for premium subsidies if you are an eligible applicant. You must experience a qualifying event. See some qualifying events below.

Loss of Health Coverage

If you lose your health insurance at any point during the year, you may be able to access the special enrollment period. There are a few reasons you might lose health coverage. You may become unemployed and lose your employer-sponsored health insurance plan. Another is if you turn 26 and no longer qualify to be on your parents’ health insurance plan.

Change in Household Status

If there is a change within your household, you may be eligible to enroll in health insurance outside of the open enrollment period. Some of these changes may include getting married or divorced, having or adopting a child and a death in the family.

Change in Income or Residence

If there is a change in your residence, you may have to change your health insurance plan. 

If your income greatly increases or decreases, your qualification for your current health insurance plan may change. 

Become a U.S. Citizen

If you become a citizen of the United States outside of the open enrollment period, you will need access to a new health insurance plan.

Leave Incarceration

Ending your time in jail or prison is a qualifying life event that will allow you to enroll in a health plan outside of the open enrollment period.

Medicaid/CHIP Eligibility

If you qualify for Medicaid or the Children’s Health Insurance Program (CHIP), you can enroll in coverage at any time of the year. You will also be eligible for a special enrollment period if there is a change during the year that makes you no longer eligible for these programs. 

If you become eligible for an employer-sponsored health plan at some point throughout the year, you will be able to enroll in your employer’s plan at that time. If none of these options are available to you, your options for health coverage outside of the open enrollment period are limited.

You may be able to receive coverage from policies that are not regulated by the Affordable Care Act. Most of these plans are designed to provide supplemental coverage and not intended to act as your only health coverage. Some of these options are:

  • Farm Bureau plans: If you are a member of the Farm Bureau and live in Kansas, Tennessee or Iowa, this may be an option for you.
  • Health care sharing ministry plans: These are faith-based nonprofit organizations that pool members’ money to share each other’s medical expenses. 
  • Short term health plans: Short term health plans are an option for coverage if you need to shore up the gap between your current plan and the next plan. 

How to Get Health Insurance After Open Enrollment Ends

If you missed your state’s open enrollment period to buy health insurance, you have other options. 

Special Enrollment Periods

Special enrollment periods are opportunities to sign up for health insurance coverage outside of open enrollment periods. You typically qualify for a special enrollment  if you’ve experienced a life event like marriage, divorce, the birth or adoption of a child, moving or losing other health insurance coverage. You may have 60 days before or after the event to enroll in a plan, depending on the type of event. 

Health insurance plans from employers must allow at least 30 days for special enrollments. 

Short-Term Health Insurance

Short-term health insurance is another health insurance option if you’ve missed open enrollment and you don’t qualify for a special enrollment period. 

Short-term health insurance is different from traditional health insurance, though. It’s not required to follow the rules for health insurance plans set by the Affordable Care Act (ACA). For example, insurance companies can deny your application for coverage based on your health. They also aren’t required to cover pre-existing conditions, including pregnancy. 

Short-term health plans also tend to have high deductibles, and they have annual coverage limits. This is the most the plan will pay in benefits in a given year. Depending on the laws in your state, they can last up to 12 months and may be able to be renewed for a total of 36 months of coverage. 

Short-term insurance plans do provide some coverage, and they’re less expensive than unsubsidized health insurance plans. If you’re considering buying short-term health insurance, be sure to review the plan details carefully so you know exactly what you’re buying. 

How to Compare Health Insurance on the Marketplace

If you’re buying a plan from your state’s Health Insurance Marketplace, there’s a lot to consider. First, be sure to enter your financial information accurately, as this is what determines your eligibility for tax credits. These credits help cover the premiums (monthly costs) of your health insurance, which lowers your costs. Here are other factors to consider: 

  • Metal tiers: The Marketplace divides plans into 4 metal categories: Bronze, Silver, Gold and Platinum. Bronze plans have the lowest premiums and the highest coinsurance, which means you pay more when you need care. Platinum plans have the highest premiums and the lowest coinsurance. This means you pay more each month but less when you need care. 
  • Plan type: Health maintenance organizations (HMOs) and preferred provider organizations (PPOs) are 2 common types of plans you’ll see on the Marketplace. Both plan types have a network, which is a group of physicians and other healthcare providers who have contracted with the insurance company. With an HMO, you’re typically required to see doctors within the network unless you’re experiencing an emergency. With a PPO, you can see out-of-network providers, but you’ll pay more if you do. 
  • Deductible: This is the amount you’ll pay for covered services before your plan starts paying. 
  • Copays and coinsurance: Copays are a fixed dollar amount you pay for items or services. For example, you might pay $5 for a generic prescription. Coinsurance is a percentage you pay for an item or service after you’ve met your deductible. For example, you might pay 20% of the cost of durable medical equipment like a wheelchair. 
  • Out-of-pocket maximum: This is the most you’ll pay out of pocket for covered services each year. 

How to Buy Health Insurance on the Marketplace

To buy health insurance from the Marketplace, you’ll need to visit your state’s Marketplace website. We list some below, or you can visit Healthcare.gov, which will direct you to your state’s Marketplace. 

From there, you’ll need to create an account and answer questions about your age, gender, income, tax filing status, employment status and dependents. You’ll also need to enter the Social Security numbers of everyone in your household, even if they’re not applying for coverage. 

Once you’ve completed your application, you’ll find out whether you’re eligible for a tax credit and how much that credit is. You can then review plans in your area and choose the best health insurance for your budget and needs. Once you select a plan, you’ll receive information on how to pay your first premium. 

Quick Look: The 5 Best Carriers for Open Enrollment Health Insurance

Open Enrollment Health Insurance Options: The 5 Best Carriers

Ready to find the best health insurance possible? Here are a few of our favorite options.

1. BlueCross BlueShield

BlueCross BlueShield offers coverage to residents across all 50 states. This means that it can offer you a large provider network. The company partners with local health care companies in different states. 

The company you work with directly depends on which state you live in. For this reason, customer service can vary across its local partner companies. Overall, this insurance company is a great choice because it’s accepted at a large number of doctors’ offices and medical facilities.

get started Call Now securely through Blue Cross Blue Shield’s website
# of Healthcare Providers
28k+
Online Application?
Yes
1 Minute Review

Blue Cross Blue Shield consists of 35 separate companies that provide health insurance for roughly one-third of Americans. The company serves all 50 states, Washington D.C., Puerto Rico, and many international areas.

While you look into the BCBS affiliates near you, understand what health plans are available as well as the health insurance cost. It offers extensive coverage that gives just about every American the opportunity to purchase a BCBS-affiliated health plan. However, be sure to read up on the company because the premiums and deductibles may not suit you and your circumstances. 

Best For
  • Desire for a new doctor with plenty of options
  • No cap on annual maximum limits
  • Comprehensive coverage with exclusive discounts and partnerships
Pros
  • Coverage in all 50 states and outside the country
  • Covers both generic and brand-name drugs
  • Wide network of doctors, hospitals and specialists
Cons
  • Plans offered through regional companies, meaning you must look to your regional company for specific policies
  • Main customer service helpline may be difficult to reach

2. Humana

Humana offers a number of affordable health insurance options that work for its members. Most of its affordable plans are health maintenance organization (HMO) plans. This means that you can only receive coverage for visits with providers in Humana’s network. 

Since Humana is a large health insurance company with a wide range of participating providers, this shouldn’t be much of an issue. Humana provides competitive pricing on its premiums, no matter your age.

# of Healthcare Providers
N/A
Online Application?
Yes
1 Minute Review

It isn’t easy to choose a health insurance company. You want to ensure you select the best carrier that will offer you the ultimate protection and has an excellent reputation within the industry. With annual revenue in the billions, Louisville, Kentucky-based Humana Health Insurance Co. is one of the largest health insurance carriers in the U.S. and offers coverage for millions of people. Humana is available in all 50 states and sells individual insurance, Medicare plans and group health insurance plans to businesses.

Best For
  • People ages 65 and older and looking to enroll in Medicare
  • Extras such as dental and vision coverage
  • Free fitness program
  • A business of any size
Pros
  • Partnerships with Walgreens and Walmart to bring you expanded prescription drug coverage
  • Rewards for healthy habits
  • Large provider network
Cons
  • HMO plans only available in 22 of 50 states
  • No short-term plans offered
  • Costlier plan required if you need international coverage

3. Molina Healthcare

Molina Healthcare offers several policy tiers to meet the needs of all customers. This health insurance company is only available in select states, so its network of providers is more limited than some of the other health insurance companies. However, Molina is unique in a couple of different ways. 

It offers physical clinics and health centers in the states where its coverage is available. It also offers a number of wellness services to help its members make healthy decisions. For example, Molina Healthcare offers discounts for weight loss and smoking cessation programs.

Best For
Preventative care
N/A
1 Minute Review

Molina Healthcare is a Fortune 500 company based in California that provides health plans under state marketplaces. It also provides healthcare services under Medicare and Medicaid. The company serves around 4.6 million people through the locally operated health plans it offers plans in 15 states.

Molina has a storied history of helping low-income patients receive healthcare regardless of their ability to pay for services.   

It encourages diversity, equity and inclusiveness by offering a program to certify suppliers who are friendly toward women, minorities, veterans and others living with disabilities as well as the LGBT community. 

Best For
  • Low income families
  • Preventative care
Pros
  • 3 to 4 tiers of health insurance plans
  • Competitive quotes
  • Focus on wellness
Cons
  • Customer service could be better
  • Not available in all states

4. Aetna

Aetna offers a wide range of health insurance plans. Whether you’re seeking an individual, family or employer plan, Aetna likely has an attractive option for you. It also offers Medicare plans for qualified individuals. 

You can also enroll in a health savings plan with Aetna. You can combine it with a high-deductible health plan to help you save money on any medical expenses you have. 

# of Healthcare Providers
700k+
Online Application?
Yes
1 Minute Review

In the past, Aetna health insurance plans were available on Affordable Care Act (ACA) Marketplaces across the country. Though Aetna no longer offers ACA-compliant plans, the company continues to make healthcare more affordable through Medicare Advantage Part D coverage and dental insurance plans.

Aetna’s Medicare options extend to most parts of the country, and premiums for Advantage plans begin at $0 a month. Part D coverage, which helps pay for prescription drugs, begins at about $7 a month in most states. Additionally, Aetna offers dental insurance and dental discount plan options that anyone who doesn’t have dental coverage through their employer can take advantage of. In addition, Aetna also offers a number of additional benefits not seen with other coverage providers, including discounts on prescription drugs and rewards for meeting health goals. 

 

Best For
  • Member support
Pros
  • Offers multiple mobile app offerings to reward you for reaching fitness goals
  • Dental discount plans may include coverage for prescription drugs
  • Medicare Advantage plans available with no monthly premiums
Cons
  • Vision insurance only available when purchased with a dental plan
  • ACA-compliant health insurance no longer available

5. National General

Are you in need of a short term insurance option? You may want to check out National General. This company has been around since 1920 and specializes in short term policies. 

It offers coverage for many routine medical needs, such as doctor visits, diagnostic testing and visits to emergency rooms and urgent care facilities. It also offers a quick turnaround time so you can get covered sooner rather than later. National General’s policies do tend to have premiums that are higher than average, but it can offer good coverage if you’re short on options.

Get a Quote Call Now securely through National General Health Care’s website
# of Healthcare Providers
Wide range of provider access
Online Application?
Yes
1 Minute Review

Get next day short term health insurance coverage from National General Health Insurance. Licensed agents are waiting to help you find the right coverage today.

Best For
  • Families and individual plans
  • Anybody who needs temporary health insurance
Pros
  • Licensed agents available for help
  • Telemedicine available
  • Flexible policy terms
Cons
  • Short term health plans offer limited benefits

Buy From the Marketplace in Your State

As noted above, some states have their own marketplaces. In these states, you’ll need to complete the steps outlined above on the state Marketplace website rather than through the federal exchange. Here are state-specific marketplaces. 

List: State Health Insurance Marketplaces

Choosing Health Insurance

Open enrollment is a great time to buy health insurance. Whether you’re buying a plan from an employer or the Marketplace, dig into the plan details before deciding which one to buy. Explore Benzinga’s insurance information to learn more about ways to protect your family’s financial future. 

Frequently Asked Questions

Q

What is the health insurance marketplace phone number?

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What is the health insurance marketplace phone number?
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The federal Health Insurance Marketplace phone number is 800-318-2596. You can also look for a local health insurance agent or broker or assister or ask to be contacted by an agent or broker. Agents and brokers are licensed insurance agents who are trained and registered by the Marketplace and paid by insurance companies. Assisters are trained and certified people who can help you apply for a health insurance plan or for Medicaid. They are required to provide fair and impartial information. 

 

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Q

Is health insurance required?

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Is health insurance required?
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The federal mandate that required health insurance has been lifted but some states have enacted state-level mandates that require residents to have health insurance.

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What does health insurance cover?

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What does health insurance cover?
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Most health insurance plans provide the 10 essential health benefits that were part of Obamacare requirements. Coverages include preventive and wellness services, prescription drug coverage, emergency services, ambulatory services, lab services, pediatric services, and more.

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Q

How can I save money on health insurance?

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How can I save money on health insurance?
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For healthcare plans that comply with the Affordable Care Act, only a handful of rating factors affect your premium. These include age and location, at least one of which can’t be changed. Smokers will pay more in most cases and your choice of plan level can affect premiums as well. Choosing a high deductible health insurance plan can reduce the cost of premiums.

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