What Is an Open Enrollment Period?

Open Enrollment Dates May Vary

Open enrollment is a period of time each year when you can sign up for health insurance or change your plan (if your plan is provided by an employer, open enrollment is also an opportunity to disenroll if you no longer want the coverage). If you don't sign up for health insurance during open enrollment, you probably can't sign up for health insurance until the next open enrollment period, unless you experience a qualifying event.

Woman signing up for the ACA during Open Enrollment
Joe Raedle / Staff / Getty Images

If you’re eligible and apply for health insurance during open enrollment, the health plan must insure you. The company is not allowed to use medical underwriting or require evidence of insurability, both of which could make it harder for you to get health insurance.

What Types of Health Insurance Use Open Enrollment Periods?

Open enrollment periods are used for most types of health insurance, including:

When Is Open Enrollment?

The time of year for open enrollment depends on the health care plan you choose:

  • Medicare open enrollment (for Medicare Advantage and Part D plans) runs from October 15 to December 7 each year, and there is a separate open enrollment period from January 1 to March 31 for people who already have Medicare Advantage. Note that the Medicare open enrollment periods do NOT apply to Medigap plans, which don't have an annual open enrollment period. Medigap plans are only available without medical underwriting during your initial enrollment period or during one of the very limited special enrollment periods that apply to those plans, although a few states have implemented rules that allow Medigap enrollees to make changes to their plans on an annual basis.
  • Job-based health insurance open enrollment periods are set by your employer and can happen at any time of the year. However, it's most common for employers to have their open enrollment period in autumn so the new coverage begins on January 1 of the next year. But some employers choose to have a health plan year that doesn't align with the calendar year, so for example, you might find that your employer offers open enrollment in June, with a new plan year that starts in August.
  • Open enrollment in the individual market (on and off-exchange) runs from November 1 to December 15 in most states. This is the schedule followed by HealthCare.gov, which is the exchange platform that's used in 38 states as of 2020 (dropping to 36 for 2021, as Pennsylvania and New Jersey will be running their own exchange platforms). The District of Columbia and the other 12 states (14 in 2021) have more flexibility with their enrollment schedules, and most of them tend to offer longer enrollment windows. DC, Colorado, and California have permanently extended their enrollment windows, and a few other state-run exchanges have already announced extensions to the open enrollment period for 2021 individual market health plans. Note that Native Americans can enroll in individual market health plans through the exchange year-round, and are not limited to the annual open enrollment period.

Prior to 2014, enrollment was available year-round in the individual market, but in most states insurers determined eligibility based on applicants' medical history, which meant people with pre-existing conditions could be denied coverage; that no longer happens, thanks to the ACA.

Special Enrollment Is the Exception to Open Enrollment

Insurance plans that use an open enrollment system also have an exception that allows you to enroll outside of open enrollment under extenuating circumstances known as qualifying life events. When you experience a qualifying event, you're eligible for a special enrollment period that allows you to sign up for health insurance outside of open enrollment. Qualifying life events encompass a variety of circumstances, including:

  • involuntarily losing other health insurance coverage (due to losing or quitting a job, aging off a parent's health plan, COBRA insurance expiring, getting divorced, etc.)
  • moving out of your old plan's service area, or to an area where different health plans are available.
  • getting married
  • having a new baby or adopting a child

You won't be eligible for a special enrollment period if you lost your other health insurance because you didn't pay the monthly premiums though, or if you voluntarily canceled your prior coverage.

Note that although qualifying events and special enrollment periods in the individual market are similar to those that have long existed for employer-sponsored plans, they are not identical. Healthinsurance.org has a guide that pertains specifically to special enrollment periods in the individual market, on and off-exchange. And the Society for Human Resource Management has a good summary of qualifying events that trigger special enrollment periods for employer-sponsored health insurance.

What Types of Health Insurance Don't Use Open Enrollment?

Most health insurers in the United States use some sort of open enrollment program that limits sign-ups to a particular time each year. Here are some exceptions:

  • Medicaid, the state-based health insurance, doesn't limit enrollments to an open enrollment period. If you qualify for Medicaid, you can enroll at any time.
  • CHIP, the U.S. government's Children's Health Insurance Program, doesn't limit enrollments to a particular time either.
  • Travel insurance isn't subject to open enrollment restrictions. Due to the short-term nature of travel insurance policies, they're not usually subject to open enrollment. However, some travel insurance companies restrict your ability to purchase a travel insurance policy to the period of time immediately after you book your travel.
  • Short-term health insurance doesn't use open enrollment periods. Like travel insurance, short-term insurance isn't regulated by the ACA, and plans are available year-round in states that allow them (medical underwriting is used to determine eligibility for coverage, and short-term plans generally don't provide any coverage for pre-existing medical conditions). There are 11 states where short-term health plans aren't available, and numerous states that impose restrictions on short-term plans that go beyond what the federal government requires.
  • In some cases, supplemental insurance products. Supplemental insurance plans sold to individuals are available year-round. But if your employer offers supplemental insurance, your opportunity to enroll will likely be limited to your employer's overall open enrollment period. Medigap plans, which are designed to supplement Original Medicare, are available for purchase year-round. But after a person's initial six-month enrollment window ends, Medigap insurers in nearly every state are allowed to use medical underwriting to determine an applicant's eligibility for coverage.

More Open Enrollment Opportunities

Most employers allow you to sign up for or change other job-based benefits during open enrollment. Generally, you’re only allowed to make these changes during open enrollment. For example, you may be able to:

  • Set up a flexible spending account or health savings account (FSA contributions are established prior to the start of the plan year and normally cannot be changed later in the year without a qualifying event; HSA contributions can be stopped, started, or changed anytime, but you must have HSA-qualified health insurance in order to make contributions, and your ability to enroll in an HSA-qualified health plan will be limited to the annual enrollment window. Note that to address the COVID-19 pandemic, the IRS is allowing employers to relax the rules for mid-year FSA contribution changes ).
  • Sign up for, or adjust the amount of, life insurance, disability insurance, vision insurance, dental insurance, legal insurance, supplemental insurance benefits, etc.

Also Known As: annual enrollment, annual benefits enrollment

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Article Sources
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  2. Medicare.gov. Joining a health or drug plan. Open enrollment period for Medicare Advantage and Medicare prescription drug coverage; Medicare Advantage open enrollment period.

  3. Norris, Louise. medicareresources.org. Medigap—Medicare Supplement Insurance.

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  9. Norris, Louise. healthinsurance.org. 'So long' to limits on short-term plans. Current state regulations: More than half the states restrict initial terms and/or total duration of short-term plans. July 16, 2020.

  10. Internal Revenue Service. Notice 2020-29: COVID-19 Guidance Under § 125 Cafeteria Plans and Related to High Deductible Health Plans. May 2020.