What to Know About Health Insurance Open Enrollment

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Selecting the right health insurance plan is one of the most important decisions facing individuals and families in the world today. Healthcare costs continue to rise significantly every year, quickly becoming one of the biggest financial burdens facing households, businesses, and other organizations. Being able to select an effective healthcare plan will provide a financial safety net for unexpected medical expenses and ease the burden of paying for routine doctor's visits. One of the most important factors to remember when pursuing a healthcare plan is the open enrollment period that most health insurance companies utilize.

Open Enrollment - What Is It?

Open enrollment is the time when people can enroll in a healthcare plan, most often occurring at the end of the year. Almost all major insurance companies implement an open enrollment period which typically lasts anywhere from 2-4 weeks for many private, employer-based health insurance plans to nearly 2 months for Medicare recipients. One of the reasons open enrollment periods are so popular among health insurance companies is because they streamline the application process, saving time and money. They also prevent individuals from constantly switching plans throughout the year which would make the funding and functioning of health insurance plans almost impossible.

Special Enrollment Period

Special enrollment periods are available for individuals who need to need to sign up for health coverage or change their current coverage outside of the regular open enrollment period if they have a specific qualifying event. Qualifying events can include the following scenarios:

  • Involuntarily losing healthcare coverage - Losing healthcare coverage due to losing a job, becoming too old to remain on parents' healthcare plan, or COBRA insurance expiring

  • Moving to a new state or region where the current healthcare plan isn't available

  • Moving to a new state or region with other available healthcare plans

  • Experiencing certain life events - Marriage, divorce, or having a child

  • Getting released from jail or prison

  • Changes in citizenship or legal resident status

  • Getting a Health Reimbursement Arrangement (HRA) from an employer

It is important to remember that losing health coverage because of voluntarily discontinuing health coverage or failing to pay monthly premiums usually do not count as a qualifying event. Individuals in these situations will be unable to purchase a new plan until the next open enrollment period. Also, most individuals who sign up for a healthcare plan only to find out that their doctor is not covered by their new plan typically cannot qualify for a special enrollment period either. As a result, it is strongly advisable for a person to check with their doctor before signing up for a new plan to make sure that they work with the specific insurance plan.

Health Insurance Plans Without an Enrollment Period

While most health insurance companies and plans use an open enrollment period to sign up most of their customers, some forms of insurance do not. Medicaid, the jointly funded state and federal program for low-income individuals, allows qualified individuals to enroll at any point during the year. CHIP, an extension of Medicaid that specifically covers low-income children, also provides year-round enrollment. Finally, short-term insurance such as travel insurance is offered year-round as well, along with some forms of supplemental insurance.