Open enrollment is the time period each year when you’re allowed to start, stop or change your health insurance plan. Normally, you sign up around the end of one calendar year for coverage that lasts the next full year.
Open enrollment for 2018 health insurance
|Marketplace plans (Healthcare.gov and state exchanges) and individual health insurance plans||Nov. 1 to Dec. 15, 2017|
|Employer-sponsored health insurance||Dates depend on your employer, but typically in the fall|
|Medicare||Oct. 15 to Dec. 7, 2017|
|Medicaid||No date restrictions — you can apply at any time|
Open enrollment for federal and state marketplace plans
The open enrollment window for private, individual health plans for 2018 will last 45 days: Nov. 1, 2017, to Dec. 15, 2017. This is a change from previous years, when open enrollment lasted three months.
You can shop for individual health plans in four ways:
- On the federal marketplace or a state exchange via Healthcare.gov
- On the phone, by calling the marketplace call center at 1-800-318-2596
- Directly on an insurer’s website
- Via a local health insurance broker
The only way to get an individual health plan outside of open enrollment is to qualify for a special enrollment period.
An advantage of using Healthcare.gov is that tax credits to lower your monthly premiums are available only on this federal marketplace or a state exchange. In 2017, 83% of consumers who bought on the federal marketplace had subsidized premiums, according to the Centers for Medicare and Medicaid Services.
The main reasons to shop elsewhere and not use the Affordable Care Act exchanges are:
- You don’t qualify for tax credits because your income is too high, which is above 400% of the federal poverty level. A health insurance broker may help you find a better plan than those offered on a state or federal marketplace.
- You want more health plan options. Insurers can offer the same plans on the exchange and off, at the same price, and many do. They also may offer additional plans through their website or brokers that aren’t available on the marketplace.
- The provider network doesn’t work for you. Your preferred doctors are not in the provider networks of the plans on the exchange.
- You have a chronic condition and the marketplace plans don’t cover your needs. Plans purchased directly from an insurer or through a broker might have better benefits. For example, if your drug is not on a plan’s drug formulary or medical equipment you need isn’t covered, non-marketplace plans may have better coverage for you.
You won’t sacrifice plan quality by not buying on an exchange. All health insurance policies are required to cover the same essential benefits and meet minimum standards.
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Open enrollment for employer-sponsored insurance (group health insurance)
If your health insurance comes from an employer, your open enrollment period might change each year. Timing can depend on several factors, but selection is generally during the fall.
You can purchase a different plan than one your employer offers if you wish, but take note of these rules:
- If you decline your employer’s insurance, you can’t get premium tax credits for a marketplace plan if your employer’s plan costs less than 9.69% of your household income and pays at least 60% of medical bills to meet a minimum value standard.
- If you decline your employer’s health insurance but then fail to buy a plan during the open enrollment period for individual plans, you’ll be uninsured and risk paying a penalty for not having health insurance.
Medicare open enrollment
Medicare open enrollment is Oct. 15 to Dec. 7, 2017. Medicare beneficiaries also have other time periods throughout the year when they can change benefits. And unlike other types of insurance, Medicare has additional “disenrollment” periods.
|Important dates for Medicare|
|Oct. 15 to Dec. 7||Open enrollment|
|Jan. 1 to Feb. 14||Medicare Advantage disenrollment period, when you can switch from Medicare Advantage to Original Medicare.|
|Jan. 1 to March 31||Medicare Parts A and B general enrollment. You can enroll in Parts A and B during this time, if you didn’t sign up when you were first eligible.|
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Other health plans
There are some short-term health plans you can purchase outside of open enrollment without a special enrollment period. Those plans usually don’t count as minimum coverage under the Affordable Care Act, so you could buy one and still have to pay the penalty for not having health insurance. Additionally, they tend to have high deductibles and poor coverage.