Alyssa Lane
The Affordable Care Act's (ACA) open enrollment period is an annual window during which individuals and families can compare and select from a range of health plans to meet their needs for the upcoming year. Typically, open enrollment runs from November 1 to January 15, with coverage beginning on a specified date after this period. During this time, people can sign up for new insurance plans, switch plans, or make adjustments to their existing policies without penalty. While the open enrollment period is the primary opportunity for individuals to obtain health insurance, special enrollment periods exist outside of this window, accommodating life changes such as moving, marriage, or the birth of a child.
| Characteristics | Values |
|---|---|
| Time period | November 1 – January 15 |
| Yearly enrollment | Yes |
| Enrollment outside the time period | Possible in case of a qualifying life event, such as moving, marriage, or the birth of a child |
| Enrollment methods | Online through the healthcare marketplace or directly with an insurance company |
| Enrollment assistance | Available through health insurance brokers or health benefits navigators |
| Enrollment numbers | 16.6 million consumers signed up for coverage on HealthCare.gov, the highest ever for January 1 coverage |
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What You'll Learn
Enrollment via the Health Insurance Marketplace
The Health Insurance Marketplace, also known as the Health Insurance Exchange, is a service provided by the U.S. Department of Health & Human Services. It allows individuals and families to compare and select from a range of health plans that best fit their needs. The Affordable Care Act's (ACA) open enrollment period typically runs annually from November 1 through to January 15, though dates may vary across states with their own exchanges.
During this period, individuals can make changes to their health insurance coverage or enroll in a new plan. For instance, those with a Medicare plan can review new plan options and insurance companies, as well as check for changes to extra benefits, such as dental, vision, food, wellness programs, non-emergency transportation, or home modification. People with specific medical needs, such as Cystic Fibrosis, may also have the option to make changes to their plan during this time.
Enrollment can be completed online, over the phone, through a paper application, or in-person with a local broker, navigator, or enrollment assister. These professionals can also help individuals apply for premium tax credits and compare marketplace plans for free. Signing up for email reminders can help individuals stay informed about important dates and deadlines.
Outside of the open enrollment period, individuals may still be able to enroll or make changes to their Marketplace plans if they experience a significant life event, such as moving, getting married, or having a baby. Additionally, low-income individuals may qualify for a Special Enrollment Period (SEP) at any time during the year, allowing them to find affordable health coverage.
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Enrollment for Medicare plans
Open enrollment is an annual period when individuals can make changes to their existing health insurance coverage or enroll in a new plan. This period typically runs from November 1 to December 15 for plans starting in the following year. If you enroll between November 1 and December 15, your plan will take effect on January 1 of the following year. However, some states may have different open enrollment dates, so it is essential to check with your state's marketplace website or exchange for specific information.
For those with Medicare plans, open enrollment is an important time to review any new plan options or changes in terms for extra benefits, such as dental, vision, or wellness programs. It is also a chance to assess whether there have been changes in income, resources, or household size, which may impact eligibility for Medicare Extra Help or the Medicare Savings Program.
Individuals can enroll in Medicare plans by visiting the Medicare.gov website or contacting the plan directly through phone or their website. Some plans may also accept paper forms, but these must be submitted before the enrollment period ends. It is worth noting that Medicare is a health insurance program for individuals aged 65 or older or those with specific disabilities or permanent kidney failure.
During the open enrollment period, individuals already enrolled in Medicare Advantage by December 31 can make changes to another Medicare Advantage plan or switch to Original Medicare from January 1 through March 31. However, deadlines may vary slightly from state to state, so it is always recommended to confirm with the state marketplace website.
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Enrollment for Medicaid
Open enrollment is a time each year when individuals can make changes to their health insurance coverage or enroll in a new plan. There is no annual open enrollment period for Medicaid and the Children's Health Insurance Program (CHIP). You can apply for coverage at any time of the year.
The Center for Medicaid and CHIP Services (CMCS) works with states to identify and enroll people who are eligible for Medicaid or CHIP. States may use these and other strategies to make it easier for people to enroll in Medicaid and CHIP coverage. For example, states may rely on eligibility information from "Express Lane" agency programs to streamline and simplify enrollment and renewal in Medicaid and CHIP. Express Lane agencies may include the Supplemental Nutrition Assistance Program (SNAP), School Lunch programs, Temporary Assistance for Needy Families (TANF), and the Women, Infant, and Children's program (WIC), among others.
States may also provide children with 12 months of continuous coverage through Medicaid and CHIP, even if the family's income changes during the year. This guarantees ongoing coverage and helps doctors develop relationships with children and their families. Additionally, 34 states use continuous eligibility to keep eligible children enrolled in Medicaid and/or CHIP. States may provide Medicaid and CHIP coverage to children and pregnant women who are lawfully residing in the United States, including those within their first five years of having certain legal status.
In some cases, states, with Centers for Medicare and Medicaid Services (CMS) approval, can require Medicaid beneficiaries to enroll in a managed care plan to obtain some or all Medicaid benefits. Many states mandate managed care enrollment for certain Medicaid beneficiaries and make it voluntary for others. There are a number of statutory authorities through which states can allow or require Medicaid beneficiaries to receive services through a managed care delivery system. However, all Medicaid managed care programs must adhere to the requirements in Section 1932 of the Social Security Act and Section 438 of Title 42 of the Code of Federal Regulations (CFR 438).
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Enrollment deadlines
Open enrollment is a period each year when individuals can make changes to their health insurance coverage or enroll in a new plan. This period typically runs from November 1 to January 15. Those who enroll between November 1 and December 15 will have their plan start on January 1 of the following year, while those who enroll between January 1 and January 15 will have their new plan start on February 1.
It is important to note that there is no annual open enrollment period for Medicaid and the Children's Health Insurance Program (CHIP). Individuals can apply for coverage under these programs at any time of the year. However, if you are already enrolled in a managed care Medicaid plan, there may be limited periods when you can make changes or switch to a different plan.
For individuals with Medicare plans, it is recommended to review the availability of new plan options or insurance companies during open enrollment. This includes checking for any changes in the terms of extra benefits offered, such as dental, vision, food, wellness programs, non-emergency transportation, or home modification. Additionally, assessing changes in income, resources, or household size during this period is crucial, as it may impact eligibility for Medicare Extra Help or the Medicare Savings Program.
While the aforementioned dates apply to the Health Insurance Marketplace, it is worth mentioning that job-based plans may have different open enrollment periods. Therefore, it is advisable to check with your employer for specific deadline information. Moreover, some states have their own exchanges with varying open enrollment dates, so it is recommended to visit your state's exchange website for accurate details.
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Enrollment for families
Open enrollment is a period of time, usually in the fall, when individuals can make changes to their health insurance coverage or enroll in a new plan. This period typically lasts a few weeks from November 1 to December 15 for plans starting in the following year. If you enroll between November 1 and December 15, your plan will start on January 1. If you enroll between January 1 and January 15, your new plan will start on February 1.
For families, it is important to consider different factors when choosing a health insurance plan. Firstly, review the benefits offered by each plan before deciding to enroll. Some plans may cover preventive services, such as dental, vision, or wellness programs. Understanding the costs associated with the plan is also crucial. These costs may include monthly premiums, copayments, and out-of-pocket expenses. Additionally, it is essential to check the coverage details to know what services are covered under the specific plan.
When enrolling in insurance for your family, you can apply for coverage through the Health Insurance Marketplace, also known as the Health Insurance Exchange or Marketplace. This platform allows you to compare different plans and choose the one that best suits your family's needs. You can create an account on Healthcare.gov, the official source for the Marketplace, to get started.
During open enrollment, families can make changes to their existing plans or enroll in new ones. It is a good time to reevaluate your insurance choices, especially if your family has experienced any significant life changes, such as the birth of a child, marriage, or a change in income. Additionally, open enrollment allows you to ensure that your plan provides adequate coverage for your family's unique needs and budget.
If you miss the open enrollment period, there may still be opportunities to enroll in health insurance plans through a Special Enrollment Period. This period exists outside of the standard open enrollment timeframe and allows individuals and families to enroll due to specific life events or income-based qualifications.
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Frequently asked questions
It varies. In 2025, nearly 24 million consumers enrolled in insurance during the ACA Marketplace open enrollment. In 2024, 16.6 million consumers signed up for coverage with HealthCare.gov, which was the highest ever for January 1 coverage.
Open enrollment typically runs from November 1 through January 15, but the dates vary in some states that run their own exchanges.
You can enroll online through the healthcare marketplace or with an insurance company directly.
