Deadline For Changing Health Insurance: When?

The deadline for changing health insurance varies depending on the state and the insurance provider. In most states, the Open Enrollment Period (OEP) for 2024 health insurance plans begins on November 1 and ends on January 15. However, in some states, the OEP may start as early as October 15 or end as late as January 31. It's important to note that to have healthcare coverage by January 1, individuals typically need to enroll by December 15.

Outside of the OEP, individuals can still qualify for a Special Enrollment Period (SEP) if they experience a qualifying life event, such as losing health coverage, moving, getting married, having a baby, or if their household income falls below a certain level. These special periods can be as short as 30 days, so it's important to act quickly if you need to make changes to your health insurance outside of the OEP.

Open Enrollment Period (OEP)

The Open Enrollment Period (OEP) is the annual period when you can enroll in, renew, or change health insurance plans through the Marketplace. This period typically begins on November 1 and ends on January 15 in most states, with coverage starting on January 1 for those who enroll by December 15. However, the end date may vary slightly depending on the state and the plan chosen. For example, in 2024, the OEP was extended to January 16 in many states due to a federal holiday.

During the OEP, individuals can stop, start, or change their health insurance plans. This is especially useful if an individual's health needs have changed and they require a plan that better suits their current needs. It is important to note that the effective date for health insurance plans purchased during the OEP is typically January 1 of the following year. However, if an individual enrolls in a state with an extended OEP, their coverage start date may vary.

For Affordable Care Act insurance plans, the OEP usually runs from November 15 to January 15. To have coverage by January 1, individuals must sign up by December 15. State-run marketplaces may have different enrollment dates, so it is important to check the specific dates for your state.

Missing the OEP deadline does not mean you are completely out of options. If you have experienced a qualifying life event, such as losing health insurance through your job, household changes, or a change in home address, you may be eligible for a Special Enrollment Period (SEP). An SEP allows you to enroll in or change your health insurance plan outside of the OEP. However, the timeframe for an SEP is shorter, typically lasting only 30 to 60 days after the qualifying event.

Special Enrollment Period (SEP)

A Special Enrollment Period (SEP) is a time outside the yearly Open Enrollment Period when you can sign up for health insurance. You qualify for an SEP if you've experienced certain life events, such as losing your health coverage, moving, getting married, having a baby, adopting a child, or if your household income is below a certain amount. Depending on your situation, you may have 60 days before or after the event to enrol in a plan. If you miss that window, you will have to wait for the next Open Enrollment Period.

Job-based plans must provide an SEP of at least 30 days. You can enrol in Medicaid or the Children's Health Insurance Program (CHIP) at any time.

Some examples of qualifying life events include:

• Losing job-based health insurance
• Permanent moves to a new state or location within a state that makes new health plans available to you
• Getting married or entering into a domestic partnership
• Getting divorced or legally separated
• Getting pregnant
• Having a baby, adopting a child, or placing a child in foster care
• Becoming eligible or ineligible for financial help to pay for your Qualified Health Plan coverage
• Becoming a US citizen, national, or lawfully present individual
• Gaining or becoming a dependent due to a court order
• Experiencing domestic abuse/violence or spousal abandonment
• Successful appeal decisions regarding your health coverage
• Unexpected situations, such as a serious medical condition, natural disaster, or other emergencies
• Errors or delays in your enrollment or plan information
• Gaining access to a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) or Individual Coverage Health Reimbursement Arrangement (ICHRA)

Short-term health insurance plans

In California, the sale and renewal of short-term health insurance plans have been prohibited since 2019. As a result, residents must explore other coverage options, such as special enrollment periods or ACA-compliant plans through Covered California.

For those outside of California, short-term health insurance can be a viable option under certain circumstances. Here are some scenarios where short-term health insurance might be suitable:

• Waiting for Open enrollment: If you are waiting for the annual Open Enrollment Period to sign up for an ACA plan, a short-term plan can provide temporary coverage.
• Not eligible for a Special Enrollment Period (SEP): If you haven't experienced a qualifying life event, such as losing health coverage or having a baby, you may not qualify for an SEP. In this case, a short-term plan can fill the gap.
• Waiting for ACA coverage to start: If you have enrolled in an ACA plan but need immediate coverage, a short-term plan can bridge the gap until your ACA coverage begins.
• Turning 26 and transitioning off your parent's insurance: When you turn 26, you may need to arrange your own health insurance. A short-term plan can provide coverage during this transition.
• Between jobs or waiting for benefits to begin: If you are between jobs or waiting for benefits to start at a new job, a short-term plan can ensure continuous coverage.
• Healthy and under 65: Short-term plans typically cater to individuals who are generally healthy and do not require extensive health services or regular prescriptions.

It's important to carefully consider your needs and review the details of short-term plans, as they may have limitations on coverage for pre-existing conditions, maternity care, mental health, and other benefits. Additionally, short-term plans may have waiting periods and restrictions on renewals, and they are not available in all states.

State-specific deadlines

For instance, in 2024, the OEP was extended to January 16 in many states due to a federal holiday falling on January 15. Some states with their own ACA exchanges, such as California, Colorado, Connecticut, District of Columbia, Idaho, Maryland, Massachusetts, Minnesota, New Jersey, Pennsylvania, Rhode Island, and Washington, have set their own enrollment deadlines, which may fall after the federal deadline. These deadlines can change annually, so it is essential to stay informed about the specific dates for your state.

In addition to the annual OEP, individuals may qualify for a Special Enrollment Period (SEP) if they experience a qualifying life event, such as losing health insurance, moving to a new state, getting married, having a baby, or adopting a child. The SEP allows individuals to enroll in or change their health insurance plan outside of the regular OEP. The duration of the SEP can vary, typically ranging from 30 to 60 days after the qualifying life event.

It is important to note that state-run exchanges have the flexibility to set their own enrollment deadlines, which may differ from the federal schedule. Therefore, it is advisable to consult official state sources or insurance providers for the most accurate and up-to-date information regarding specific deadlines and requirements for changing health insurance in your state.

Qualifying life events

A qualifying life event is a life-changing situation that can impact you and your health insurance. Experiencing a significant life change may allow you to change your health plan outside of the annual enrollment period.

There are four basic types of qualifying life events:

Loss of Health Coverage

• Losing existing health coverage, including job-based, individual, and student plans
• Losing eligibility for Medicare, Medicaid, or CHIP
• Turning 26 and losing coverage through a parent’s plan

Changes in Household

• Getting married or divorced
• Having a baby or adopting a child

Changes in Residence

• Moving to a different ZIP code or county
• A student moving to or from the place they attend school
• A seasonal worker moving to or from the place they both live and work
• Moving to or from a shelter or other transitional housing

Other Qualifying Events

• Changes in your income that affect the coverage you qualify for
• Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
• Becoming a U.S. citizen
• Leaving incarceration (jail or prison)
• AmeriCorps members starting or ending their service

Frequently asked questions