Key Takeaways
- Open enrollment is a time when you can make changes to your current health insurance plan or sign up for a new health insurance plan.
- The open enrollment period occurs at the end of each calendar year, but the exact dates depend on your state.
- Qualifying life events can allow you to make changes to your health insurance plan outside of the open enrollment window.
- It’s important to be prepared for open enrollment by researching plans that make the most sense for you and your family before it begins.
Whether you currently have health insurance or need to begin searching for plans, you need to know about open enrollment. Open enrollment is an important time for securing the insurance coverage you’ll need over the course of the year. Understanding how this process works and how to prepare will ensure that you can find a healthcare plan that meets your and your family’s needs while avoiding any gaps in coverage.
How Does Open Enrollment Work?
Open enrollment is the set period of time each year when you can make changes to your current health insurance plan or sign up for a new one. This period occurs during the final months of each calendar year.
Open enrollment is important as the needs of individuals and families are constantly changing. The open enrollment period allows you to add or change coverage to your current plan based on your new needs. On the other hand, if you do not have health coverage, this window is the time to find a plan that fits your needs.
It’s important to take open enrollment seriously because this period only happens once a year. If you do not sign up for health coverage during this time, your options will be limited.
When Is Open Enrollment?
Open enrollment occurs at the end of each calendar year, between November and January. In most places, open enrollment dates are set between November 1 and January 15.
However, the exact dates for open enrollment depend largely on the state you live in, as each state sets its own timeline. Some states may vary in their timelines by a few weeks, with some states starting as early as October 15 and others ending as late as January 31.
It’s important to know the exact dates in your state so that you can prepare to find the best plan for you. Before open enrollment starts, it’s a good idea to research plans, so you’re prepared for when the period begins.
Coverage Options
Open enrollment provides a time to explore several coverage options and sign up for a new plan. During this period, you can search for several types of insurance plans to ensure you have full coverage.
Some of the plans you can sign up for include:
- Individual health plans
- Family health plans
- Dental coverage plans
- Vision coverage plans
Because of the limited time during open enrollment, it’s crucial to find a plan that works for you during this time. If you miss out, then it will be much harder to find a plan that meets your and your family’s needs.
Be sure to take your time to review the plans you’re considering adding because you won’t be able to make changes during the year.
Dental and vision insurance coverage are exceptions—you can also add these coverage options throughout the year, as they are considered supplemental insurance.
Open Enrollment Deadlines
The open enrollment deadline is one of the most important milestones in health insurance, as it has important implications for you and your coverage needs. If you miss the deadline, you may miss out on having the coverage you need for a year.
Some of the disadvantages of missing the deadline include:
- Having gaps in coverage – If you don’t already have a health plan, not signing up for a plan during open enrollment could leave you without comprehensive coverage for a whole year. Meanwhile, if you do have a plan but missed the deadline for adjusting your current coverage for your current needs, you may end up with gaps in your coverage until next year.
- Limited coverage options – If you look for health insurance after the end of the open enrollment period, you’ll be much more limited in your options. Plans that you choose after often do not offer full coverage.
- Risks of unexpected costs – Missing the open enrollment deadline and choosing to forego healthcare coverage can result in you having to pay considerable costs if a healthcare need does arise.
Exceptions and Special Circumstances
Open enrollment is an important time for health insurance coverage, and everyone should prioritize using this time to ensure they have the coverage they need for the year. However, you can make changes to your health insurance outside of open enrollment under the right circumstances. The most common circumstance is if you have a qualifying life event.
What Is a Qualifying Life Event?
A qualifying life event is an event that allows you to sign up for or change your health insurance plan outside of an open enrollment period. To be eligible for a special enrollment period, you’ll need to report your qualifying life event, have documentation ready, and make any changes to your health insurance coverage within 60 days of the event taking place.
Some examples of qualifying life events include:
- A change in household – Changes in your household or family situation can allow you to make changes in your health insurance. These changes can include having a child and getting married or divorced.
- Loss of coverage – If you lose your current coverage, you qualify for a Special Enrollment Period. Some common examples include losing coverage through your job or aging out of being on your parent’s insurance plan after age 26.
- Relocation – If you move to a new state or zip code, you may be eligible for a special enrollment period, as different locations may have different health insurance options.
These are just a few examples of qualifying life events, so you may be eligible for other reasons depending on changes that occur throughout the year.
What Happens If I Miss the Deadline for Open Enrollment?
Although the open enrollment period is the best time for finding a comprehensive plan that meets your needs, you’re not completely out of options. You can still find health insurance plans if you miss the deadline and do not have coverage on the other side.
The most common option is to pursue a short-term health insurance plan. These plans are often less comprehensive and may have limits on their benefits. However, if you miss open enrollment, it’s better to have a plan with less coverage than have no plan at all.
You may also be eligible for a government-assisted program, like Medicaid or another option provided by your state. If you qualify for the income requirements, you can apply year-round.
Outside of these options, you may have to wait for a special enrollment period or the next year to be eligible for coverage.
How To Choose the Right Health Insurance Plan
As you gear up for open enrollment, it’s important that you begin thinking about what you’re looking for in a healthcare plan. Knowing how to choose the right health insurance plan before open enrollment starts will make the enrollment process much smoother.
Everyone is different, so everyone has different expectations of their health insurance. Here are some key things to consider so you can pick the right healthcare plan for you and your family:
- Your healthcare needs – Consider how often you visit the doctor and whether a plan will cover any preexisting conditions you may have. Think about your healthcare needs and how you interact with your medical providers to determine which plans will best fit your needs.
- Preventive care – Preventive care is an important part of a health plan, helping you stay healthy and catch issues before they arise. Consider choosing a plan that provides easy access to preventive care like check-ups and vaccinations.
- Plan costs – Be sure to compare costs across health insurance options. Some of the most important costs to consider are the monthly premium, the deductible, the out-of-pocket maximum, and any potential copays.
- Provider networks – Healthcare plans typically only cover a set network of providers. Make sure you find a plan that covers either your current provider or one that meets your needs.
- Prescription drug coverage – If you need medications for your health, then it’s important to choose a plan that covers them so you can protect your budget. Review a plan’s prescription formulary to determine whether any medications you need will be covered.
The right plan will offer a balance of all your needs and preferences based on the above criteria. Carry out thorough research for each plan so that you can find a plan that works for you.
Find the Right Plan for You
Open enrollment is an important time for you to find a healthcare plan that meets your needs and ensures you have quality coverage for you and your family year-round. Missing out on this time can leave you without coverage, so it’s important that you’re prepared for open enrollment for health insurance in the new year. Check open enrollment dates for your state and stay informed about your plan options so that you’re ready to go when it starts.
At Redirect Health, we offer plans that feature low-cost preventive care and around-the-clock care support, allowing you to access care when you need it. Our unique healthcare model allows us to provide quick access to quality healthcare at affordable prices.
Explore Redirect Health plans to see all the ways you can benefit. Contact us today to learn more about what sets us apart from traditional insurance.