What Should You Do if You Miss Open Enrollment for Health Care?

If you miss open enrollment, you may not be able to sign up for a new health insurance plan or switch from your current plan to a different one until the next open enrollment period — unless you qualify for a special enrollment period due to a major life event that changes your coverage needs. That said, alternative coverage options may be available outside of open enrollment, such as buying a short-term or supplemental plan or enrolling in a public health care program.

If you miss open enrollment, you generally must wait until the next enrollment period to obtain or change qualifying health coverage unless you qualify for a special enrollment period or another coverage option.

Read below to learn more about what happens if you miss open enrollment and what steps you may be able to take to secure health insurance coverage.

On This Page

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  When Is Open Enrollment?

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  What Happens if You Miss Open Enrollment for Health Insurance?

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  Missed Open Enrollment? Start Here

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  What Happens if You Miss Open Enrollment at Work?

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  What Options Are Available if You Missed Open Enrollment?

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  What Happens if You Miss Open Enrollment at a Glance

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  Frequently Asked Questions

When Is Open Enrollment?

Open enrollment occurs on the federal Health Insurance Marketplace from Nov. 1 to Jan. 15, with coverage beginning at the start of the new year if you enroll by Dec. 15.^[1] Several states operate their own health exchange websites and may have slightly different open enrollment dates as a result.^[2] Outside of this limited-time window, you generally aren’t allowed to join a new Marketplace plan or update your existing coverage.

If you receive health insurance coverage through your employer, your enrollment dates won’t necessarily correspond with the Marketplace’s enrollment period — though many employers do run open enrollment in the fall around the same time as open enrollment on the Marketplace.^[3] Contact your company’s human resources department for clarification on when you can sign up for a work-based health plan.

You may not have as much time to enroll in employer-sponsored health insurance, as most businesses opt to keep enrollment open for only two to four weeks.^[3]

There are also open enrollment deadlines you need to be aware of if you’re eligible for government-sponsored coverage through Medicare. Specifically, the annual open enrollment period for Original Medicare lasts from Oct. 15 to Dec. 7 each year. Meanwhile, Medicare Advantage open enrollment occurs annually from Jan. 1 to March 31.^[4]

What Happens if You Miss Open Enrollment for Health Insurance?

When you miss open enrollment, you generally aren’t able to change your current health insurance — and may be stuck without coverage altogether if you’re currently uninsured. While most states don’t explicitly enforce penalties for missing open enrollment, some states will issue a fine if you fail to maintain health insurance that complies with the Affordable Care Act. Here’s an overview of the states that impose penalties for not having health insurance:

What if You’re Already Insured?

Missing open enrollment may not be a problem if you’re satisfied with your current coverage. Existing Marketplace plan members who don’t take action during open enrollment may be automatically reenrolled in the same plan or a similar plan. Automatic reenrollment often occurs by Dec. 15 so coverage can start on Jan. 1 — which means you may have time to make changes before the end of open enrollment if you don’t like the plan you’re reenrolled in.^[10]

How Do You Get Coverage if You Miss Open Enrollment?

Even if you miss open enrollment, you can update your health coverage or buy a new plan if you qualify for a special enrollment period. SEPs are generally triggered by major life events that significantly alter your health insurance needs. Examples of common qualifying life events include getting married, having a child, moving to a new state and losing access to your parents’ coverage after turning 26.^[11]

You may also be able to buy coverage directly from a private insurance company outside of open enrollment. However, off-Marketplace plans typically don’t meet the minimum essential coverage standards of the ACA. In addition, you can’t use income-based premium tax credit subsidies to lower the cost of an off-Marketplace plan like you can for a Marketplace plan.^[12]

Missed Open Enrollment? Start Here

In the event that you forget to sign up for Marketplace health insurance before Jan. 15, you need to take the following steps to try to obtain coverage for the upcoming year:

1. If you live in a state with its own health exchange, confirm whether enrollment is actually closed (e.g., open enrollment doesn’t end until Jan. 31 in California).^[13]
2. If you’re already covered, determine whether you were reenrolled during open enrollment and, if so, whether your coverage has changed at all.
3. If you aren’t already covered, research qualifying life events to figure out whether you may be eligible for a special enrollment period.
4. Collect documentation needed to prove your eligibility for an SEP, if applicable.
5. Check whether you may be eligible for government-funded health care through a program like Medicaid.
6. Look into non-ACA-compliant health insurance options, if necessary.

What Happens if You Miss Open Enrollment at Work?

You won’t be able to add coverage or adjust your existing plan if you miss open enrollment for your employer-sponsored group health insurance — and you may even be stuck with your current coverage for the next year. Unlike Marketplace plans, which you can cancel at any time, work-based plans can only be canceled during open enrollment or a special enrollment period if your premiums are paid using pretax payroll deductions.^[14][15]

Job-based health plans may automatically renew like Marketplace plans, but you should check with your HR department to confirm whether you risk losing coverage if you don’t take action during open enrollment.^[16] Keep in mind that you’ll often qualify for an initial enrollment period shortly after starting a new job — regardless of the time of year — so you likely won’t have to worry about waiting to sign up if you happen to get hired outside of open enrollment.^[17]

How Do You Get Coverage if You Miss Open Enrollment at Work?

If you miss open enrollment at work, check your eligibility for an SEP — your company must offer one lasting at least 30 days if you experience a qualifying life event.^[18] You could also get a Marketplace plan if open enrollment is ongoing or you’re eligible for an SEP. However, your employer won’t contribute to the premium payments for a Marketplace plan like it would for your job-based plan, so you may end up paying more for coverage.

Alternatively, you could see if you qualify for coverage under your spouse’s employment-based health plan, assuming their open enrollment period is still in progress. Finally, if your employer doesn’t automatically renew your insurance and you lose coverage due to missing open enrollment, you may be able to get back on your parents’ health insurance as long as you’re under the age of 26.^[19]

Can COBRA Help if You Missed Open Enrollment?

The Consolidated Omnibus Budget Reconciliation Act won’t help if you fail to sign up during open enrollment at work. While COBRA allows you to extend your employer-sponsored health insurance for up to 18 months or more in instances where it might otherwise be terminated, this only applies to situations like being laid off, quitting or experiencing a reduction in your employment hours — not simply forgetting to enroll at the proper time.^[20]

What Options Are Available if You Missed Open Enrollment?

If you’ve missed open enrollment, you may want to check whether you or your dependents are eligible for either Medicaid or the Children’s Health Insurance Program. Medicaid and CHIP are government-funded programs that provide subsidized health care coverage for low-income families and those who can’t afford private health insurance for their children. Eligible individuals can enroll in these programs year-round.^[1]

Another option is purchasing short-term health insurance to tide you over until the next open enrollment period. However, short-term health plans may not offer the same level of coverage as ACA-compliant major medical insurance plans. Additionally, limited-duration health insurance plans are not available at all in some states, such as California and New Jersey.^[21][22]

Finally, you may be able to enroll in one or more supplemental health insurance plans at any time.^[23] These types of plans cannot adequately replace major medical insurance, but they can at least provide limited coverage for specific situations. Examples of supplemental plans include accident insurance, critical illness insurance and hospital indemnity insurance.

What Happens if You Miss Open Enrollment at a Glance

1. Open enrollment refers to the limited-time window when health insurance shoppers can freely buy or swap plans. It lasts from Nov. 1 to Jan. 15 on the Health Insurance Marketplace and from Oct. 15 to Dec. 7 if you’re on Medicare. Open enrollment for employer-sponsored coverage typically happens in the fall, but dates may vary by business.
2. Barring extenuating circumstances, you’ll be stuck without health insurance or with whatever coverage you currently have if you fail to take action during open enrollment.
3. Going without health insurance can result in tax penalties if you live in California, Massachusetts, New Jersey, Rhode Island or Washington, D.C.
4. Marketplace and work-based plans may automatically renew during open enrollment, so you may not need to take action if you’re content with your existing coverage. Still, it’s best to review your options during open enrollment in case your current plan is slated to undergo changes.
5. Outside of open enrollment, you can sign up for coverage during a special enrollment period only if you experience a qualifying life event, such as getting married, moving to a new address, having a baby or losing your existing health insurance.
6. If you meet their eligibility requirements, you can enroll in Medicaid or CHIP at any point throughout the year.
7. You can join a short-term or supplemental health plan at any time, but they don’t provide the same benefits and protections as ACA-compliant plans.