When Does Open Enrollment Begin And End?

Health insurance open enrollment lasts from November 1 to January 15 in the majority of states, although some states have different enrollment periods. During this time frame, you can shop for insurance plans that conform to the standards set by the Affordable Care Act (ACA) or change your existing coverage through the federal Health Insurance Marketplace or your state’s equivalent health exchange.

Keep reading to learn more about buying health insurance including how you can sign up for coverage and what options are available to you if you miss your state’s open enrollment window.

Key Takeaways Open enrollment generally runs from November 1 to January 15, although it could start as early as October 15 and end as late as January 31 in some states. You can only join a new ACA-compliant health plan or switch to a different one during open enrollment unless you qualify for a special enrollment period at some other point during the year. Medicare open enrollment lasts from October 15 to December 7 and Medicare Advantage open enrollment lasts from January 1 to March 31, while Medicaid enrollment and CHIP enrollment are open all year. If you already have health insurance, you will be automatically reenrolled in the same plan or a similar plan during open enrollment unless you intentionally make changes to your coverage. You can access the federal Health Insurance Marketplace or your state’s equivalent marketplace online, in person or over the phone.

What Is Open Enrollment?

Open enrollment is a time period when anyone can sign up for an ACA-compliant health insurance plan, switch to a new plan or otherwise adjust their coverage. In most states, open enrollment lasts from November 1 to January 15.^[1]

You may need to sign up between November 1 and December 15 for your coverage to take effect by the beginning of the new year. Otherwise, you can sign up from December 16 to January 15 for a health plan that will begin on February 1.^[1]

Some types of health insurance have their own separate enrollment periods. For example, Medicare open enrollment lasts from October 15 to December 7, while Medicare Advantage open enrollment lasts from January 1 to March 31.^[2]

Why Does Open Enrollment Exist?

By limiting when customers can buy coverage, open enrollment periods help keep the health insurance market stable. Specifically, they alleviate the issue of people enrolling in a health plan only when they are already sick or injured, which would significantly raise health insurance payouts and likely require insurers to charge drastically higher premiums.^[3]

That said, some private insurance companies may allow you to sign up for a health plan outside of open enrollment. However, you won’t be eligible for tax credits or other income-based savings opportunities if you enroll in one of these plans since they won’t be listed on the Health Insurance Marketplace.^[4]

How Often Does Open Enrollment Occur?

Open enrollment only takes place once per year but you may be able to sign up for an ACA-compliant plan outside of open enrollment if you qualify for a special enrollment period. Major life events like those listed below can trigger a special enrollment period because they can cause your health insurance needs to suddenly change.

• Getting married, divorced or separated
• Giving birth to or adopting a child
• Changing or losing your job
• Moving to a new home
• Graduating from college
• Losing your existing health coverage due to the death of a family member
• Becoming a United States citizen
• Leaving prison

It’s also worth noting that certain types of health insurance have multiple enrollment periods per year. For example, if you have a Medicare plan along with either Medicaid or Extra Help, you can make changes to your Medicare prescription drug coverage up to three times per year outside of open enrollment.^[5]

Who Is Open Enrollment For?

All citizens, nationals and lawful residents of the United States are allowed to buy coverage through the Health Insurance Marketplace during open enrollment as long as they actively live in the United States and aren’t in prison.^[6]

Government-funded health programs generally have additional eligibility requirements. For example, Medicare is exclusively available to individuals who are at least 65 years old or who have end-stage renal disease, Lou Gehrig’s disease or some other disability.^[7]

When Is Open Enrollment in 2023?

While open enrollment lasts from November 1 to January 15 in most states, some states have different health insurance enrollment deadlines. The below table goes over the regions with open enrollment dates that differ from the standard open enrollment period.

State/District	Open Enrollment Period
California[8]	November 1 to January 31
District of Columbia[9]	November 1 to January 31
Idaho[10]	October 15 to December 15
Maryland[11]	November 1 to December 31 for coverage beginning on January 1, January 1 to January 15 for coverage beginning on February 1
Massachusetts[12]	November 1 to January 23
New Jersey[13]	November 1 to January 31
New York[14]	November 16 to January 31
Rhode Island[15]	November 1 to December 23 for coverage beginning on January 1, December 24 to December 31 for coverage beginning in January, January 1 to January 31 for coverage beginning in February

You should note that some of the regions listed above have not formally announced their open enrollment dates for plans beginning in 2024. In those cases, it has been assumed that they will have the same open enrollment dates as last year or another recent year.

How Does Open Enrollment Work?

During open enrollment, you are free to make changes to your health insurance such as joining a plan for the first time or switching to a different plan. You can also cancel an existing health plan, although you don’t have to wait until open enrollment to cancel your health insurance.

To activate a new health plan, you’ll need to pay the premium for your first month of coverage up front. Meanwhile, if you already have a plan and don’t intend to change your coverage, then you’ll automatically be reenrolled in the same plan or switched over to a similar plan during the annual open enrollment period.^[16]

How Do I Sign Up for Health Insurance During Open Enrollment?

You can sign up for health insurance in person, over the phone or online during open enrollment. Every state either has its own health exchange website or takes advantage of the federal government’s Health Insurance Marketplace at HealthCare.gov.^[17]

When applying for coverage, you may need to share information like your Social Security number, address, current health insurance details, household income and more.

To simplify the process, you can type in your zip code below and then fill out SmartFinancial’s online questionnaire. We’ll share your coverage needs and budget with agents in your area who can provide you with no-cost health insurance quotes.

What Happens if I Miss Open Enrollment This Year?

In some states, missing open enrollment and going without health insurance coverage could result in a financial penalty if you haven’t been approved for an exemption from the state’s individual mandate. See the below table for an overview of the regions that charge fines if you fail to maintain health insurance.

State/District	Penalty
California[18]	$800 per adult and $400 per child or 2.5% of the amount of gross income that exceeds your filing threshold requirements based on your tax filing status and number of dependents, whichever is higher
District of Columbia[19]	$695 per adult and $347.50 per child or 2.5% of your household income, whichever is higher
Massachusetts[20]	$23 to $159 per month depending on your income relative to the federal poverty level
New Jersey[21]	$695 to $19,793 depending on your household income and number of dependents
Rhode Island[22]	$695 per adult and $347.50 per child or 2.5% of your household income, whichever is higher

To tide yourself over until next year’s open enrollment, you may be able to purchase a short-term health insurance policy from a private insurance company. However, these types of plans may not provide the minimum essential coverage outlined in the ACA, which means they may not meet the health insurance requirements of the regions listed above.

Alternatively, you could see if you are eligible for Medicaid or the Children’s Health Insurance Program (CHIP) since you can enroll in these government-funded programs at any point during the year.^[1] Otherwise, you may have to wait until the next open enrollment period or until you qualify for a special enrollment period to get coverage.

What Types of Health Insurance Are Available During Open Enrollment?

The below table goes over some of the most common types of ACA-compliant health insurance plans that you may be able to purchase through the Health Insurance Marketplace during open enrollment.

Plan Type	Description
HMO (Health Maintenance Organization)	HMO insurance covers treatments from medical providers who work for or contract with the plan but only covers emergency services from out-of-network providers and won’t allow you to see a specialist without a referral from your primary care physician
EPO (Exclusive Provider Organization)	EPO insurance exclusively covers in-network care outside of emergencies but allows you to see a specialist without a referral from your primary care physician
POS (Point of Service)	POS insurance allows you to receive care from in-network and out-of-network providers but you will pay more for out-of-network care and you will need a referral from your primary care physician to see a specialist
PPO (Preferred Provider Organization)	PPO insurance covers in-network care at a lower cost and out-of-network care at a higher cost but doesn’t require you to choose a primary care physician or get a referral to see a specialist
HSA (Health Savings Account)	HSA insurance typically combines a high-deductible health plan (HDHP) with a savings account that has pre-tax money you can use to pay for covered medical expenses before you hit your deductible

How Do I Maximize the Open Enrollment Period This Year?

In order to best take advantage of this year’s open enrollment period, you should evaluate your family’s health insurance needs for the upcoming year such as expected medical treatments and medication costs. Then, consider whether your current plan meets your needs or if you should switch to a different plan. If you are interested in changing plans, be sure to check whether any doctors you currently see are part of the new plan’s network.

You should also think about how often you are likely to use your health insurance and weigh plans based on the health insurance tier they fall into.

Plans in the bronze and silver tiers come with lower premiums but also require you to pay more in deductibles, copays and coinsurance whenever you visit a healthcare provider. Meanwhile, gold and platinum plans are more expensive when it comes to your regular premium payments but cheaper when it comes to out-of-pocket costs.