What Is Open Enrollment?

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What Is Open Enrollment?

What is open enrollment?

Open enrollment is a period of time each year when you can sign up for health insurance. If you don’t sign up for health insurance during open enrollment, you probably can’t sign up. At least you can’t sign up for health insurance until the next open enrollment period.

If you’re eligible and apply for health insurance during open enrollment, the health plan must insure you. The company is not allowed to use underwriting or require evidence of insureability. Both of which could make it harder for you to get health insurance.

But does this apply to everyone?

No.  Open enrollment periods are common and are used for Medicare, job based health insurance and the Affordable Care Act.

When is it?

This depends.  The time of year for open enrollment depends on your health care plan. The open enrollment for Medicare runs from the 15th of October to December 7th each year. Your job based open enrollment will be set by your employer.  Usually its’ in the fall so your new coverage can begin on the first of the next year.

Are there any exceptions?

Yes.

Most insurance sources that use an open enrollment system also have an exception that allows you to enroll at other times under certain circumstances.  These are normally referred to as “life events”.

Known as a special enrollment period, this exception would allow you to sign up for health insurance if you lost your other health insurance because you lost your job or moved. Getting married or divorced may also qualify you for this exception.  In addition, the death of your spouse would also make you eligible for special enrollment.

You can also qualify for special enrollment if you became of age that you are no longer covered under your parents’ health insurance plan.

A few other examples that may qualify you for this special enrollment period is if you let your COBRA insurance expire or with the birth of a baby.

One event where you are NOT eligible for a special enrollment period if you lost your other health insurance because you didn’t pay the monthly premiums.

There are a few other situations where you don’t have to worry about open enrollment or special enrollment periods.  If you are enrolling in state sponsored Medicaid you can enroll at anytime you qualify.  Also CHIP doesn’t have an enrollment time period.  This Children’s Health Insurance Program run by the federal government also allows enrollment at any time.

Short term travel insurance is another type of insurance where you don’t have to worry about open enrollment periods.

Also be aware that your employer will most likely make you wait until open enrollment to make changes to your current plan. For example you may need to wait until open enrollment to set up a flexible spending account or health savings account.  In addition, changes such as signing up for or adjusting the amounts of you life, disability, vision, dental and legal insurance may have to be made during the open enrollment period.

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