What Is Open Enrollment? How to Change Healthcare Plans Before the Year Ends
June 6, 2023
Everything you need to know about Open Enrollment
What does Open Enrollment mean?
Around this time of year at SuperBill, people often ask us “What is Open Enrollment?” We decided to clear up these questions with a post. Open Enrollment is your chance to cancel, change, or enroll in a healthcare plan for the following year.
For example, Open Enrollment 2022 refers to your opportunity to update your health insurance for 2023. Open Enrollment happens each year for a limited time, so make sure to act before you’re locked into a plan you don’t want.
Choosing a health insurance plan is an important decision during Open Enrollment. If you want to learn more about the various types of plans, read our post on How to Choose a Health Insurance Plan That’s Right for You. If you have questions like “What is Open Enrollment?” “When is Open Enrollment?” or “When does Open Enrollment end?” you’ve come to the right place. We’ll discuss how Open Enrollment started and how it works, as well as the important dates to mark on your calendar. We’ll also talk about what to do if you miss Open Enrollment. (Just in case…)
How did Open Enrollment begin?
It’s unclear when exactly Open Enrollment originated, because the US healthcare system has evolved gradually over time. But, it was likely around the time of WWII, as tight labor markets forced health insurance plans to expand as an incentive for workers. Over time, the Open Enrollment period emerged to keep people from signing up for health insurance only when they’re sick.
Health insurance companies take on more risk when people who are unwell join their plans. So, they try to balance that risk by insuring healthy people. Restricting enrollment periods to a few weeks out of the year ensures more healthy people will sign up. Open Enrollment helps insurance companies’ bottom lines, so it’s not going anywhere anytime soon.
In 2010, the Affordable Care Act, also known as Obamacare or the ACA, made adjustments to the US healthcare system. The ACA required every American to have healthcare and created a Marketplace where Americans could shop for plans. Since 2010, the importance of Open Enrollment has grown considerably, due to the rising number of Americans buying non-job-related healthcare plans on the Marketplace.
(Side note: the increasing number of self-employed Americans is a big part of this growth. If you’re self-employed, read our related post for help choosing a self-employed health insurance plan.)
When is open enrollment for health insurance (2022)?
2022 Open Enrollment started on November 1. The timeline can vary from state to state, but in most states, Open Enrollment for ACA plans lasts until January 15, 2023. However, if you want your new insurance plan to take effect on January 1, you need to select it by December 15, 2022.
Basically, you have a one-month grace period if you miss the soft deadline in mid-December. But to avoid gaps in coverage, it’s best to select or make changes to your plan by December 15.
Who is eligible for Open Enrollment?
Everyone is eligible for Open Enrollment between November 1 and January 15, but how you enroll depends on your employment status.
If you receive health insurance from your employer, your employer should have sent you a message about Open Enrollment. Check your work emails for instructions on how to enroll or make updates. Usually, your employer gives you access to a benefits website where you can update your plan each year. Alternatively, they may have you notify Human Resources about your decision to change or update your plan. It's important to note, some companies align their enrollment period with the ACA Open Enrollment period. But others ask employees to update their benefits at a different time of year.
Many people get better deals on their insurance premiums by purchasing through their employer. This is because employers often receive discounts from insurance companies for buying plans in bulk. If you have the option to get health insurance through your employer, make sure to take advantage of it before Open Enrollment ends. You could save a lot of money.
If you do not receive health insurance through your employer, then keep reading. We have detailed instructions for choosing your own health insurance plan during Open Enrollment below.
How do I enroll in an insurance plan during Open Enrollment?
The best place to start your search for healthcare during Open Enrollment is www.healthcare.gov. Healthcare.gov, also known as the Health Insurance Marketplace, allows you to shop for and compare open enrollment plans. It also lets you see if you qualify for government subsidies that may lower your premiums.
Some states have their own marketplace for health insurance. If you live in a place with a state-specific exchange, you will have to use that exchange and not the federal one. Don’t fret, though! Healthcare.gov will redirect you to your state’s site, so you can still start your search there. Or, you can find a list of states with their own marketplace here.
Your third option is to look on specific insurance companies’ sites. Every insurer has a website describing their various plans where you can shop to your heart’s content. Be warned however, that insurers’ sites try to paint a rosy picture of their plans and won’t let you compare with competitors. If it reflects poorly on the plan, they might leave out important information like out-of-network benefits. Open Enrollment, therefore, is best handled through the Health Insurance Marketplace.
How do I get help enrolling in health insurance?
If you need help enrolling, editing, or canceling a plan, healthcare.gov has a handy list of resources to assist you. They even have a countdown in the bottom right corner that reminds you how many days you have until January 15.
For the less Internet-savvy among us, there are phone and in-person options for finding health insurance. Don’t let the complications of online health insurance stop you from taking advantage of Open Enrollment 2022. Getting the best and most affordable health insurance possible is worth the effort.
And if it’s help navigating your health insurance benefits you’re looking for, look no further. SuperBill has your back. We file and track your out-of-network claims so you don’t have to. To start saving time and money with SuperBill, just click the Get Started button at the top of the SuperBill homepage.
I missed Open Enrollment. What should I do?
The end of the year can be an extremely busy time, and it just so happens to coincide with Open Enrollment. If you’re wondering how to get health insurance after Open Enrollment ends, consider these options:
- Stay on the same plan.
If you already had health insurance through the end of this year, take a deep breath. Your health insurance will most likely continue into the new year. All you missed is the opportunity to change health plans. In general, without any action during Open Enrollment, your plan automatically renews.
- See if you qualify for a Special Enrollment Period.
People affected by certain “qualifying life events” have another option to choose a healthcare plan any time during the year. This option is called a Special Enrollment Period, and it’s available year round for qualifying parties. Look through the list of qualifying life events below to see if any apply to you.
Qualifying Life Events
Loss of Health Coverage
- Loss of existing coverage such as employer provided, individually funded, and student health plans
- Loss of eligibility for Medicare, Medicaid, or CHIP
- Loss of eligibility for a parent or guardian’s plan (at age 26)
Changes In Household
- Marriage or divorce
- A death in the family
- Having or adopting a child
Changes in Residence
- Moving to a new ZIP code
- A student moving to or from their school
- See if you qualify for Medicaid or CHIP.
If your income qualifies you for Medicaid or the Children’s Health Insurance Program (CHIP), you may apply at any time of year. Simply fill out an application to begin.
(Note: the ACA no longer makes uninsured people pay a tax penalty. A few states do though. If you live in California, Massachusetts, New Jersey, Rhode Island, Vermont, or Washington D.C., and you can afford insurance but choose to go without it, you will face a state tax penalty.)
SuperBill helps with out-of-network insurance claims!
That does it for Open Enrollment 101. Make sure you take advantage of this opportunity before it’s gone. And if you end up choosing a plan with out-of-network coverage and see providers outside your network, SuperBill is your claims-filing sidekick!
Read Getting Started with SuperBill to learn more about how to join. Power to the patient!