What Is Open Enrollment and Why Does It Exist?
By now you’ve probably gotten a few emails and letters from your health insurance provider about Open Enrollment starting on November 1st. But even though the Affordable Care Act (aka Obamacare) has been in effect for six years now, many people still don’t know what Open Enrollment is and why they have to go through it every year.
So if that’s you, you’re not alone. And it’s not your fault that the healthcare system is confusing. That’s why we’re here: to decode all of this health insurance jargon, empowering you with the necessary knowledge to get more out of your healthcare.
What is Open Enrollment?
Think of Open Enrollment as the health insurance industry's tax season. Every year you have the chance to change your health insurance plan, whether you have a reason or not. But you can only change your plan (or sign up for a new one if it’s your first time getting health insurance) during a predetermined period of time, usually from November 1st to January 31st.
You don’t need to wait until Open Enrollment to sign up for Medicaid or the Children’s Health Insurance Program (CHIP). You can apply to those initiatives at any time.
Why does Open Enrollment exist?
Open Enrollment comes from the Affordable Care Act, and it exists to prevent people from only buying health insurance when they get sick. This keeps overall healthcare costs down for everyone.
Who needs to use Open Enrollment?
Everyone! Open Enrollment is a yearly opportunity for you to get a better value. Your health needs might have changed over the past year, requiring you to get a different type of plan that’s a better fit for your lifestyle. Even if you have insurance through your employer, you should shop around and look at your options to make sure you’re getting the best plan for you. And you should definitely shop around if you work for a small business because you’ll often get better coverage at a lower price if you buy your insurance on your own.
What happens if I miss Open Enrollment?
You can still get insurance, but you'll need a reason to buy it. This is called a Special Enrollment Period (SEP). So if you moved, got married or divorced, had a new baby, changed jobs or are on the dreaded and expensive COBRA plan, then you qualify for SEP. You can also purchase a Short Term Medical plan at any time as either a supplement to your current long-term medical plan or as your primary coverage. Important Note: Short Term Medical plans are not compliant with the Affordable Care Act, which means that you'll still have to pay the tax penalty.
Important 2016-2017 Open Enrollment dates
Shortly before November 1, 2016 - Health insurance plans will offer a preview of their rates and any plan changes.
November 1, 2016 - The first day of Open Enrollment. Starting from this day, you can enroll, re-enroll, or change your health plan through the Marketplace. Your healthcare coverage will begin on January 1, 2017.
December 15, 2016 - This is the last day that you can enroll or change plans if you want your coverage to start on January 1, 2017.
January 1, 2017 - The day that 2017 coverage begins if you enrolled or changed plans by December 15.
January 31, 2017 - This is the absolute last day that you are allowed to enroll in or change your health insurance plan. You can only change or sign up for a new plan after this date if you qualify for SEP.