What is Open Enrollment for ACA plans?

When is Open Enrollment?

Open Enrollment occurs annually, and the exact dates can change year-to-year. Typically, the Open Enrollment Period runs from Nov. 1 through Jan. 15, but you’ll want to enroll by Dec. 15 to ensure you’ll have coverage starting Jan 1. If you enroll after Dec. 15, your coverage may begin later.

During the Open Enrollment Period, you can enroll in a new plan, renew your current plan or make changes to your coverage (like adding or removing dependents, updating your income, etc.).

Who can enroll during Open Enrollment?

If you buy health insurance on your own through the ACA Health Insurance Marketplace^®, you can enroll during the Open Enrollment Period. This applies to all individuals and families who do not have health insurance through an employer, Medicare or Medicaid.

What happens if you miss Open Enrollment?

One of two things could happen.

Situation 1: If you are already enrolled in an ACA plan and do nothing to change your coverage before the Open Enrollment deadline, you’ll likely be automatically enrolled in the same plan.

However, even if you intend to keep your same plan, Wellmark recommends actively re-enrolling so you can verify your household and income information is correct — and confirm that your current plan will still fit your needs for the upcoming year. Making sure this information is up to date ensures you pay the correct premium amount and don’t miss out on savings or underpay and have to repay some or all federal tax credits (subsidies). Plans can also change year-to-year, so you’ll want to know what will be different ahead of time.

Situation 2: If you miss the Open Enrollment deadline and are not currently enrolled in Marketplace health insurance, you will need to wait to enroll in coverage until the next Open Enrollment Period. The only exception to this is if you qualify for a Special Enrollment Period (SEP).

What is a Special Enrollment Period?

A Special Enrollment Period is a time when you can enroll in health insurance coverage or change your plan outside of the Open Enrollment Period. You typically are eligible for a Special Enrollment Period after experiencing a big life change, also called a qualifying life event. Some common examples of qualifying life events include losing health coverage through your employer, turning 26, getting married or moving.

How can I get help finding a health plan during Open Enrollment?

With Wellmark, you have options for support. Wellmark’s online shopping platform and self-service tools make it easy to compare plans and enroll when you’re ready. And if you have questions or want personalized guidance, health insurance agents are available to help you navigate Open Enrollment. Find an agent today.

What do I need to do to get ready for this year’s Open Enrollment Period?

Start by thinking about how you’ve used your coverage in the past year. Consider what your costs have been and if you anticipate needing more or less care in the year ahead.

Then, read this article to learn more about what you need to consider when shopping for an individual or family ACA marketplace insurance plan.