When is Open Enrollment for ObamaCare, Medicaid, Medicare and Other Insurance Types?
Open enrollment is the only time of year you can get a major medical plan that counts as minimum essential coverage in the individual and family market without qualifying for a special enrollment period. This is true both inside and outside the health insurance marketplace. Other health insurance types like Medicare and Medicaid have unique enrollment periods.
Below we will cover open enrollment dates for each health insurance type for each year and some tips and tricks for making the most out of enrollment periods, getting covered outside of open enrollment, and avoiding the fee.
Open Enrollment Dates and Other Key Facts
Each year there is an annual open enrollment period for the Health Insurance Marketplace and all other private coverage for individuals and families.
- For 2014 coverage the open enrollment period was October 1st, 2013 – March 31st, 2014
- Open enrollment 2015 ran from November 15th, 2014 – February 15th, 2015.
- Moving forward open enrollment dates are expected to go from October 1st – December 15th. So open enrollment 2016 will be October 1st, 2015 – December 15th, 2015.
- Open enrollment is the only time that you can enroll in a plan, change plans, or apply for cost assistance unless you qualify for a special enrollment period. All Private Health Plans share the Health Insurance Marketplace’s open enrollment period, while other types of plans like employer based coverage, Medicaid, and Medicare have unique enrollment periods.
- The only way to get subsided insurance is by enrolling in the health insurance marketplace.
- The only way to avoid the per month fee for not having insurance is to obtain minimum essential coverage and maintain it throughout the year or to qualify for an exemption. All marketplace coverage counts as minimum essential coverage.
- Make sure to verify your plan and cost assistance each year to avoid auto-renewal and make sure you get the right cost assistance. Not all plans auto-renew. You MUST verify your renewal or get new coverage during open enrollment!
- To avoid the fee for 2014 you needed to Get Coverage that started by May 1st, 2014. To avoid the fee moving forward you’ll need to maintain coverage for each month throughout the year, although you are allowed grace period of less than three months in a row without coverage.
- If you miss the deadline to sign up for health insurance you may still have options.
- You can apply for special enrollment all the way up until open enrollment starts each year. So don’t hesitate to contact your health insurance marketplace outside of open enrollment if you have lost coverage for any reason.
- Healthcare.gov is the official Health Insurance Marketplace.
There are many different types of Health Insurance that count as minimum essential coverage and each has it’s own unique enrollment period. Let’s take a look at the open enrollment periods for ObamaCare’s health insurance marketplace, Medicare, Medicaid and CHIP, job based coverage and off-marketplace private insurance plans.
ObamaCare Open Enrollment Period Definition
ObamaCare’s open enrollment period is an annual period of time when you can enroll in a plan inside or Outside The Marketplace, switch plans, get cost assistance, and apply for Medicaid through the marketplace.
The only way to get major medical insurance known as minimum essential coverage (the type of coverage you’ll need to avoid the fee) is to enroll in a plan during open enrollment or by qualifying for a special enrollment period. This is true both inside and outside of the marketplace as insurers have unofficially adopted ObamaCare’s enrollment periods for all major medical coverage!
ObamaCare Open Enrollment 2014 Details
ObamaCare’s 2014 open enrollment period started October 1st, 2013 and ended March 31st, 2014. If you enrolled during the 2014 open enrollment period you’ll want to sign into the marketplace and see what new plans are available and update your information during 2015’s open enrollment period.
ObamaCare Extended Open Enrollment 2014
If you signed up for the marketplace by March 31st, 2014, but weren’t able to enroll, you were able to check a box that allowed you to enroll until mid-April due to a last minute extension. This was a one time extension for open enrollment 2014 only. Even if you enrolled during the extension or if you enrolled during a special enrollment period you will still be able to switch plans during open enrollment 2015.
ObamaCare Open Enrollment 2015
ObamaCare’s open enrollment 2015 starts on November 15th, 2014 and ends on February 15th, 2015. Starting in 2015 open enrollment only lasts for three months, however this open enrollment period is subject to change.
Open Enrollment 2015 Changes
Open enrollment 2015 is your opportunity to see what new plans your state’s marketplace is offering and to update your information. Check out our guide to ObamaCare in 2015 for more specific information on the 2015 enrollment period changes. It’s very important that you verify your plan and information to make sure you are getting the coverage you want with the cost assistance you deserve.
The deadline to make sure you had the right plan and right cost assistance for 2015 was December 15th, 2014.
ObamaCare Extended Open Enrollment 2015
There was a special enrollment period for those who owe the fee for 2014, and don’t have coverage for 2015. This special enrollment period essentially extended open enrollment 2015 until April 30th for many Americans.
ObamaCare Open Enrollment 2016 and Beyond
ObamaCare’s Open enrollment 2016 will go from October 1st to December 15, so to get coverage for January 1, 2016, you would have to enroll between October 1st, 2015 – December 15th, 2015.
This period has moved once already, and both 2014 and 2015 open enrollment periods were extended, so we can expect the 2016 to be extended as well. That being said moving forward extensions are not guaranteed and the open enrollment will be expected to narrow to October 1 through December 15 every year. See Federal Register “Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2016″ for details on 2016 open enrollment.
Important Open Enrollment Period Dates
Here are dates you need to know to make sure you are covered during ObamaCare’s open enrollment period.
- November 15, 2014: Open enrollment starts. This is true both inside and outside of the marketplace.
- December 15th, 2014: Anyone who wants their plan to start by January 1st, 2014 must take action to ensure they are renewing the plan they want for 2015. You can still change plans for the rest of open enrollment, but your plan won’t start by January 1st.
- December 31st, 2014: All plans enrolled in during last open enrollment end.
- January 1st, 2015: Plans that will be offered next year automatically renew with same cost assistance if applicable.
- February 15th, 2015: This is the last day to enroll in a plan, change plans, or apply for cost assistance. This is true both inside and outside of the marketplace.
- October 1st (moving forward): Open enrollment begins
- December 15th (moving forward): Open enrollment ends and plans auto-renew if applicable.
- January 1st (moving forward): All new plans begin.
What Happens if I Missed ObamaCare’s Open Enrollment?
If you miss open enrollment in ObamaCare you won’t be able sign up again until the next open enrollment period without qualifying for a special enrollment period.
Special Enrollment Periods
A special enrollment period time outside of the open enrollment period when you and your family can sign up for health insurance. Most types of health insurance have special enrollment periods for certain qualifying life events, but all types of health insurance have different criteria. below are the rules for ObamaCare’s special enrollment period:
You may qualify for a special enrollment period of 60 days following certain life events that involve a change in family status (for example, marriage or birth of a child) or loss of other health coverage.
If you don’t have a special enrollment period, you can’t buy insurance inside or outside the Marketplace until the next open enrollment period. Job-based plans generally allow special enrollment periods of 30 days.
ObamaCare Qualifying Events
The following life events will generally qualify you for a special enrollment period under ObamaCare.
- Getting married
- Having, adopting, or placement of a child
- Permanently moving to a new area that offers different health plan options
- Losing other health coverage (for example due to a job loss, divorce, loss of eligibility for Medicaid or CHIP, expiration of COBRA coverage, or a health plan being decertified). Note: Voluntarily quitting other health coverage or being terminated for not paying your premiums are not considered loss of coverage. Losing coverage that is not minimum essential coverage is also not considered loss of coverage.)
- For people already enrolled in Marketplace coverage, having a change in income or household status that affects eligibility for tax credits or cost-sharing reductions
ObamaCare Enrollment Advice
During ObamaCare’s open enrollment you need to create an account through your states marketplace, choose a plan, and enroll before the deadline. The verification process during applying for an account can take time, beyond that choosing the right plan and making sure you are enrolled can take some time to. Don’t leave the process until the last minute and make sure you enroll in ObamaCare each years open enrollment deadline.
Private Health Insurance Enrollment Periods
While there are no official enrollment periods for private health insurance purchased outside of the marketplace, insurers have adopted the marketplace open enrollment model.
Many individual and families plans could be purchased at anytime before the Affordable Care Act was signed into law. Due to the new rights and protections insurers have adopted a new model which subjects individual and family plans to the same enrollment periods set forth by the ACA. There is no wording in the law that makes it mandatory, rather this practice has been adopted to avoid sick people going without coverage and signing up at the last minute. Most plans found in the interim will be short term health insurance options, which won’t help you avoid the fee for not having insurance and can’t be subsided under the Affordable Care Act.
Even if you missed open enrollment for ObamaCare you can still buy some private health insurance plan outside of the marketplace, but many won’t help you to avoid the per month fee for not having insurance.
Medicaid and CHIP Open Enrollment
Medicaid and CHIP can be enrolled in at anytime and that coverage can start retroactively up to two months. If you want to make life easy and sign up for Medicaid or CHIP through the marketplace you’ll have to sign up during open enrollment. If you miss open enrollment in the marketplace you have other Medicaid sign up options.
Employer Based Open Enrollment Perio
ObamaCare Open Enrollment Small Business
ObamaCare’s open enrollment for small businesses originally started during 2014 open enrollment (Oct 1st, 2013 – March 31st, 2014). However the SHOP (Small Business Health Options Program) marketplace that allows businesses with 50 or less full-time equivalent employees to enroll doesn’t start until open enrollment 2015 (Nov 15th 2014 – Feb 15th 2015). Starting 2016 small businesses with between 50-100 full-time equivalent employees can use the marketplace in states that don’t allow this sooner. Small businesses can still get small business tax credits through an agent retroactively since 2010 and moving forward each year until they can use the marketplace to apply for tax credits.
Learn more about the Small Business Health Options Program.
Open Enrollment For Job Based Insurance
The open enrollment period for job based insurance is different for each employer. Open enrollment typically occurs sometime in the fall, but not always. Your employer should notify you about your open enrollment period.
Like ObamaCare your employer will have a special enrollment period for qualifying life events and new hires. Contact your Human Resources department for employer specific details.
If you lose your job you can switch to COBRA or you to a marketplace plan. During open enrollment you can switch from your COBRA coverage or employer based coverage by simply enrolling in a marketplace plan. Outside of open enrollment if you lose your employer based coverage or your COBRA is ending you can switch to a marketplace plan via a special enrollment period.
Medicare Open Enrollment
For most people, the initial enrollment period for Medicare Part A and Part B starts 3 months before their 65th birthday and ends 3 months after their 65th birthday. After initial open enrollment there are two open enrollments each year where you can switch your plan or add to it. The first general enrollment period goes from January to March with coverage starting July 1st.
Individuals who have Medicare Part A and Part B may enroll in a Medicare Advantage plan during the Annual Election Period (AEP), the second enrollment period, which lasts from October 15 through December 7. Individuals who were eligible for Medicare Part A or enrolled in Part B as of the effective date of coverage can enroll in a Part D plan or switch Part D plans during this time. Individuals can also enroll in a Part D plan if they had qualified for a Special Election Period (SEP).
In addition, beneficiaries have from January 1 through February 14 to dis-enroll from their plan and return to traditional Medicare. A Medicare Advantage enrollee, however, cannot switch from his or her existing Medicare Advantage plan to a different plan during this period.
Learn more about Medicare open enrollment peroids.
If you have another insurance type that we haven’t covered on this page either contact us and let us know so we can cover it, or simply ask your plan provider for specifics on open enrollment dates.
When Is Open Enrollment For Health Insurance?