Whether you have health insurance through your employer or buy your own health plan through the Health Insurance Marketplace established by the Affordable Care Act (ACA), you typically can only get comprehensive health insurance during an annual Open Enrollment Period (OEP.)
If you get insurance through your employer
If you have health insurance through your employer, check with your human resources department (HR) about when your open enrollment period is. This is when you can pick a new health care plan or renew your health coverage for the upcoming year.
If you buy your own insurance through the Marketplace
However, if you’re buying your own individual coverage through the Marketplace, in most cases you’ll have a six-week window to enroll between Nov. 1 and Dec. 15 each year. Some states, like California and New York, extend their Open Enrollment periods into January. You can check to see dates in your state here.
During this time, you can renew an existing plan. You can also compare and shop for a new plan. You may also review what cost savings you will be eligible for in the upcoming year. This amount is calculated based on your past year’s income and household size.
Grab our free step-by-step guide to enrolling in Marketplace health insurance here.
Special Enrollment Periods
If you’re trying to shop for Marketplace insurance at a time outside of Open Enrollment, you’ll only be able to do so if you have a Qualifying Life Event (QLE) that gives you you for a Special Enrollment Period (SEP). Generally speaking, the following things may qualify you for a SEP:
- Losing access to the health insurance coverage you had
- Having a change in your household size (i.e., get married or welcome a new baby)
- Moving to a new zip code or state
- Having a change in your eligibility status for Marketplace insurance (ie no longer incarcerated or gain citizenship)
To find out more about whether you might qualify for one of these 60-day windows that lets you buy Obamacare for you and your family outside of Open Enrollment, click here or contact a HealthSherpa Consumer Advocate at (872) 228-2549.
You can also enter your zip code below to see available plans in your area.
What makes Marketplace insurance different
Health insurance purchased on the Health Insurance Marketplace is comprehensive and must include all of the consumer protections laid out in the Affordable Care Act. For example, Marketplace plans must cover prescription drugs, pre-existing conditions, emergency care, mental health care, and more.
Marketplace plans can be quite affordable, especially if you qualify for subsidies, tax credits, or cost-sharing reductions. Last year, the majority of HealthSherpa users paid $35/month or less for Marketplace health insurance.
Medicaid and CHIP on the Marketplace
You can also apply for Medicaid or CHIP (Children’s Health Insurance Program) at any time, even outside of Open Enrollment, and if you qualify you can enroll and have your coverage start almost immediately. For Medicare, those who are eligible can apply when they turn 65.