Once a year, all eligible Americans get a chance to shop the Health Insurance Marketplace and get a Marketplace plan, also known as Obamacare or an Affordable Care Act plan. This time is known as the annual Open Enrollment Period (OEP). The Affordable Care Act (ACA) ensures that all eligible Americans get this opportunity once a year to buy affordable health coverage for themselves and their families. And the ACA also means that all plans available on the Marketplace offer the following key consumer protections:
For 2021, the Open Enrollment Period runs from Sunday, November 1 through Tuesday, December 15, 2020 in most states.
Coverage purchased during the OEP window will begin on January 1, 2021
You can shop available plans and compare prices here or enter your zip code below to see available plans.
Who is eligible to shop during Open Enrollment?
Not sure if you’re eligible to shop the Marketplace for an Obamacare plan? Good news: Most people are!
If you are a U.S. citizen, national or legal resident of the United States who currently resides in the U.S., you’re qualified to shop the Marketplace. This includes green card holders, refugees, asylees, and individuals with non-immigrant status who have a valid worker visa.
The only exceptions? If you’re currently enrolled in Medicare or currently incarcerated.
Grab our free step-by-step guide to enrolling in Marketplace coverage to learn more.
Keep in mind that if you are offered ACA-compliant health insurance by your employer and choose to opt-out of it and instead purchase your own Obamacare plan, you usually won’t be eligible for any subsidies and will need to pay full price for your monthly premiums. Because of this, if you have access to health insurance coverage through your employer, we recommend you utilize that instead of the Marketplace, unless your employer insurance costs more than 9.61% of your household income.
For everyone else, though, welcome to shopping the Marketplace during OEP! We’ve tried to compile all the essential information you’ll need to make this year’s OEP as seamless as possible for you. Remember that should you have any questions at all, the HealthSherpa Consumer Advocate Team is here to help and can be reached at 872-228-2549.
You can shop available plans and compare plan premiums here. Enrolling on HealthSherpa only takes an average of 15 minutes.
During Open Enrollment Period, anyone who’s eligible can enroll in a Marketplace health plan. The rest of the year is known as Special Enrollment Period (SEP), and you’ll need a Qualifying Life Event (QLE) such as losing your health coverage, having a child, getting married, or another change in household size or health coverage.
When can I shop the Marketplace during Open Enrollment?
In most states, Open Enrollment Period runs from November 1st, 2020 to December 15, 2020. Some states, however, have extended their Open Enrollment Period. This means that anyone living in these states will have extra time to enroll. Regardless of which state you live in, you can shop for a 2021 plan at any point during Open Enrollment.
So far for the 2021 OEP, the following states have extended Open Enrollment Periods to the following dates:
- Minnesota: Dec 22, 2020
- Colorado: Jan 15, 2021
- Nevada: Jan 15, 2021
- Pennsylvania: Jan 15, 2021
- Washington: Jan 15, 2021
- Massachusetts: Jan 23, 2021
- Rhode Island: Jan 23, 2021
- California: Jan 31, 2021
- District of Columbia: Jan 31, 2021
- New Jersey: Jan 31, 2021
- New York: Jan 31, 2021
We will update this list as any other states announce extended Open Enrollment Periods.
Will I have to pay a fine if I don’t have health insurance in 2021?
Congress repealed the penalty for having health insurance in 2018. That means in most states, you won’t have to pay a fine if you go without coverage in 2021.
However, California, Massachusetts, New Jersey, Rhode Island, and DC have passed their own individual mandates. This means you may have to pay a penalty to the state if you go without coverage for a certain period of time.
No matter which state you live in, it’s important to remember that health insurance limits your financial risk. All Marketplace plans have an annual out of pocket maximum, which means that if you receive high medical bills, you’ll only pay a portion of the cost.
After I enroll during Open Enrollment Period, when does my health insurance begin?
Almost everyone who enrolls during Open Enrollment Period (OEP) will have insurance coverage beginning on January 1, 2021. This coverage will continue until Dec. 31, 2021 as long as all monthly premium payments are made. If you gain other coverage during this period—for example, through a new job—you can cancel your Marketplace plan at any time.
Did you enroll for Obamacare in a state with an extended OEP? Then your coverage may have a different start date. Check with your local state exchange for more details about your start date if you enroll during the extended enrollment period.
What do I need when I’m ready to enroll?
You’ll need some basic information on-hand to get started with the Open Enrollment process.
First, you’ll need to provide information about your household, including household size (including anyone you claim on your tax return). For each of these people, you’ll need some basic information like birth dates, home addresses, and social security numbers.
Additionally, you’ll need information about your best estimate for your 2021 income, information on how you file your taxes if you have a spouse, information about your sources of income, and policy numbers from any current health insurance plans.
A note on immigration status
Although you’re providing information about every member of your tax household, you do not have to provide immigration status unless you yourself are applying for coverage. If you don’t have a social security number, you also do not need to provide this on your Marketplace application. It’s important to know that information about immigration status collected by the Marketplace is carefully protected and cannot be used for immigration enforcement. More generally, by law the personal information that you provide on this form can only be used to determine your eligibility for coverage and to enroll you in a plan, and must be stored securely.
If anyone in your household is a Permanent Resident, you’ll need their Resident Alien (A-number) ready. Typically, you will just need to enter the number, but you may need to upload the document so have it ready to scan in case you need it.
You can find out about what documents you will need for other eligible immigration statuses here.
What if I already have a plan from last year?
If you had Marketplace health insurance in 2020, you will be automatically re-enrolled in that plan for next year if that plan is still being offered. If that plan is no longer available, you’ll be enrolled in an “equivalent” plan. Although that might sound like the easiest way to approach OEP, it isn’t necessarily your best option. In fact, people who who shop and switch plans save an average of 38% on their monthly premiums.
Most insurers are expanding their coverage areas this year, which means there will be more plans available to you. Without shopping to compare what plans, and savings, are available to you this year, your premium payments may increase substantially. Plan details can change from year to year, too, meaning that prescription coverage, provider networks, and coverage benefits could change even if you keep the same plan. By shopping the Marketplace, you’ll find out what kinds of available plans might best suit your needs for the coming year, and what cost savings you will be eligible for with those plans. It only takes a few minutes to shop and compare your options, and this can keep you from paying more later.
What about subsidies, cost-sharing reductions, and tax credits?
Many Americans are eligible to save on their health insurance costs as a result of the Affordable Care Act. No matter where you live, if you earn between 100 – 400% of the Federal Poverty Level (determined by the federal government) and aren’t eligible for Medicaid, you will qualify for a premium tax credit that will help lower your premium costs. By 2020’s FPL numbers, this meant that a family of four whose combined household income was between $26,200 and $104,800 would qualify for a premium tax credit.
Depending on your income, you may also qualify for Cost Sharing Reductions (CSR), which are special savings built-in to Silver-level Marketplace plans for people who earn between 100 and 250% of the federal poverty limit. These CSRs limit and reduce out-of-pocket costs like copays and deductibles.
Remember that if you are married and do not file taxes jointly with your spouse, you will not be eligible for any subsidies or CSRs in the Marketplace.
How do I sign-up for Marketplace insurance during Open Enrollment?
Want to enroll in Marketplace insurance for 2021 but not sure where to start? We have a step-by-step breakdown of how to shop the Marketplace and what that process looks like here.
In short, you can self-enroll online, have a Consumer Advocate help you over the phone, find local, in-person assistance, or complete and mail-in a paper application.
Applying online through HealthSherpa, a certified enrollment partner of the government, is straightforward and simple. If you’re unfamiliar with HealthSherpa, know that we offer all of the same plans at the exact same prices as HealthCare.gov, the government’s enrollment site. The difference? We offer a simpler enrollment process, a website that’s easier to use, and have a phenomenal Consumer Advocate team on-hand to help you at each step along the way. Reachable by phone, email, and online chat, our Consumer Advocate Team are here to help both before and after you sign up for your new Obamacare plan. Our advocates are licensed health insurance experts with a background in advocacy, not salespeople.
It only takes an average of around 15 minutes to complete an application on HealthSherpa, versus an average of 56 minutes when using Healthcare.gov.
Of course if you have any questions before Open Enrollment begins or would like assistance in choosing a plan, please feel free to call our Consumer Advocate Team anytime at (872) 228-2549. We’re here to help you navigate the Open Enrollment Period process and find the best possible plan for your needs.
You can see plans and prices, and see how much financial help you’re eligible for, by entering your zip below.
What about other coverage options like Medicare and Medicaid?
You can apply for Medicaid year-round here—there’s no need to wait for an Open Enrollment Period. You can apply for Medicaid here.
If you’d like to enroll in Medicare, you’ll become eligible three months before your 65th birthday, and you may become eligible earlier if you have certain disabilities. You can learn more about Medicare here.
If you’re already enrolled in a Medicare plan and you’d like to make changes to it, Medicare open enrollment runs from October 15 to December 7. During this annual enrollment period (AEP), you can make changes to your coverage, such as switch between Original Medicare and a Medicare Advantage plan, or vice versa.
If you have any questions, give our Consumer Advocate Team a call at (872) 228-2549.