Open Enrollment Guide for 2023 Coverage

We hear you. We know open enrollment for health insurance is confusing.

You’ve got dates to remember, plans to compare and, potentially, increased costs to budget for. Worse, the information you need is usually scattered all over the internet.

But it's also a great opportunity to find the right health insurance plan at the right price. So before you jump straight into the deep end, let’s sort some things out.

We included everything you need to know in one place, so you can bookmark and reference it any time. That way, you can feel confident about your 2023 health insurance decisions.

When Is Open Enrollment for 2023 Health Insurance Coverage?

Before we dive into specific dates and deadlines, you need to understand where you’ll be getting your coverage from. If you’re not getting your insurance through your employer, you’ll need to explore your health coverage options through a health insurance marketplace. Depending on your income, family size and other factors, you could qualify for discounts on coverage you get through these marketplaces.

Because most states rely on the federal marketplace (aka exchange) to offer up health insurance options for their residents, many people will use that. But there are currently 18 states that run their own health insurance exchanges, so you’ll want to check out our map below to figure out which marketplace your state uses.

First, let’s talk about open enrollment deadlines for the states that use the federal marketplace. For the last couple years, the U.S. government extended the enrollment deadline. And they’re doing it for 2023 as well, pushing the deadline out from December 15, 2022, to January 15, 2023. That gives you an extra month to enroll!

Next, the 18 states that run their own health insurance exchanges have individual enrollment deadlines and plan effective dates. Let’s look at those dates in detail along with the states that use the federal marketplace.

Dates and Deadlines for 2023 Health Insurance Coverage

The map and chart below show the open enrollment and plan effective dates for all 50 states and D.C.

If you're still unsure about your state-run exchange’s plan effective date, check with your state's marketplace for further details.

What Should I Know About COVID-Related Open Enrollment?

Because of COVID-19, federal and some state marketplaces extended open enrollment in 2021 and 2022. Like we mentioned above, this year the federal marketplace and some states are continuing the extension with an extra month.¹ If you need more time because COVID-19 prevented you from enrolling within the open enrollment period (maybe you were in the hospital), you can apply for extra time through an exceptional circumstances special enrollment period (aka SEP). For 2023 coverage in the federal marketplace, open enrollment is November 1, 2022–January 15, 2023.²

What Information Do I Need to Enroll in a 2023 Health Plan?

Now that you know when you need to enroll, let’s go over what you need to know before you enroll.

Don’t worry. You won’t have to learn anything complicated or dig up ancient paperwork. You just need to follow some simple guidelines before you sign up for a year-long commitment. Let’s break down each one.

Identification

You’ll need some basic personal information for everyone you want to include in your plan:

• First and last name
• Email address
• Birthdate
• State of residence
• Social Security number
• Estimated income for the year you want coverage (include all household members even if they don’t need health insurance)

Cost

Whether you’re enrolling in a plan just for yourself or for your entire family, you’ll need to understand some basic health-insurance industry jargon so you can select the best plan for the best price. Make sure you understand these terms before you sign anything.

• Premium: the dollar amount you pay to an insurance company for an insurance policy—premiums are usually paid on a monthly or yearly basis
• Deductible: the dollar amount you must pay out of pocket before your insurance company starts chipping in
• Copay: the dollar amount you pay each time you need a specific medical service (copays don’t usually contribute to your deductible)
• HMO vs. PPO: HMO and PPO are types of insurance plans—HMO stands for health maintenance organization and PPO stands for preferred provider organization
• Coinsurance: the percentage of the cost you pay after you reach your deductible
• HSA: HSA stands for Health Savings Account. Essentially, it’s a tax-advantaged savings account dedicated to health care costs

The more you understand these terms the easier it will be for you to figure out where you can save money. For example, understanding the relationship between premiums and deductibles could save you a butt-load of money because choosing to pay more up front will knock your monthly premiums down. But before you sign up for a $10,000 deductible, let’s talk about when this works and when it doesn’t.

Coverage

While health insurance is an essential part of your financial plan, the right health insurance policy looks different for different families. Look at all your options to see what makes sense for you, your family and your money goals.

Do you have the right health insurance coverage? Connect with a Trusted pro today.

If you have a healthy body and emergency fund, you could opt for that high-deductible plan that qualifies you for an HSA to save on premiums. On the other hand, if your body isn’t cooperating and you need more regular care, a lower deductible might make sense for you.

Spend some time on this decision and do some research if you need to. Remember, you’ll have to stick with the plan you choose for a full year.

What Happens if I Miss the Open Enrollment Deadline?

If you don’t sign up for health insurance during the normal enrollment period (November 1, 2022–January 15, 2023), it’s possible you won’t be able to enroll or change your health insurance plan until the following year’s enrollment period. Really? Yes, really.

The only time you can make changes or sign up after the deadline is if you experience a major life event (marriage, birth, job loss, etc.). Events like that trigger a special enrollment period (SEP) where you can update your health insurance choices for the year.

But first you need to qualify. The health insurance industry calls these events qualifying life events. And like we mentioned above, another qualifying factor could be exceptional circumstances with COVID-19.³ Let’s go over the life changes that qualify for a SEP.

Loss of Prior Health Coverage

Losing your health insurance can be scary, but the good news is that any of the following events will qualify you for a SEP:

• Losing your job
• Turning 26 years old
• Getting cancelled by a private carrier
• Losing your eligibility for government-funded coverage

Moving

Whether you’re moving out of state or to a different town in the same state, you could qualify for a SEP if your move is permanent. If you have questions, the U.S. Department of Health and Human Services (HHS) maintains up-to-date guidelines for the use of a permanent move for SEP eligibility.

Marriage

Congrats! Finding the love of your life is cause for celebration! Even better? You might qualify for a SEP so you can officially add your spouse to your health insurance.

Household Change

A happy family event like giving birth or adopting a child qualifies for a SEP. More celebrations are in order! You can now add your new family member to your existing health insurance plan.

A not-so-happy event like death or divorce can also trigger a SEP. But only if the event results in a loss of coverage.

Timing

If you’re enrolled in a federal marketplace health care plan, and you qualify for a SEP you have 60 days before and 60 days after the qualifying event to enroll or change your health insurance details.⁴ Once the 60 days expires, the SEP is over and you’ll need to submit an application for a new SEP.

If you’re enrolled in a state-run plan, the SEP timing requirements are managed by your individual state. If you're unsure about your state-run exchange’s SEP dates, check with your state's marketplace for further details.

Job-based health care plans have their own SEP timing requirements that are also different from the federal marketplace. Companies must provide a SEP of at least 30 days.⁵

Our advice? Regardless of where you get your health insurance, don’t put off a SEP application. If you qualify for a SEP, sign up or make changes to your plan as soon as possible. The longer you wait, the longer you’ll be without the health insurance you need, and the longer you’ll be risking financial disaster.

Questions to Ask Your Employer

We collected answers to the questions employees most often ask about employer-sponsored health plans. We can’t provide specific details about your employer’s health plan, but we can guide you toward the questions you should ask to get the answers you need.

1. What are the plan’s enrollment and effective dates?

Most enrollment periods for company-sponsored health insurance plans are scheduled in November, and the plan effective date is usually January 1 of the following year. But companies do have some wiggle room here. Be sure to ask your company’s plan administrator what the specific enrollment/effective dates are for your company.

2. How does the plan manage prescription drug costs?

Changes in health insurance provider drug coverage happen all the time. Before you enroll in or change your health plan, find out if your employer has added or excluded coverage that could affect how much you pay for your prescriptions.

3. What’s the cost for covering my spouse and children?

If you previously had coverage for a working spouse, ask your company’s plan administrator if they’re adding or increasing a surcharge for your spouse’s coverage. Also, companies can make changes in employee premium contributions to cover dependent children. Ask about that too.

4. Can I go to my preferred doctor and hospital?

Some employers change health insurance companies, plans or provider networks to keep costs down. This can mean that your preferred doctors and hospitals might not be available on your plan anymore. Ask your plan administrator about this so you can adjust if needed.

5. Does this company do anything to help employees save money on health care costs?

Everyone is concerned about health care costs. Companies too. In fact, some companies have made changes specifically designed to lower health care costs for their employees, including lower out-of-pocket costs, lower premiums for low-wage workers, and some have even made contributions to employee Health Savings Accounts (HSAs). Ask your company’s plan administrator if your employer has taken any actions like this to help you save money.

Frequently Asked Questions