Think about some of your favorite reminders of the fall season. Maybe it’s kids’ football team sign-ups? Falling leaves and cozy nights? Pumpkin-flavored coffee? All of the above?
And of course, don’t forget the most important autumnal reminder of all—health insurance open enrollment. (We know, we know, it’s not quite as much fun.)
Whether you’re covered through your employer or through the open marketplace, health insurance open enrollment happens at the same time every year between fall and early winter. The timing is set up to make sure you have health insurance in place for the following year.
But before we get into deadlines, let’s talk about open enrollment basics.
What Is Open Enrollment?
Generally, open enrollment is the only time you can either sign up for a new health insurance plan or change your existing plan—with the exception of a few situations that qualify for special enrollment (more on that later). But typically, the insurance enrollment period is between November 1 and December 15 for the following year.
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Here’s what that looks like. Let’s say you sign up for coverage on Nov. 1, 2021. The coverage you pick on November 1 will be in effect from Jan. 1, 2022, to Dec. 31, 2022. Unless you qualify for one of those exceptions we mentioned, you can’t make changes until the open enrollment period in 2022. Those changes will take effect Jan. 1, 2023.
We know it can get a little confusing, but the most important thing to remember here is that with health insurance, you have to get the right coverage in place before the following year begins.
That’s why it’s so important to do your homework before you sign on the dotted line. Let’s explore exactly what you need to do to prepare, and when.
When Is Open Enrollment?
Remembering dates can be a struggle for everyone. Here’s a simple table to help you keep track of open-enrollment dates for all types of health insurance.
Nov. 1 to Dec. 15
Typically in the fall
Oct. 15 to Dec. 7
Now that those open enrollment dates are permanently etched in your brain, let’s take a look at what you need to do to get ready.
Preparing for Open Enrollment
Good news! There’s no need to become a health insurance expert before open enrollment starts, but there are some basic things you’ll want to understand before you sign up for a year-long commitment.
Know the dates of enrollment. We made this one easy for you. All you have to do is check out the table above.
Know the cost. You might need health insurance just for yourself. Or maybe you need to find a plan that covers your entire family? Just you and your spouse? Regardless of the circumstances, all plans do have some things in common that affect your health insurance cost. We’ll break these down in the lingo section in just a second—but just know that you’ll want to get familiar with cost factors.
Gather the information you’ll need to sign up. You’ll need to know some pretty basic stuff about everyone in your household, like:
- First and last name
- Email address
- 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)
Learn the lingo. These are some basic health insurance terms to brush up on before you sign on the dotted line:
- Premium – the amount you pay to an insurance company for an insurance policy—these are often paid on a monthly or bimonthly basis
- Deductible – the amount you have to pay out-of-pocket before your insurance company starts chipping in
- Copay – the amount you pay each time you need a specific medical service (these don’t usually contribute to your deductible)
- Coinsurance – the percentage of the cost you pay after you hit your deductible
- HMO vs. PPO – these are types of insurance plans—HMO stands for health maintenance organization and PPO stands for preferred provider organization
- HSA – HSA stands for Health Savings Account, and it’s basically a tax-advantaged savings account dedicated to health care costs
Review coverage details. Whether you’re keeping the same plan or signing up for the first time, review the details of your coverage. Remember that the plan you buy will be in effect for an entire year. A lot can happen in a year!
As you’re reviewing your options, keep in mind that insurance is a necessary part of your financial plan and wealth-building goals. Make doubly sure the plan you choose will protect you, your loved ones and your hard-earned money.
Other Times to Enroll in Health Insurance
If you don't sign up for health insurance during open enrollment, there’s a chance you can't enroll or change your health insurance plan until the next open enrollment period. Oof.
But don’t panic yet. There’s an exception to every rule, including open enrollment! If you experience a qualifying life event, you might be eligible for what’s called a special enrollment period (SEP).
But what’s a qualifying life event? Think of it as an extenuating circumstance.
Here’s a list of events that the health insurance industry considers qualifying life events:
- Maybe you met the love of your life and got married? (If so, congrats!) Any change in your household qualifies as a life event. It can be a marriage, a divorce, a birth, an adoption, or sadly, a death.
- Did you lose your previous health insurance? There are a lot of events that qualify for a SEP, including if you or anyone in your household lost qualifying health coverage due to job loss, turning 26 years old, cancellation by a private carrier, or loss of eligibility for government-funded coverage.
- If you finally made that long-awaited move to a place with more sunshine, that’s great news! When you have a change in residency, including moving to a new country or zip code, you officially qualify for a SEP.
Depending on your plan (job-based or open marketplace), you have between 30 and 60 days to enroll or change your health insurance policy with your qualifying life event information.1
The sooner you call, the sooner you’ll be covered and can focus on the rest of your financial progress along the Baby Steps.
Get Help During Open Enrollment Season
Now that you’re up to speed on open enrollment, the next step is to choose the right health insurance plan for you and your family.
If you don’t have a plan through your employer, your smartest move is to contact an independent insurance agent, like an Endorsed Local Provider (ELP). Independent agents aren’t captive to one company, so they can shop around to find the right coverage for you at the best price. They’re also experts in answering questions about health insurance, so you can feel confident that you understand what you’re signing up for.