Navigate Open Enrollment 2024: Tips for Choosing the Best Plans

What is Open Enrollment in the US?

Open enrollment in the U.S. is a period of time during which you can enroll in, change, or cancel health insurance coverage for yourself and your family. It is a window of time lasting a few weeks, typically in the fall, when you can review and change your health plan from the Affordable Care Act (ACA) Marketplace, your employer, or Medicare.

Why Does Open Enrollment Exist?

Open enrollment exists to prevent people from signing up for health plans or changing their plans only when they fall sick. If people only got health insurance when they needed medical care and stopped their contributions when their health improved, there wouldn’t be enough healthy people paying insurance premiums to offset the medical costs of members who are sick. Therefore, insurers have open enrollment to prevent health insurance prices from being driven up for everybody.

Key Dates and Deadlines

Open Enrollment Period for the ACA Marketplace

The open enrollment period for health plans purchased through the ACA Marketplace is usually November 1st through January 15th.

Open Enrollment Period for Medicare Coverage

The open enrollment period (OEP) for Medicare programs typically runs from October 15th through December 7th. The OEP for Medicare Advantage plans is from January 1st through March 31st. Find out everything you need to know about Medicare enrollment.

Open Enrollment Period for Workplace Benefits

The open enrollment dates vary for workplace benefits (employer-sponsored health plans), but they are typically in the fall. Organizations usually send reminders to employees about open enrollment dates for plans offered by them. Find out how to get health insurance without a job.

Enrollment for Medicaid Programs

Individuals with Medicaid eligibility can enroll at any time. The open enrollment period is only applicable to those purchasing coverage from the Health Insurance Marketplace.

Learn about Medicare vs Medicaid: What’s the Difference?

State-Specific Enrollment Periods

The open enrollment period in most states is from November 1 through January 15. However, it may be different in some states.

What is the open enrollment period for California 2024?

The open enrollment period in California will be from November 1, 2024, through January 31, 2025.

When is open enrollment in Massachusetts 2024?

The next open enrollment period in Massachusetts will be from November 1, 2024, through January 23, 2025.

What states have a different open enrollment period?

The usual open enrollment period (OEP) runs from November 1 through January 15. States which have a different OEP include:

California: November 1 through January 31
Idaho: October 15 through December 15
Maryland: November 1 through December 15
Massachusetts: November 1 through January 23
New Jersey: November 1 through January 31
New York: November 16 through January 31
Rhode Island: November 1 through January 31
Washington D.C.: November 1 through January 31

What is the Special Enrollment Period?

A special enrollment period (SEP) is a time outside the annual open enrollment periods during which individuals can enroll in or make changes in their health plan based on a qualifying life event. Sometimes, individuals can qualify for a SEP while the open enrollment period is running. Examples of qualifying life events for the special enrollment period include:

Loss of qualifying health coverage (except due to non-payment of health insurance premiums).
Change in place of residence, allowing access to new qualifying health plans, for example, moving to a different zip code or another country.
Change in household size, for example, due to marriage, divorce, birth or adoption of children, accepting a foster child, or placing your child in foster care.
Change in eligibility for ACA Marketplace coverage or financial help in paying for health coverage.
Becoming eligible for Marketplace coverage for the first time, for example, by obtaining US citizenship, becoming a member of a tribe, being released from incarceration, or having a change in income.
Loss of Medicaid or Children’s Health Insurance Program (CHIP) coverage between March 31, 2023, and November 30, 2024.
Estimated annual household income below 150% of the FPL (federal poverty level).
Errors in the enrollment or plan.
Other exceptional circumstances.

Consumers typically have 60 days from the date of the qualifying event to enroll in coverage. Alaska Native Claims Settlement Act (ANCSA) Corporation shareholders and members of federally recognized Indian tribes can sign up for or adjust plans once a month at any time during the year without meeting the criteria for a qualifying life event.

How Open Enrollment Works

Eligibility

Each year, during open enrollment, you can sign up for a health insurance plan, change your plan, or disenroll if you no longer want health coverage.

The open enrollment period applies to health insurance plans purchased from insurers in the ACA Healthcare Marketplace, Medicare, and employer-sponsored insurance. It is applicable to health, dental, vision, life, and disability insurance programs. A HSA (health savings account) and FSA (flexible spending account) can also be added, changed, or removed during this window of time.

Required Documents

You may be asked to verify or add to the information you provide during your ACA Marketplace health plan application. You may get a notice by email, letter, or both from the insurance company asking for one or more of the following documents:

Estimate of yearly household income such as your last pay stubs or federal and state tax returns.
Immigration status such as your Green Card, arrival and departure record in a foreign passport (I-94), or certificate of eligibility for a nonimmigrant student visa.
Citizenship status includes a U.S. passport, certificate of citizenship, state-issued enhanced driver’s license, or tribal enrollment card.
Court documents regarding foster care or adoption if you gained a dependent or became a dependent.
Other issues such as data matching issues.

Application Process

You can enroll in a new plan, make changes, or disenroll from a health plan by logging in to your Marketplace account.

Tips and Strategies: What to Avoid and Resources

Don’t Be Under-Informed

Understanding your options prior to and during open enrollment can help ease confusion. Try to obtain important information from multiple sources, such as the HR personnel at your place of employment for workplace plans, and webinars and social media for Medicare and Marketplace plans. It is vital to learn and understand as much as possible about your benefits, but don’t forget that your colleagues and one-up leader can provide helpful information, especially if you are a new employee.

Learn more: “Why Do Healthy People Need Insurance?”

Don’t Miss the Deadline for Open Enrollment Dates

Missing the deadlines can make it extremely difficult to obtain health insurance coverage unless you qualify for the special enrollment period based on a qualifying life event. Set a reminder for the next open enrollment period.

Don’t Default to Last Year’s Plan

Review your benefits, medical expenses, and insurance use from the previous year. Take into account any upcoming changes in the plan year to choose the ideal plan. You may be able to waive certain benefits, or you may need additional coverage.

Don’t Choose a Plan with the Cheapest Premium

The least expensive plan may not be the most cost-effective for you. For example, if you usually undershoot your deductible, you may benefit from moving to a high deductible plan with a lower monthly premium, for example, from a gold plan to a silver plan. In contrast, if you tend to hit your deductible early in the year, you may benefit from a current plan that has a higher premium for enhanced coverage.

Don’t Wait Until the Last Minute

Waiting until the open enrollment period is about to end can result in unnecessary stress and cause you to miss deadlines or make errors.

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Frequently Asked Questions

What Should I Do If I Miss Open Enrollment?

If you miss open enrollment, you can enroll in a short-term health insurance plan offered by a private insurance company, Medicaid, or the Children’s Health Insurance Program (CHIP). These plans don’t have limited enrollment windows, but you need to meet certain criteria to qualify for them. Also, not all states offer short-term health insurance.

Can I Cancel a Health Plan At Any Time?

Yes, you can cancel a health plan at any time, but if you do so, you may have to wait until the next open enrollment period to sign up for health coverage again.

How to Choose the Best Plan During Open Enrollment?

Ask yourself the following questions to determine the best plan during open enrollment:

Do I have a chronic health condition that requires regular medical care?
Am I taking any expensive prescription drugs?
Do I want the flexibility of getting out-of-network care by paying a higher premium?
Is the necessity of a referral from a primary care physician to see a specialist an important factor for me?
Do I want coverage for family members?
Are there any expected or anticipated changes in my household over the coming year?
What is more important to me - enrolling in low-cost coverage with lower premiums or lower out-of-pocket costs?
Could I afford high out-of-pocket health care costs in an emergency if I’m not enrolled in a health plan?
Do I want a plan that offers telemedicine (virtual) healthcare? (Pros & Cons of Telemedicine)

If you still need help in choosing a good plan during open enrollment, contact a licensed insurance advisor or broker for guidance on the different plans offered in your area, new benefits available this year, and ways to save money while still having adequate health coverage in the coming year.

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