Employee Benefits

When Is Open Enrollment?

5 min read Oct 24, 2022

The open enrollment period occurs annually, usually near the end of the calendar year. But exact dates vary depending on what kind of open enrollment you’re referencing.

When you sign up for insurance as an individual (as opposed to through your employer), then you’ll need to know open enrollment dates for the marketplace you’re using to shop for plans. For many people, that’s the federal marketplace at HealthCare.gov that lists Affordable Care Act (ACA) plans. If you’re enrolling in group insurance (or other employee benefits) through your workplace, then open enrollment dates will depend on your company’s policy.

When Is Open Enrollment for ACA Plans?

Open enrollment for ACA plans occurs annually starting in the fall, and typically runs from November 1 through January 15. During this time, you can enroll in insurance through the federal marketplace.

However, certain states have their own health care marketplaces and may have a different or extended open enrollment window. These states include:

  • California
  • Colorado
  • Connecticut
  • Idaho
  • Kentucky
  • Maine
  • Maryland
  • Massachusetts
  • Minnesota
  • Nevada
  • New Jersey
  • New Mexico
  • Pennsylvania
  • Rhode Island
  • Vermont
  • Washington, D.C.
  • Vermont

When Is Open Enrollment Through Employers?

Most companies that offer insurance benefits hold open enrollment at the end of the year. However, certain employers may choose different dates for open enrollment — the schedule is up to them.

Human resources (HR) departments usually remind employees when the open enrollment period starts and ends. Keep an eye out for those communications.

When Is Open Enrollment for Medicare?

Medicare holds an Annual Enrollment Period (AEP) from October 15 through December 7 each year. During this period, you can start a new plan or change your coverage. Additionally, you can enroll in Medicare during the 3 months before and 3 months after you become eligible at age 65.

As there are multiple components to Medicare, there are other enrollment periods that may apply to your situation. Consult the Medicare website for more guidance.

When Is Open Enrollment for Medicaid?

Medicaid has no open enrollment period. Instead, you can apply for Medicaid at any time — provided you’re eligible. Medicaid eligibility varies by state, but the program is typically available to:

  • Senior citizens
  • People with disabilities
  • Pregnant people
  • Low-income families and their children

Special enrollment period (SEP)

If you do happen to miss a designated open enrollment period, there may be other opportunities to enroll in insurance plans. If you experience what are known as qualifying life events, you can take advantage of this “special enrollment period.”

The types of events that count as “qualifying” may change depending on your location and provider. However, qualifying life events typically include:

  • Getting married, adopting or giving birth, providing foster care, or making other additions to your household.
  • Moving, as long as it is to a different zip code, state, or country.
  • A change in eligibility, like new citizenship, being released from incarceration, income changes, or becoming recognized as an Indigenous tribe member.
  • Sudden loss of health insurance due to aging out of parents’ coverage, a job loss, or a change in income.

If you think you’re eligible for a qualifying life event, you can apply at HealthCare.gov (if you’re purchasing individual insurance) or speak to your HR representative about your benefits (if you’re enrolling in employer-sponsored group insurance.

SEP and qualifying life event example

Alex and Taylor have adopted their first child, Riley. They want to get Riley covered under health insurance as soon as possible, but the open enrollment window at Taylor’s workplace has already closed.

Taylor contacts HR to ask about special enrollment. Fortunately, adopting a child counts as a qualifying life event. Because they adopted Riley less than 30 days ago, Alex and Taylor are able to adjust their benefits to include their newest family member.

Ready for open enrollment?

Whether you’re looking forward to open enrollment or hoping to qualify for the special enrollment period, there are a few steps you should take to make sure you’re prepared:

  • Research your providers and plan options.
  • Familiarize yourself with important insurance terms.
  • Make a list of your needs by asking yourself important insurance questions related to your lifestyle.

Prepare for Open Enrollment

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This article is intended to provide general information about insurance. It does not describe any Metropolitan Life Insurance company product or feature.