When Is Open Enrollment for 2023 Health Insurance?
The open enrollment period for 2023 is November 1, 2022 – January 15, 2023, for marketplace plans. For Medicare, open enrollment is October 15 – December 7, 2022. However, there may be some exceptions. Some individuals may fall under special enrollment rules for healthcare plans.
The open enrollment period is when interested buyers can apply for health insurance. The period may vary depending on where the plan is purchased and an individual’s circumstances.
The main purpose of open enrollment is to deter adverse selection when only sick people sign up for a plan. This way, insurance companies are protected. At the same time, healthy people are encouraged to enroll. Having a plan in place gives them the financial protection they may need in case of unexpected events.
An interested individual can enroll in a new health plan or switch plans during the open enrollment for 2023. Typically, a plan purchased during this period is kept through the next year.
The open enrollment period for Marketplace plans is November 1,2022 – January 15, 2023. Medicare open enrollment for 2023 is October 15 – December 7, 2022.
People may still get healthcare plans after the open enrollment period through a special enrollment period, Medicaid, short-term health insurance or plan continuation.
Preparing for health insurance enrollment involves multiple steps, from assessing your needs to comparing options and understanding the numbers. Taking these steps will help you find the best plan for you.
Marketplace Open Enrollment for 2023 Coverage
The Affordable Care Act (ACA) was enacted to make health insurance affordable and accessible to more people, especially those with income anywhere between 100% – 400% of the federal poverty level. The law encompasses health and preventive care costs and health insurance coverage.
ACA plans are available through the Marketplace, also known as the healthcare exchange. Health insurance purchased through the exchange includes the following benefits:
- An individual can purchase a plan for themselves and/or their families without an employer’s plan.
- Health insurance plans cover essential benefits.
- Premium rates are reduced for qualified individuals.
- Providers can’t deny coverage to people due to preexisting conditions.
- Dependents are allowed to stay on their parent’s plan until age 26.
The open enrollment period for these policies usually lasts 45 days, between November 1 – December 15 every year.
The enrollment dates may vary depending on the applicant’s state. Most states require individuals to enroll by December 15 to get coverage for January 1 of the next year, following the federal Marketplace open enrollment period. However, some accept applications after December 15 but will defer coverage until February.
The table below shows the 2023 open enrollment period for state-based Marketplaces.
Health Insurance Open Enrollment by State
Consumers interested in getting health insurance from the marketplace may consider any of the following methods:
- Visit www.HealthCare.gov.
- Visit the website of your preferred insurer directly.
- Call 1-800-318-2596.
- Contact a broker or use a third-party website specializing in health insurance plans.
When looking for the best insurance coverage, weighing all available options is important. This way, you can ensure you get a plan that fits your needs.
Compare Health Insurance Rates
Ensure you are getting the best rate for your insurance. Compare quotes from the top insurance companies.
Medicare Open Enrollment 2023
Medicare open enrollment, called the annual election period, is October 15 – December 7 every year. During this time, Medicare policyholders can reevaluate their coverage and make changes based on their preferences and needs.
Meanwhile, Medicare Advantage policyholders can switch to Original Medicare, or Part A and B, during the Medicare Advantage Disenrollment Period. This is annually from January 1 – February 14. Eligible enrollees can also apply for Part D during this period or during the Medicare Advantage Plan Open Enrollment period between January 1 – March 31.
The General Enrollment Period, when individuals who didn’t sign up when they first became eligible for Medicare Parts A and B are allowed to enroll, is January 1 – March 31, with coverage starting July 1 of that year.
An individual may become eligible for Medicare after the open enrollment period. In such a case, they’re allowed to enroll within three months before and three months following their 65th birthday.
There are various ways to enroll in a Medicare plan. Generally, it depends on the type of policy you want to get.
- Parts A and B
— Visit www.SocialSecurity.gov
— Call 1-800-772-1213
- Part C (Medicare Advantage)
— Visit www.Medicare.gov
— Go directly to the plan’s website
— Consult an agent
- Part D (Prescription Drug)
— Visit www.Medicare.gov
— Go directly to the plan’s website
— Visit the plan’s website
Before applying for a healthcare plan, make sure you understand the terms and coverages for each option. It will also help to check if you’re eligible for your desired plan first.
How to Get Health Insurance After Open Enrollment
Individuals looking to purchase ACA or Medicare plans should take note of the open enrollment dates. But missing the deadline doesn’t mean you can no longer purchase a policy. Here are some options if you miss open enrollment:
- Special enrollment period: Consumers may apply for a healthcare plan outside the open enrollment period during certain life events.
- Medicaid: Eligible low-income people, including children, pregnant women, adults, families, elderly adults and people with disabilities, may apply at any time. Although requirements are based on federal rules, the administration of Medicaid is by state.
- Short-term health insurance: A short-term plan is a viable option for people who want to cover temporary gaps in their health insurance coverage. Typically, this type of insurance is good for a year or less.
- Plan continuation: Some plans are automatically renewed. That means if you’re already enrolled in a policy, there’s no need to re-apply.
Taking note of healthcare open enrollment dates is a great way to find the best deals. Although it’s sometimes possible to purchase a plan after missing open enrollment, your options may be limited. You may need to wait until the next open enrollment period to get your desired plan.
An individual may qualify for special enrollment if they’re experiencing a qualifying life event. This may be any of the following:
- Loss of health coverage after getting laid off, aging out of a parent’s plan, getting divorced or losing eligibility for Medicare, Medicaid or Children’s Health Insurance Program (CHIP)
- Getting married or divorced
- Having or adopting a child
- Death in the family
- Moving to a new area
- Changes in your income
- Becoming a U.S. citizen
Enrollees are often allowed to apply for special enrollment 60 days before or 60 days after the life event. Meanwhile, the Special Enrollment Period for job-based health plans must be at least 30 days.
Preparing for Enrolling in Health Insurance
The best health insurance may vary per person because of differences in needs and circumstances. There are various steps interested individuals should take to prepare for health insurance enrollment. Below is a simple step-by-step guide to help you get started.
Assess Your Healthcare Needs
The first thing you need to do is to figure out what coverage suits you. Consider your needs and your family’s, especially medical and healthcare needs.
Research Healthcare Plans
Check all your options: Research Medicare plan types and ACA plans. If you or your spouse has an employer-sponsored policy, find out if it’s more comprehensive and affordable compared to Marketplace or Medicare plans.
Check for In-Network Providers
In-network providers are doctors, healthcare facilities and other medical providers contracted by a specific insurance provider. These typically charge lower rates to policyholders.
Ensure Necessary Services Are Covered
A good health insurance plan covers essential benefits, including:
- ambulatory patient services
- emergency services
- laboratory services
- mental health and substance use disorder services
- pediatric services
- pregnancy, maternity and newborn care
- prescription drugs
- preventive and wellness services
- rehabilitative and habilitative services and devices
Understand the Numbers
Aside from the premium, which is the amount you need to pay monthly or annually to keep your coverage, you should also consider fees like the deductible or the amount you need to pay out-of-pocket when making a claim. Clarify all fees with your insurer to prevent unexpected costs.
Open Enrollment 2023 FAQs
Understanding the open enrollment period for healthcare will help you navigate health insurance better. Below are answers to some of the most commonly asked questions about open enrollment.
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