Affordable Care Act (Obamacare) Open Enrollment Period
- ACA (Obamacare) open enrollment lasts from Nov. 1 to Jan. 15 in most states. Find out when you can enroll in a Marketplace health insurance plan in your state and learn more about eligibility and how to sign up for the federal insurance program.
Health insurance plans purchased through the Affordable Care Act (ACA) Marketplace use an Open Enrollment Period for new beneficiaries to sign up for a policy or for existing plan members to make changes to their coverage. These plans are often referred to as “Obamacare” plans.
Below is a detailed look at the ACA Open Enrollment Period, including deadlines, dates, eligibility rules and more.
What Is Open Enrollment for Health Insurance?
Open enrollment is a time of year when individuals and families can sign up for health insurance, drop their coverage or switch from one plan to another. Any changes to your coverage during an open enrollment season are generally locked into place for one year until the next open enrollment period comes around.
Open enrollment for health insurance typically takes place once per year, but additional enrollment periods are often granted at other times throughout the year.
Obamacare plans aren’t the only type of coverage to use an open enrollment period. Medicare, the nation’s largest single provider of health insurance, also uses an Annual Enrollment Period, also called the fall Medicare Open Enrollment period (AEP), each fall.
Employers also typically use an open enrollment period for employees who use health insurance provided by the employer.
In this article, we’ll focus on open enrollment on the Health Insurance Marketplace, which is the online exchange where health insurance plans are sold in accordance with the Affordable Care Act.
What Is the Point of Open Enrollment?
The purpose of open enrollment is to give individuals and families an opportunity to sign up for health insurance while discouraging adverse selection.
Adverse selection is the practice of only signing up for health insurance once you become sick or injured and require care. Adverse selection drives up costs across the health care industry and increases risk among insurers.
Where Is the Open Enrollment Marketplace?
The federal ACA health insurance Marketplace can be accessed online. There are 33 states that use the federal Marketplace while 17 states and the District of Columbia use their own respective online exchange.
If your state does not use the federal Marketplace, you can use your state’s online exchange.
When Is the ACA Open Enrollment Period for 2023 Coverage?
ACA open enrollment is over for 2022 health insurance. You can still apply for 2022 ACA health insurance if you qualify for a Special Enrollment Period due to a life event such as having a baby or getting married. You can apply for ACA coverage any time if you qualify for Medicaid or CHIP.
Based on previous years and barring any changes to current federal policy, ACA open enrollment for 2023 coverage will most likely take place from November 1, 2022, to January 15, 2022, in the following states:
- New Hampshire
- New Mexico
- North Carolina
- North Dakota
- South Carolina
- South Dakota
- West Virginia
The Open Enrollment Period will most likely last from November 1, 2022, to January 31, 2023, in the following states:
- District of Columbia
- New Jersey
- New York
- Rhode Island
Idaho’s Open Enrollment Period will likely take place from November 1, 2022, to December 22, 2022, and the Open Enrollment Period in Massachusetts will most likely last from November 1, 2021, to January 23, 2022.
Who is Eligible to Participate in Open Enrollment?
You must meet the following criteria to be eligible for a health insurance plan purchased through the ACA Marketplace.
- Reside in the U.S.
- Be a U.S. citizen or be lawfully present.
- Are not incarcerated
- Not enrolled in Medicare
Is Open Enrollment the Only Time You Can Buy Health Insurance?
For some people, open enrollment marks the only time of year that you may sign up for Obamacare health insurance through the ACA Marketplace. However, there are some exceptions.
A Special Enrollment Period may be granted at any time of the year to those who experience a qualifying life event. There are 12 life events that may qualify you for a Special Enrollment Period.
- Involuntary loss of coverage
- Individual plan renewing outside of the regular Open Enrollment Period
- Becoming a dependent or gaining a dependent (such as the birth of a child)
- Becoming a U.S. citizen or lawfully present resident
- A permanent move to a new area
- An error or other problem with enrollment
- An employer-sponsored plan that becomes unaffordable or stops providing minimum value
- An income increase that pushes you out of the coverage gap
- Gaining access to a QSEHRA or Individual Coverage HRA
- An income or circumstance change that makes you newly eligible (or ineligible) for subsidies or cost-sharing reductions
How Has the COVID-19 Pandemic Affected Open Enrollment?
2021 Marketplace enrollment for the 2022 plan year has been the largest on record.
- As of Dec. 22, 2021, more than 6 million people had enrolled in Marketplace coverage for 2022 through either the Open Enrollment Period or during a Special Enrollment Period.
- Nearly 10 million people have enrolled during the Open Enrollment Period alone, breaking the previous all-time high of 8.8 million in 2018 with still almost a month left in the enrollment period.
- The American Rescue Plan (ARP), signed into law in 2021 to combat the economic effects of the COVID-19 pandemic, includes enhanced health insurance subsidies and tax credits that will allow additional people to qualify for assistance. More than nine out of 10 enrollees qualified for premium tax credits for 2022.
The 2021 Marketplace also included the most choice in the ACA’s history, with a record 213 insurers offering coverage through the federal or state exchange. The average consumer now has more than six insurers from which to choose.
What Information is Required to Enroll in a Plan During Open Enrollment?
You will typically need the following information on hand to enroll in a health insurance plan through the Marketplace.
- Email address
- Social security number
- Citizenship status
- Payment information
- List of medications currently being taken by anyone who will be covered by the policy
- Name and business zip codes of any health care providers you would like to have included with your plan
- Household size and income if applying for any tax credits or subsidies
- Coverage details and premium cost for any employer-sponsored plan that is available to your household regardless of whether you’re enrolled
- Hardship exemption if wishing to enroll in a catastrophic plan and are age 30 or older
What if I Enrolled in My Plan Before the ACA Was Passed?
There are two types of health insurance plans that have exemptions for certain provisions of the ACA and are not required to adhere to all rules and regulations.
- The first is a “grandfathered” plan. These plans were purchased before the ACA was signed into law in March of 2010. If a company purchased the plan for its employees before the ACA was passed and still uses the plan today, any new employees who join the plan are also members of a grandfathered plan.
These plans may not include certain rights and protections available to members of ACA-approved plans, and grandfathered plans must disclose their grandfathered status to all new enrollees. Plans created before the ACA was passed may lose their grandfathered status if certain changes are made that make the plan ACA-approved.
- The second type of plan that may pre-date the ACA is a “grandmothered” plan. A grandmothered plan is one that was purchased between March 23, 2010 (the date the ACA was signed into law) and Oct. 1, 2013 (the date the federal Marketplace opened for enrollment).
Grandmothered plans may offer more rights and protections than grandfathered plans but are still not fully ACA-compliant.
If you are enrolled in a grandfathered plan, you may continue to keep it indefinitely as long as the plan remains in effect.
If you are enrolled in a grandmothered plan, it must be replaced with an ACA-compliant plan by the end of 2022. However, the termination date has been granted one-year extensions several times before and may do so again in 2022.
If you belong to a grandfathered or grandmothered plan that renews outside of the Open Enrollment Period for your state, you may qualify for a Special Enrollment Period if you wish to not renew your coverage.
How Do I Enroll in a Plan During Open Enrollment?
You may enroll in an ACA Marketplace plan online, over the phone, through the mail or in person.
To enroll online, visit the official government website for the Health Insurance Exchange. Some states have their own exchange, so you will be directed there when applicable.
You may also enroll online through a certified partner website such as an insurance company or online health insurance seller.
To enroll over the phone, contact the Marketplace call center at 1-800-318-2596 (TTY: 1-855-889-4325) or contact an insurance agent or broker who is licensed to sell ACA marketplace plans.
To apply for coverage by mail, print and complete these required forms and mail to the address listed on page 8.
To enroll in person, schedule an appointment with an insurance agent or broker who is licensed to sell Obamacare plans.