Knowledge Center

Understanding Open Enrollment

Open Enrollment gives you the opportunity to carefully review and renew your current health insurance coverage or choose a different plan for the next year.

What is Open Enrollment?

The health insurance open enrollment period (OEP) is the time frame set by employers, health insurance companies, and the government's Health Insurance Marketplace® for signing up for a health plan, renewing your current plan, or switching to a new plan.

The open enrollment period happens once a year. It ensures you have access to continuous health plan coverage and services. It's also an opportunity to change your plan to one that best fits your needs for the next year.

When is Open Enrollment?

If you buy insurance yourself, the federal open enrollment period typically runs from November 1 to January 15. If you get insurance through your employer, the timeline depends on your company, but it's typically in the fall.

If you miss the open enrollment period, you may have to wait until next fall. Or you may qualify for a special enrollment period (SEP)[D] based on certain life events in the last 60 days. Qualifying events include losing your health insurance, getting married, having a baby, getting divorced, or becoming legally separated.

How to prepare for Open Enrollment

A little planning now can help you find the right coverage for the year ahead. Here's what you can do before Open Enrollment begins to make the process smoother.
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Step One
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Consider your needs
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Before enrolling, think about what you and your family need most from your health plan. Looking at your needs first can help you choose coverage that fits your health and your budget.

Think about how often you go to the doctor, what medicines you take, and whether you want to keep your current doctor or hospital.

It also helps to look at your monthly budget and other costs, like your deductible, which is the amount you pay before your plan starts to pay for certain services.

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Step Two
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Gather your information
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Start by making a simple checklist with important deadlines, when you want to compare plans, and when you need to submit your forms. Also create a list of your doctors and medicine, so that you can compare it to what's covered by various plans.

During enrollment, you may need other information, including income details, such as pay stubs or tax forms, birth dates for people in your household, and Social Security numbers. Make sure you have these ready if you need them.

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Step Three
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Compare plan options
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Once you know what you need, compare your plan choices side by side.

When looking at the cost of a plan, don't just look at the monthly premium because there are other costs to think about like deductibles, copays, and prescription coverage.

Make sure your doctors are in-network, which means your plan works with those doctors at a lower cost. Check that your hospital and prescription medicines are covered, too.

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How to complete the enrollment process

If you're buying your health plan yourself, you'll enroll by completing and submitting an application directly with an insurance company or through the Health Insurance Marketplace. Make sure to enroll by the Open Enrollment deadline.

After you're approved, you'll get more information about your plan, like how to pay your premium and a booklet that explains your benefits.

If you get your insurance through your employer, you'll enroll through them. You can get more information about enrolling in health insurance through your company by contacting your human resources department.

Member Knowledge Center

Get reliable answers to your insurance questions, such as how to get prior authorization and submitting a claim.
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