What is the open enrollment period?

Annual checkups are key in maintaining health and wellness, but they aren’t just for your body. Reassessing your health insurance plan needs yearly—especially following new diagnoses or big life events—can go a long way toward optimizing your coverage. Each year, Americans get a chance to do just that during their annual Open Enrollment Period in the ACA marketplace, with Medicare, and/or with their employer. 

What are the various open enrollment periods?

Annual open enrollment periods are the time of year during which Americans can make changes to their elected health insurance coverage (such as the group health plan they receive through their employer) or purchase new insurance through the Health Insurance Marketplace (also known as Obamacare). (People with Medicare or Medicaid will have different stipulations and times for enrollment.)

Open enrollment also may be a good time for beneficiaries to add a spouse or dependents, or otherwise change their household composition, to their ACA plan if they haven’t done so already. 

Even if you plan to renew your current plan, it’s a good idea to check the fine print for the coming year—what is and is not included (such as prescription medications and copays) changes year to year, so you’ll want to make sure you have the right coverage for you and your family. 

If you miss the open enrollment period for the federal ACA marketplace, you may still be able to elect new coverage or make changes to your plan during a special enrollment period. However, you must have one of the following qualifying life events to participate in special enrollment: 

• Changes in your household
• Changes in your residence
• Loss of your health insurance coverage
• Other qualifying events, such as becoming a U.S. citizen

When is ACA open enrollment for 2025 coverage?

Open enrollment dates for 2025 are Nov. 1, 2024 through Jan. 15, 2025 in most states, giving beneficiaries about six weeks to shop and compare plans before purchasing them through one of the health insurance exchanges (either the federally run healthcare.gov or their state-run marketplace). 

If your state operates its own health insurance marketplace, those dates may vary slightly (for instance, California, Colorado, and Washington, D.C., have permanently extended their dates into January). In 2023, 18 states and Washington D.C. have state fully state-run marketplaces. Check the marketplace in your state for more information on enrollment deadlines.

If you sign up for coverage during the Open Enrollment Period prior to Dec. 15, your insurance will take effect Jan. 1. If you sign up for coverage during the Open Enrollment Period after that date, your insurance will start Feb. 1. 

The Medicare Open Enrollment Period differs from ACA Open Enrollment Period. Medicare open enrollment for 2025 is Oct. 15 through Dec. 7, 2024, with plans going into effect on Jan. 1, 2025. Medicare also offers a number of other unique enrollment periods for varying purposes. You can visit medicare.gov to learn more.

What happens if you miss ACA open enrollment?

If you miss the 2025 open enrollment deadline, you run the risk of not having health insurance coverage for an entire year (unless you qualify for a special enrollment period). This means you may have to pay for medical costs, such as doctors visits, prescription medications, and emergency services, out of pocket. 

While the ACA previously required those who did not have health coverage (and were not exempt) to pay a fine (otherwise known as a Shared Responsibility Payment) on their federal tax return, the Tax Cuts and Jobs Act did away with that payment for tax year 2019 and beyond. However, there are a handful of states that still charge a financial penalty, including California, New Jersey, Rhode Island, Washington D.C., and Massachusetts, so you’ll want to check with your state’s law.

RELATED: Is there a tax penalty for being uninsured in 2024?

There are other coverage options worth investigating if you’ve missed the open enrollment period:

• Your spouse or partner’s plan
• Your parent’s plan, if you’re younger than 26
• Medicaid or CHIP (Children’s Health Insurance Program)
• Short-term plans 
• Supplemental insurance

To help offset prescription medical costs without insurance, there’s also the SingleCare discount card. Free to download and use, the SingleCard card isn’t a form of insurance—but a discount program that reduces the cash price of prescriptions at U.S. pharmacies. Search for your meds and see how much you can save today!