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Open enrollment for the federal Health Insurance Marketplace typically runs from Nov. 1 to Jan. 15 annually. (However, several states, in the past, have extended the deadline past Jan. 15, so check your local marketplace for details.) During the 10-week period, customers are offered the opportunity to enroll in new healthcare coverage, switch their current health plan to a new one, and/or apply for cost assistance. Plans that were enrolled by Dec. 15 take effect on Jan. 1 of the next year.
If you miss the deadline, certain qualifications allow you to get health insurance after the open enrollment period.
Can I get health insurance outside of the enrollment window?
It is possible to obtain health insurance or change your Marketplace plan after the open enrollment period only if you experience at least one “life event” that qualifies for a Special Enrollment Period.
It’s important to note that you may not qualify for cost assistance if you’re enrolling in health coverage after the annual open enrollment period. Individuals who do not qualify for coverage in 2024 through a Special Enrollment Period can enroll in health insurance during regular ACA open enrollment for 2025 running Nov. 1, 2024 through January 15, 2025.
If you are a Medicare consumer, Medicare has several different enrollment periods, including its own Special Enrollment Period. However, unless you have low income (qualifying for a program like Medicaid, the Medicare Savings Program, or Part D Extra Help), a late enrollment into Medicare may result in a higher premium, according to medicare.gov. If you qualify for one of these low-income programs, you may be able to expand your eligibility for certain parts of Medicare, as well, outside of the usual enrollment periods described above.
RELATED: What you need to know about ACA open enrollment and 2025 health plans
How to get health insurance after open enrollment
If you’re looking to enroll in a health insurance plan after the Marketplace open enrollment deadline, here are a few options:
1. Marketplace Special Enrollment Period
A qualifying life event for a Special Enrollment Period is defined as:
- A change in household (marriage/divorce, having or adopting a baby, etc.)
- A change in residence to a new zip code or county
- A loss in coverage
- Becoming a U.S. citizen
- Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
- Starting or ending service as an AmeriCorps State and National, VISTA, or NCCC member
- Leaving incarceration
In order to find out if you qualify for a Special Enrollment Period for Marketplace plans, visit healthcare.gov to answer a few questions. If you do qualify, begin by filling out an application on the government’s website, along with visiting this section of the site to review the current plans and pricing.
2. Medicare Special Enrollment Periods
There are separate enrollment periods for people with Medicare.
- Initial enrollment period: Sign up for Medicare Part A and/or Part B within seven months of the time you first become eligible for Medicare through age or disability.
- Fall open enrollment period: Reevaluate and make changes to your Medicare or Medicare Advantage coverage, or your Part D coverage, from Oct. 15 to Dec. 7.
- General enrollment period: The time period between Jan. 1 and Mar. 31 of every year is when you can enroll in Medicare Part B for the first time if you missed your initial enrollment period. You may be eligible to enroll in a Medicare Advantage (Part C) or a prescription drug (Part D) plan. If you enroll in Medicare during the GEP, your coverage starts the first day of the month following your enrollment.
Similar to Marketplace plans, Medicare also has Special Enrollment Periods. You may qualify for a Medicare Special Enrollment Period if you meet any of these eligibility requirements, which includes losing coverage through no fault of your own, moving to or from institutional facilities, and experiencing changes in your eligibility for certain programs.
3. Medicaid or CHIP
Affordable health plans with Medicaid and CHIP are available throughout the year regardless of the date. If you qualify for one or both of these programs, enrollment can begin immediately. The first step is finding out if you qualify for Medicaid and/or CHIP by answering a few questions on healthcare.gov. If you do qualify for Medicaid and/or CHIP, you have the option of applying for coverage either through the Health Insurance Marketplace or through the Medicaid agency within your state. Visit healthcare.gov to learn more about these types of coverage.
4. Short-term health insurance plans
Also referred to as term-health insurance or temp insurance, short-term plans are available in some states for purchase throughout the year. This type of coverage can bridge the gap between policies. While these plans do cover others in your family, they are not required to cover the numerous benefits that are covered by ACA plans (such as preventive care, prescription drug coverage, and laboratory services), along with covering preexisting conditions, according to UnitedHealthcare. Short-term insurance can be canceled anytime without a penalty. Visit healthinsurance.org to find out if your state offers this type of policy. If you lost your health insurance due to job loss or changes, you might also qualify for COBRA continuation coverage, which you can learn more about here.
5. Supplemental health insurance
Supplemental health insurance plans are designed to help individuals and families pay for extra costs that are not offered in their primary policy during hospital stays (for example, deductibles and a private room), according to State Farm. Aetna states that supplemental insurance may also help with essential bills, such as mortgage and groceries. Plans vary per state and insurance carrier.
RELATED: How to get health insurance
The cost of being uninsured
There’s no doubt about it—purchasing health benefits for yourself and/or your family is costly. Valuepenguin.com, a personal finance site owned by LendingTree, estimates that the average monthly premium in the United States is $584 per person in 2023. Cost is the primary reason why people forego health insurance.
Based on the Affordable Care Act (ACA), up until 2018, people who did not purchase a plan or have health insurance through their employer, Medicare, Medicaid, etc.—but could afford to buy health insurance—were charged a fee (also known as the Individual Shared Responsibility Payment or Individual Mandate) when filing federal taxes. While this tax penalty no longer applies on the federal level—a change that took place in 2019—six states issued their own fine for not having coverage. They are:
- California
- Massachusetts
- New Jersey
- The District of Columbia
- Rhode Island
- Vermont
Read this article to learn all about state-level tax penalties.
Just because there’s no longer a federal tax penalty for not having insurance, doesn’t mean that there aren’t other financial risks associated with being uninsured.
According to statistics compiled by the Kaiser Family Foundation, individuals without coverage tend to be charged higher rates by hospitals compared to patients who have insurance through a private company or public program. Also, those without benefits for one full year pay more than one-third of their emergency visits or routine healthcare appointments out-of-pocket—where many are unable to pay their mounting medical bills, possibly leading to difficulty in affording basic necessities, as well as bankruptcy.
Plus, studies have shown that those without health insurance are less likely to receive preventive care and medical services for serious illnesses and chronic health conditions. Regardless of the insurance carrier, health insurance plans offer free preventive care for children and adults (such as screenings, vaccines, screening tests, and annual check-ups) as long as the service is provided by a physician within the network.
RELATED: How to see a doctor when you don’t have health insurance
Additional ways to save without health insurance
While not a health insurance plan, SingleCare is a prescription savings service that offers a free discount card to reduce the price of prescription medications for those with or without insurance. If you are without insurance or are paying the cash price for your medication, you could see up to 80% savings with our card. We have partnered with more than 35,000 pharmacies nationwide (including CVS, Target, Walgreens, and Walmart), so start by searching for your medication today at singlecare.com.
