UPDATE 12/09: Open Enrollment for 2017 runs from November 1, 2016 to January 31, 2017. Outside the Open Enrollment Period, you generally can enroll in a health insurance plan only if you qualify for a Special Enrollment Period. You qualify if you have certain life events, like getting married, having a baby, or losing other health coverage.
The Obama Administration announced yesterday that they have extended the Open Enrollment Period to December 17th to buy a health insurance plan through healthcare.gov that takes effect on January 1, 2016.
Normally, consumers have until December 15th to buy coverage that begins on January 1, 2016.
Pretty straightforward, right? Not exactly.
Many consumers actually have until later in December to enroll – including for some up until December 31st – depending on where you live, who your health insurance carrier is and what type of health plan you have. Enrollment also depends on whether you buy your plan on a state or federal exchange (also called marketplaces) that is eligible for a premium tax credit or directly from the insurance carrier for plans not eligible for a subsidy.
Here is how it works in states that operate their own exchanges (also called marketplaces):
- In Maryland, the deadline is extended to December 18, while in New York the deadline is a day later.
- In Washington, Rhode Island and Massachusetts consumers have until December 23rd to apply for coverage with an effective date of January 1.
- In Minnesota, the deadline is December 28th.
But it is even more complicated:
There are about 600,000 people still on plans they had before the Affordable Care Act was implemented. These are so-called “grandmothered” and ”grandfathered” plans that are now being eliminated in 2016. If you have one of these plans that is being terminated, you automatically get until December 31 to buy coverage for a January 1 start date.
And, if you are one of about 500,000 people who had been covered by a co-op health plan you also have until the last day of 2015 to buy coverage that starts the next day – January 1, 2016.
Finally, certain carriers are extending the deadline for off-exchange plans that are not eligible for premium tax credits. Check with your carrier. But several Blue Cross plans, and Anthem – one of the largest carriers that operates in 14 states – have extended the deadline to December 31.
Does it make sense to buy a plan directly from a carrier instead of at the government exchange and forgo premium tax credits? Sometimes. Carriers offer plans that have lower deductibles and broader network in the “off exchange” market. And the prices might be a bit lower, too. A consumer should do a quick calculation of the pros and cons, especially if they would only receive a small premium tax credit.
But what about after January 1? You can still buy plans that start on February 1st if you buy before January 15th (Note: It will be the 23rd of the month for Mass., R.I. and Wash.) and you could buy plans that start on March 1 if you purchase before January 31.
Remember, you can find all these plans – and more – at HealthCare.com, the leading search and comparison shopping site for individuals.
Consumer tip: If you already bought a plan for 2016, or switched to a new carrier earlier in the OEP, but now want to change your mind, you can. Does that make sense? Yes – if you can save money and you have not incurred much in medical expenses that count toward your deductible. But let’s say you found a new plan for a $100 a month less than the one you have. You want it to start on March 1, 2016. But if you have already incurred, for example, $1,500 in out of pocket expenses toward a $2,000 deductible, it would be ill-advised to change to a new plan and start over with a new deductible.
Remember: Consumers are free to shop around until the last minute. And they cannot be denied coverage because of any pre-existing medical conditions.