What Is Open Enrollment For Health Insurance?


Once each year many health insurance programs hold an open enrollment period.

The open enrollment periods apply to Medicare, health insurance offered by your employer and the Affordable Care Act.

During an open enrollment period you can make changes to your current coverage or apply for new coverage.  Insurance carriers need to accept you during the open enrollment period without regard to evidence of insurability or underwriting procedures.

If you miss your opportunity during the open enrollment period you may have to wait until the next year’s open enrollment.

Having an open enrollment period instead of allowing you to obtain coverage at anytime protects the insurance companies from someone who is only taking coverage if they already know they need to use it shortly.  Without the open enrollment system premiums probably would need to be increased to make up for those people who would try to abuse the system.

Before you choose the plan you want you need to consider several things.  You want to be sure your current doctor and the hospital, pharmacy and labs you prefer, or currently use, are covered.  If  you need to go out of network for these services will any of the cost be covered.  If you need to cover a spouse or dependent children you want to be sure the plan will cover them.  Be sure to check the approved list of drugs to see that prescriptions you need are covered.

Time to Sign Up

Read all the material thoroughly so you are familiar with what is covered by the plan.  If you do not understand the written material talk with someone qualified to explain the program.

Be sure you understand what deductibles will apply, how much you will need to pay for premiums, and what co-pays you are expected to cover.

Open enrollment periods for employer based coverage may be held at anytime, but usually they are held in the autumn.

Medicare open enrollment runs from October 15 to December 7 each year.
The Affordable Care Act open enrollment period for its second year is November 15 to December 7, 2014.  Thereafter, the open enrollment period for the Affordable Care Act is expected to be from October 15 to December 7 each year,