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What is Open Enrollment?

written by Skye Kalil Written by Skye Kalil
Skye Kalil

Skye Kalil

Skye likes writing about mental health, nutrition, and wellness. She is passionate about sharing information that will educate, and positively affect people's lives.

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reviewed by Leann Poston, M.D. Reviewed by Leann Poston, M.D.
Leann Poston, M.D.

Leann Poston, M.D.

Leann Poston, M.D. earned her medical degree from the Wright State University Boonshoft School of Medicine. She completed an MBA from Raj Soin College of Business, focusing on healthcare. She is a full-time medical communication writer and educator.

October 19, 2021 Read Time - 5 minutes

When Is Open Enrollment for Health Insurance?

Open enrollment is a period in time each year that allows people to enroll, change, or stop health insurance plans for the upcoming year. Options are available for benefits such as health, vision, dental, disability, and life insurance. Open enrollment is typically two to four weeks at the end of the year, before coverage for the next year starts, usually taking place in November for benefit plans that start January first. 

  • Book on our free mobile app or website.

    Our doctors operate in all 50 states and same day appointments are available every 15 minutes.

  • See a doctor, get treatment and a prescription at your local pharmacy.

  • Use your health insurance just like you normally would to see your doctor.

PlushCare-App-Steps

How Does Open Enrollment Work?

Open enrollment is a time where people can start, stop or change their insurance. It works by providing a time period to make these changes. To apply or re-enroll in your Health Insurance Marketplace coverage, you will need the following: 

  • Your basic personal information
  • Information about everyone applying for coverage
  • Social Security Numbers (SSNs) for everyone on your application
  • Information about the professional helping you apply (if any)
  • Immigration document information (this only applies to lawfully present immigrants)
  • Employer and income information for everyone in your household
  • Health coverage information (this only applies if anyone in your household currently has a health plan)
  • A completed “Employer Coverage Tool” (this only applies if anyone in your household has or is eligible for coverage through their employer)
  • Health Reimbursement Arrangement (HRA) notice (this only applies if anyone in your household is offered an HRA through their employer)

Open enrollment for 2021 is now over, but if you qualify for a special enrollment plan, you may still be able to enroll in a Marketplace health insurance plan for 2021. You may be eligible for a special enrollment period due to a change in your life, such as losing other coverage, moving, getting married, or having a baby.

Open enrollment for 2022 runs from November first through January fifteenth, 2022, for Marketplace coverage through HealthCare.gov. Coverage can start as soon as January 1st, 2022. After January 15th, you can enroll in 2022 health insurance only if you qualify for a special enrollment period. 

What Happens if I Do Not Have Health Insurance?

If you do not have health insurance, you can sign up as open enrollment is about to begin. Starting November 1st, you can apply using any of the following methods: 

  • Online
  • By phone
  • With the help of someone in your community
  • Through a licensed agent or broker
  • Through certified enrollment partner websites
  • With a paper application

What Happens if You Miss Open Enrollment?

If you miss open enrollment, you could still apply, if you qualify for a special enrollment period due to a life event such as:

  • Losing other coverage
  • Moving
  • Getting married
  • Having a baby

Applying for Health Insurance 

There are a few different ways that you can apply for and enroll in 2022 Marketplace health coverage. You can start by doing one of the following: 

  • Find and contact an licensed agent/broker
  • Have an licensed agent/broker contact you
  • Use a certified enrollment partner’s website
  • Use HealthCare.gov to apply online
  • Contact the Marketplace Call Center to enroll by phone
  • Fill out and mail in a paper application

How to Choose a Health Plan During Open Enrollment

Choosing a health plan during open enrollment can be confusing and make you feel pressured, but it can be navigated. Open enrollment for 2022 coverage starts November 1st, so before signing up, review the following information to help the process be more straightforward. 

Choosing a health plan comes down to a few key factors that should be considered before looking at your plan options. Here are our open enrollment tips: 

The 4 “Metal” Categories

There are four categories of health insurance plans: Bronze, Silver, Gold, and Platinum. These categories show how you and your plan share costs. Plan categories have nothing to do with the quality of care.

  • Bronze: The insurance company pays 60%, you pay 40%
  • Silver: The insurance company pays 70%, you pay 30%
  • Gold: The insurance company pays 80%, you pay 20%
  • Platinum: The insurance company pays 90%, you pay 10%

Your Total Costs for Health Care

You pay a monthly bill to your insurance company, called a premium. You must pay this baseline cost, even if you do not use medical services that month. You pay out-of-pocket costs, including a deductible, when you get care. It is important to think about both kinds of costs when shopping for a plan.


Related: What is a Doctor App?


Plan and Network Types

Some plan types allow you to use almost any doctor or health care facility. Others limit your choices or charge you more if you use providers outside their network.

  • EPO: Exclusive Provider Organization
  • HMO: Health Maintenance Organization
  • POS: Point of Service
  • PPO: Preferred Provider Organization
  • Book on our free mobile app or website.

    Our doctors operate in all 50 states and same day appointments are available every 15 minutes.

  • See a doctor, get treatment and a prescription at your local pharmacy.

  • Use your health insurance just like you normally would to see your doctor.

PlushCare-App-Steps

Star Ratings

HealthCare.gov offers quality health insurance plan ratings (or “star ratings”), reflecting member experience, medical care, and health plan administration. The ratings let you quickly compare plans based on quality.

Telehealth Coverage

When you are applying, one key thing to remember is checking your telehealth services coverage. Most major insurance companies will cover all telehealth-related healthcare. PlushCare is an in-network provider for most major insurers. 

To make an appointment with an online doctor at PlushCare, click here


Read More About Health Insurance


Sources:

PlushCare is dedicated to providing you with accurate and trustworthy health information.

Ways to apply for 2022 health insurance. HealthCare.gov. Accessed October 13, 2021 at  https://www.healthcare.gov/apply-and-enroll/how-to-apply/

Open Enrollment Guide & Resources. Society for Human Resource Management. Accessed October 13, 2021 at https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/open-enrollment-benefits-guide.aspx

How to pick a health insurance plan. HealthCare.gov. Accessed October 13, 2021 at https://www.healthcare.gov/choose-a-plan/comparing-plans/

Most PlushCare articles are reviewed by M.D.s, Ph.Ds, N.P.s, nutritionists and other healthcare professionals. Click here to learn more and meet some of the professionals behind our blog. The PlushCare blog, or any linked materials are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. For more information click here.

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