When is the Open Enrollment Period?
The Open Enrollment Period is the time of year when individuals can enroll in a health insurance plan. For the Health Insurance Marketplace, this period typically runs from early November to mid-December, with coverage starting in the New Year. However, due to the COVID-19 pandemic, the enrollment period for 2021 has been extended. You can now enroll in Marketplace health coverage from February 15 through May 15.
There are also alternative ways to obtain health insurance for 2021:
- Special Enrollment Period: If you experience a life event such as losing other coverage, getting married, moving, or having a baby, you can enroll at any time.
- Medicaid or CHIP: If you qualify for Medicaid or the Children’s Health Insurance Program, you can apply at any time.
To apply for or re-enroll in Marketplace coverage, you can visit HealthCare.gov or call the Marketplace Call Center at 1-800-318-2596. TTY users can call 1-855-889-4325.
Before starting your application, it’s helpful to gather the following information to expedite the process. Note that this information is not necessary if you are applying for coverage without savings:
- Your name and date of birth
- Household information
- Home and/or mailing addresses
- Information about individuals applying for coverage
- Social Security numbers (SSNs)
- Information about the professional assisting you with the application (if applicable)
- Immigration document information
- Details about your tax filing method
- Employer and income information
- Health coverage information
- Completed “Employer Coverage Tool”
- Health reimbursement arrangement (HRA) notice
What are Special Enrollment Periods?
Special Enrollment Periods (SEPs) are specific time frames outside the Open Enrollment Period when individuals can sign up for health insurance. You may be eligible for a Special Enrollment Period if you have experienced certain life events, such as losing health coverage, moving, getting married, having a baby, or adopting a child.
Depending on the type of Special Enrollment Period, you may have 60 days before or after the event to enroll in a plan. If you miss this window, you may have to wait until the next Open Enrollment Period to apply.
Regardless of whether you qualify for a Special Enrollment Period, you can enroll in Medicaid or the Children’s Health Insurance Program (CHIP) at any time throughout the year if eligible.
Who is Eligible for Marketplace Health Insurance?
To be eligible for Marketplace Health Insurance, you must reside in the U.S., be a U.S. citizen or national (or be lawfully present), and not be incarcerated. Individuals with Medicare coverage are not eligible to purchase health or dental plans through the Marketplace.
What Types of Coverage are Available?
Depending on your income, you may qualify for an insurance plan with tax credits, Medicaid, or CHIP. To determine your eligibility, assess your income to see if you meet the criteria.
What do Marketplace Health Insurance Plans Cover?
All plans offered in the Marketplace provide coverage for the following 10 essential health benefits:
- Ambulatory patient services (outpatient care without hospital admission)
- Emergency services
- Hospitalization (including surgeries and overnight stays)
- Pregnancy, maternity, and newborn care
- Mental health and substance use disorder services (including counseling and psychotherapy)
- Prescription drugs
- Rehabilitative and habilitative services and devices (for the recovery of skills in individuals with injuries, disabilities, or chronic conditions)
- Laboratory services
- Preventive and wellness services, including chronic disease management
- Pediatric services, including oral and vision care
Having access to affordable and comprehensive health insurance is crucial, as it allows you to receive medical treatment at a lower cost compared to paying out of pocket. Benefits.gov encourages you to explore your options for health coverage. If you currently don’t have health insurance, now is the perfect time to consider enrolling in a plan. Take our Benefit Finder questionnaire to discover other benefits you may be eligible for.
