If you are in the market for an individual or family health insurance plan for 2023, the annual Open Enrollment Period (OEP) is your time to shop. This guide answers all the key questions about dates, deadlines, plan options and how to enroll so you’ll have the right coverage when you need it.
What is the Open Enrollment Period (OEP) for health insurance?
The Open Enrollment Period (OEP) is a yearly opportunity for you to sign up for, or change your individual or family health insurance plans for any reason. It occurs every fall into early winter so you can select the best coverage for the upcoming calendar year.
Open Enrollment is available to consumers who don’t already have health insurance coverage from Medicaid, an employer sponsored plan, their parents plan, or from Veterans Affairs.
Employers have their own open enrollment periods, which can vary. And if you are 65 and older, you’re eligible for the Medicare Annual Enrollment Period (AEP) which runs from Oct. 15 through Dec. 7.
When is Open Enrollment for health insurance coverage for 2023?
Open Enrollment typically runs from Nov. 1 through Dec. 15, but may vary from year to year.
However, due to changes in federal regulations, Open Enrollment for 2023 individual and family insurance plans purchased in the marketplace has been extended to Jan. 15, 2023, for marketplace plans on healthcare.gov and MNsure.
Because of this extended enrollment period, your coverage dates will be based on when you enroll for your insurance plan.
If you enroll on or before Dec. 15, your coverage begins on Jan. 1, 2023
If you enroll between Dec. 16 and Jan. 15, your coverage begins on Feb. 1, 2023
There is an important distinction between the year of enrollment and the year of coverage. When you sign up for, or switch your health insurance during OEP, coverage kicks in the following calendar year. So, the enrollment dates and deadlines in 2022 are for setting up your 2023 coverage.
What insurance plans and benefits are available?
The Affordable Care Act (ACA) guarantees a range of consumer protections for all individual medical policies. Thus, any ACA-compliant plans requires that all health insurance plans, sold in the individual marketplace, provide these 10 essential health benefits:
- Prescription drugs
- Pediatric care
- Preventive care
- Emergency services
- Mental health
- Maternity care
- Outpatient services
- Laboratory services
- Rehabilitative services and devices
Additionally, you can’t be denied coverage due to a preexisting condition.
How to enroll in health insurance
Whether you have already found your ideal plan or not, there are several ways to shop and enroll. Each option provides a level of customer support to help you make the right choice.
Buying through a health insurance company
This is when you purchase a plan directly from an insurer, such as HealthPartners. Health insurance companies are the most knowledgeable about their plans and can break down the details of their offering. This option is also referred to as an off-exchange purchase.
Working with a health insurance broker
A broker can show you different types of plans from a variety of insurance companies to consider, rather than one single insurer. This can help you weigh your options more broadly but still get the assistance you need to pick a plan that meets your needs. Plus, brokers can usually provide ongoing support after you enroll.
Shopping through a health insurance exchange
Exchanges are great for shoppers who want to compare health plan prices and benefits in a single location. Minnesota residents can shop via MNsure on their own, or they can take advantage of support from an assigned navigator to help navigate enrollment. Wisconsin residents can shop via healthcare.gov.
The most common documents you’ll need to sign up for health insurance
When applying for health insurance, depending on the plan and where you live, you may need documentation to verify certain things like your citizenship (proof of lawful residency status may be required).
Here are the most common documents you should have available:
- For proof of age, you’ll need any one of these:
- Voter Id card
- Driver’s license
- Birth certificate
- For proof of identity, you’ll need any one of these:
- Voter Id card
- Driver’s license
- Social Security card
- For proof of address, you’ll need any one of these:
- Driver’s license
- Rental agreement if applicable
- Utility bill
What happens if I miss Open Enrollment for 2023?
If you miss your Open Enrollment deadline, you might be able to qualify for a Special Enrollment Period (SEP). You may qualify if you have experienced a qualifying life event such as:
- The loss of health insurance from your employer, or other minimum coverage
- Household changes such as marriage, divorce, a death in the family, or having a baby
- A change in your home address, where available health plans are different than what was previously available to you
If you do qualify for a Special Enrollment Period, you’ll have 60 days to enroll in a new plan. However, if you miss that window, you will have to wait until the next Open Enrollment period to sign up for an individual health insurance plan for the following year.
Another option is to see if you qualify for Medicaid. Enrollment is available all year for those who qualify, depending on household income levels. If you experienced a significant income loss during the year, it’s worth it to check your eligibility for Medicaid.
Also, if you’re already on Medicaid and your income increases to a level so that you’re no longer eligible, you’ll be able to switch to a private plan at that point, with the loss of your Medicaid plan being the qualifying event that triggers a Special Enrollment Period.
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