Open enrollment is the time period allotted for families and individuals to sign up for a health insurance plan for the following year through a public health insurance marketplace. The Marketplace also allows you to purchase a dental plan alongside your health insurance, although both will be separate entities.

These online marketplaces were established within the Affordable Care Act (ACA) in order to allow more affordable rates based on income. This means if you are eligible to shop in the Marketplace, the prices you are offered (for copayments, deductibles, and premiums) will typically be lower than the original cost of that plan through the private carrier themselves. Each state has their own Marketplace.

You are not required to purchase your health insurance from the Marketplace and can go directly through a carrier. However, you will not receive those discounted prices (called premium tax credits and cost-sharing reductions – based on your income) that many individuals are eligible for.

If you don’t get health insurance at all, four states enforce a penalty: New Jersey, California, Rhode Island, Massachusetts, and Washington D.C. 

If you’re in a state without a penalty, be aware that choosing to not have health insurance at all will put you in a position of having barely any accessibility to healthcare services. One accident or illness can put you in the face of a medical debt and inability to access prescriptions for treatments without spending hundreds of dollars on urgent care. 

Money is difficult, especially when you need groceries, rent, car payments, etc. But before kicking out the idea of health insurance completely, go through the Marketplace application to see if you’re eligible for discounts because it’s possible you can be offered a plan with a very low premium. It would also let you know if you’re eligible for Medicaid instead, which can offer $0 premiums and copays. After knowing what you’re offered, make your decision from there on what’s best for you.

The time period every year is from November 1 to January 15 of the next year. 

Special tip: If you’d like your coverage to begin on January 1st for the new year, enroll before December 15th. Keep in mind, you will need to submit required documents and wait for them to be verified, so do not wait till the 15th to submit your application.

If you complete your enrollment after December 15, your coverage will begin February 1 of the next year. This means any appointments or services you have in January will not be covered.

Medicare has a different annual time period from October 15 to December 7.

If you miss the enrollment period, you may not need to wait till next year. 

Most marketplaces offer a Special Enrollment Period. This period is for any time of the year that’s not the enrollment period, and allows individuals to apply for multiple circumstances. According to healthcare.gov, these reasons can include: “life events, including losing health coverage, moving, getting married, having a baby, or adopting a child, or if your household income is below a certain amount.”

If you miss the enrollment period and can define a legitimate circumstance in your life that prevented you from applying, you may qualify through special enrollment and can get health insurance through the marketplace. 

Special tip: If you’re unsure if your circumstance would qualify, call your Marketplace and say you’d like to be considered for special enrollment due to [state life reason]. Let the representative tell you if you would be eligible. And if you are, they will carry you through with the next steps. Don’t doubt that your circumstance would be ineligible until you actually ask. Only downfall: the call wait time, but don’t let that discourage you!

If you see your state in the list below, your state has its own Marketplace and website.

If your state isn’t in the list below, your marketplace will be through Healthcare.gov and the needed information is within the method menus underneath.

You can apply online, through phone, through a broker, enrollment partner websites, or with a paper application. The pros and cons of each method are included below the list of states.

Washington

Methods of Applying:

While states with their own Marketplace may have their own specific requirements, most Marketplaces will ask you for similar documents to verify your income, citizenship or immigration status, social security number, and lack of minimal essential coverage through an employer. These documents need to be submitted as soon as possible after submitting your application. It will take up to 2 weeks for these documents to be reviewed, which factors into the start of your coverage.

In addition, you may be asked to confirm that you don’t have qualifying health coverage through another government program (Medicaid, CHIP, TRICARE, Veterans Health Care Program, Medicare, and Peace Corps). Being qualified for these programs would prohibit you from being eligible for Marketplace insurance.

To see a list of accepted documents to help you prepare, click here for an official list divided by topic by Healthcare.gov. If you see your state in the list below, click it to be redirected to your state’s Marketplace list of accepted documents.

California, Colorado, Connecticut, District of Columbia, Idaho, Kentucky, Maine, Maryland, Massachusetts, Minnesota, Nevada, New Jersey, New Mexico, New York, Pennsylvania, Rhode Island, Vermont, Virginia, Washington