When is the next open enrollment for health insurance 2022? If you don’t have health insurance, that could be an important question for you. The Open Enrollment Period is generally the only time of the year when you can shop for and enroll in new health insurance plans via the Marketplace on healthcare.gov, a healthcare shopping and enrollment service managed by the federal government.
This page provides a comprehensive overview of Open Enrollment for the second half of 2022 and 2023. By the time you’re done reading, you’ll know exactly how and when you can get your ideal health insurance plan from the Marketplace during the Open Enrollment Period.
When enrolling in a new healthcare plan via the Marketplace, you’ll be able to choose which company you want to purchase your plan from. Be sure to work with a modern health insurance company that puts an emphasis on digital management of your plan. When you can conveniently access everything you need regarding your plan in just a few clicks, you can spend less time on the phone, and as a result, get the care you need faster.
Find in this article:
- What Is the Deadline to Enroll in 2023 Health Insurance Coverage?
- Is the Open Enrollment Period the Same for Every State?
- Who Can Enroll in ACA-compliant Health Plans Year-round?
- Why Is It Important to Sign Up for ACA Coverage?
- What Do You Need to Prepare for ACA Enrollment?
- How Much Does Insurance Cost During Open Enrollment?
- Who Is Eligible for ACA Open Enrollment?
- Which Insurance Plans and Benefits Are Available?
- What Happens if You Miss the ACA Open Enrollment Period?
- Should You Open an FSA/HSA?
- What Other Benefits Should You Consider During Open Enrollment?
What Is the Deadline to Enroll in 2023 ACA-compliant Health Insurance Coverage via the Marketplace?
The Open Enrollment Period for 2023 begins on November 1, 2022 and ends on January 15th, 2023.
The Centers for Medicare & Medicaid Services recently announced new initiatives to make healthcare more accessible and affordable via the Marketplace for 2023.
Is the Open Enrollment Period the Same for Every State?
No. Some states do not use the federal Marketplace. Instead, they use state-based marketplaces. These state-based marketplaces perform a similar function as the federal Marketplace, with the primary difference being they’re run by their respective state government instead of the federal government.
The states that run state-based marketplaces are California, Colorado, Connecticut, the District of Columbia, Idaho, Kentucky, Maine, Maryland, Massachusetts, Minnesota, Nevada, New Jersey, New Mexico, New York, Pennsylvania, Rhode Island, Vermont, and Washington.
In states that use state-based marketplaces, the starting date and duration of the Open Enrollment Period varies by state.
Who Can Enroll in ACA-compliant Health Plans Year-round?
On the Marketplace, if you want to enroll in a new healthcare plan or make changes to your existing one, you must do so within the Open Enrollment Period. If you don’t, you’ll have to wait for the next Open Enrollment Period.
There is one exception: if you qualify for a Special Enrollment Period, you are able to enroll in a new healthcare plan or make changes to your existing one outside of the Open Enrollment Period.
Depending on the type of Special Enrollment Period you qualify for, you have the opportunity to make changes to your plan either 60 days before or after the qualifying life event. Qualifying life events include losing healthcare coverage (for example, if you lose healthcare coverage after being fired), moving to a new house or apartment, getting married, having or adopting a baby, and if your household income falls below a certain amount.
Outside of the Marketplace, you have the opportunity to enroll in ACA-compliant health plans year-round if you take advantage of enrolling in your workplace’s group health insurance plan, or one from a membership organization such as AARP.
Why Is It Important to Sign Up for ACA Coverage?
“ACA coverage” refers to a healthcare plan which meets the standards set forth by the Affordable Care Act. Marketplace plans, plans from your workplace, and public health insurance plans, such as Medicaid, Medicare, and CHIP, all must provide ACA coverage.
Under the ACA, certain rules apply. For example, ACA plans cannot discriminate based on pre-existing health conditions and are required to cover these 10 essential health benefits. As such, it’s generally ideal to get a plan with ACA coverage, though short-term healthcare plans, which are not required to follow the rules outlined in the ACA, can also be useful if you do not qualify for a Special Enrollment Period but need to get healthcare coverage before the next Open Enrollment Period begins.
What Do You Need to Prepare for ACA Enrollment?
Before the Open Enrollment Period begins, it’s wise to understand the basics of different healthcare plans so that you can pick the one that’s right for you and/or your family.
To get prepared, learn more about five common and popular types of healthcare plans, including the different costs and restrictions associated with each one.
How Much Does Insurance Cost During Open Enrollment?
Insurance costs for healthcare plans depend on a variety of factors, including but not limited to:
- How many people do you need to insure? It goes without saying that it costs more to insure a family than an individual.
- How comprehensive do you want your healthcare plan to be? More covered services, or a higher covered amount per service, will cost more.
- Do you want a high or low deductible? A deductible is an annual fixed dollar amount you need to pay by yourself before insurance starts helping out with costs. Higher deductibles generally mean lower monthly payments, and vice versa.
Who Is Eligible for ACA Open Enrollment?
US citizens, US nationals, and lawfully present immigrants are all eligible to purchase healthcare plans via the Marketplace. Other states, such as California, have similar rules regarding who is eligible for Open Enrollment on the state-run Marketplace.
Depending on your income level, you may also be eligible for public health insurance programs that make use of the Marketplace, such as Medicaid.
Which Insurance Plans and Benefits Are Available?
Millions of individuals use the Marketplace during the Open Enrollment Period to find insurance for themselves and their families. With so many people wanting different types of plans, almost every type of plan you can think of is available via the Marketplace. As long as you can afford private health insurance in the first place, you will likely be able to find the right healthcare plan on the Marketplace that suits your wants and needs perfectly.
The only types of plans/benefits not available on the Marketplace are those that do not meet the ACA’s requirements on essential benefits. Insurance companies are not allowed to offer plans on the Marketplace that do not meet the ACA’s criteria for minimum essential coverage (MEC).
What Happens if You Miss the ACA Open Enrollment Period?
If you miss the ACA Open Enrollment Period, you have a few different options depending on your life circumstances.
- Wait until the next Open Enrollment Period. This approach is the riskiest one, as if you come across unexpected health problems, you will not get any help with your bills.
- See if you qualify for a Special Enrollment Period. If you do, you can purchase a plan just like you would during the Open Enrollment Period.
- See if you can get insurance from your workplace. A group health insurance plan from your employer can take effect at any time during the year. If you’r e married, check to see if you can get on the group health insurance plan of your spouse’s workplace.
- Get short-term health insurance. Short-term health insurance is generally more expensive than other types of health insurance and it generally does not need to be compliant with the ACA. That being said, it’s still a viable short-term solution for individuals who miss the Open Enrollment Period for 2022-2023.
Should You Open an FSA/HSA?
Flex savings accounts (FSAs) and health savings accounts (HSAs) are similar types of health insurance plans in that they both allow you to set aside and pay for healthcare services without your funds first being taxed. Due to the lack of taxation, paying for healthcare services via a FSA or HSA is almost always significantly cheaper than if you used regular funds from an ordinary bank account.
FSAs and HSAs are available only if you have a high-deductible health plan (HDHP). A HDHP puts an emphasis on low monthly premiums, but at the cost of receiving very little coverage outside of core preventative services until your deductible is met.
HDHPs, and by extension FSAs and HSAs, are generally ideal for individuals who do not foresee themselves making frequent use of healthcare services. These types of individuals may save money with lower monthly premiums and higher expenses when they do need to make use of healthcare services.
If you plan on making frequent use of healthcare services, you may want to explore a more standard healthcare plan such as a health maintenance organization (HMO) or preferred provider network (PPO).
The primary difference between HSAs and FSAs is that FSAs are owned by the individual and generally allow for greater flexibility. FSAs are owned by the employer and generally allow for less flexibility.
What Other Benefits and Policies Should You Consider During Open Enrollment?
Because you can generally only buy plans from the Marketplace during the Open Enrollment Period, it makes sense to understand exactly what you’re purchasing before you enroll in a plan. If you don’t enroll in the right plan, you’ll usually have to live with your lackluster coverage for a full year before you can modify it.
When you’re purchasing your Marketplace plan, be sure to keep these six things in mind.
- Covered services. Not all plans cover the same services. Although all Marketplace plans are required to cover certain essential benefits, more expensive plans will often cover a wider range of healthcare services outside of the basics.
- Monthly premium. Your monthly premium is the monthly fee you have to pay to maintain health coverage, even if you use no healthcare services during that month. Higher monthly premiums generally mean lower deductibles and vice versa.
- Deductible. A deductible is a certain dollar amount you must pay out of pocket every year before your insurance plan starts helping out with costs. Plans with high deductibles are generally cheaper in terms of monthly premiums, but high deductibles can also come back to bite you in the future if you have lots of unexpected need for healthcare services.
- Copay rates. Certain healthcare services, such as physical examinations, are usually covered even if you haven’t met your annual deductible yet. You’ll just need to play a flat fee—called a copay—to access these types of services. Compare copay rates for the healthcare services you plan on using—if one plan is cheaper, you could save hundreds of dollars on copay fees throughout the year.
- Coinsurance rates. After you’ve met your deductible, your insurance company usually won’t cover the entire bill for healthcare services. Most often, the bill will be split between you and your insurance company on a coinsurance basis. For example, if the bill is $1,000 and your coinsurance rate is 80% (paid by the insurance company) and 20% (paid by you), you will be responsible for covering $200 of the $1,000 payment. Small differences in coinsurance rates can lead to big differences in payments on larger healthcare expenses.
- Restrictions. Many healthcare plans don’t allow you to visit any healthcare professional you want. Some require you to visit only in-network healthcare professionals, except in emergency situations. Others will provide coverage for out-of-network healthcare professionals, with or without a referral from your primary care physician. Be sure to understand the specifics of which healthcare professionals you can visit before you enroll in a new plan.
When is Open Enrollment for health insurance in 2022? The Open Enrollment Period for the federal Marketplace begins on November 1, 2022 and ends on January 15th 2023. However, not all states use the federal Marketplace; they may use state-based marketplaces instead, which sometimes have different dates for Open Enrollment. Therefore, it’s wise to confirm your particular state’s Open Enrollment Period to make sure you’re prepared.
When the time comes to enroll in your new plan or modify your existing one, try to work with a trustworthy health insurance company that puts the convenience of the patient first. A digital-approach to managing and accessing your health insurance plan means you spend less time on the phone and more time on the things you love.