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When Does Open Enrollment End?

Q. What is the Deadline for Open Enrollment in The Individual Market?

In many states, the open enrollment deadline for 2021 health plans is scheduled to run from November 1, 2020, to December 15, 2020. HealthCare.gov, the exchange platform used by many states, tends to follow this schedule closely, while states that run their exchange platforms offer longer enrollment windows slightly. HealthCare.gov is used in 38 states as of 2020, though this is expected to drop to 35 states by the time the open enrollment window starts in the fall of 2020.

Outside of open enrollment, health insurance changes and new enrollments are only possible for individuals who experience a qualifying event.
Alaska Natives and Native Americans can enroll year-round in plans provided in the exchange. Applicants who are qualified for Medicaid or CHIP can also enroll year-round.

California, Colorado, and DC: Open Enrollment Has Been Permanently Extended

California: November 1 – January 31. California enacted legislation in 2017 and again in 2019 that permanently establishes various enrollment dates within the state, both on and off-exchange. Open enrollment for 2021 health plans will start on November 1, 2020, and continue through January 31, 2021. California’s enrollment schedule has differed in previous years, but this three-month window, from the beginning of November through the end of January, will be the permanent enrollment window going forward.

Colorado: November 1 – January 15. Colorado’s Division of Insurance has likewise permanently prolonged open enrollment. The state concluded regulations in late 2018 that call for an annual special enrollment period, running from December 16 to January 15, that is added to the end of open enrollment every year. Thus, open enrollment in Colorado will effectively last 2.5 months for all future enrollment periods (November 1 to January 15). Plans designated between December 16 and January 15 must take effect no later than February 1.

DC: November 1 – January 31. DC’s exchange board voted unanimously to permanently implement an open enrollment window that runs beginning November 1 to January 31.

In Pennsylvania’s new state-run exchange, enrollment will proceed through January 15, 2021
Pennsylvania has used HealthCare.gov in previous years but is shifting to a new state-run exchange, known as Pennie, in the fall of 2020. Pennie’s board of directors has endorsed a longer open enrollment period for 2021 coverage, which will run between November 1, 2020, to January 15, 2021.

Outside of the Open Enrollment Window, Enrollment is Only Availabl with a Qualifying Event

After open enrollment ends, individuals can only buy coverage if they have a particular enrollment period triggered by a qualifying event such as:

• Marriage (From 2017, this generally only applies if at least one spouse already had coverage prior to the wedding, although there are some exceptions),
• Becoming a United States citizen,
• Birth or adoption,
• Involuntary loss of other health insurance plans.
• A permanent move to a location where new health coverages are available (since July 2016) only applies if you already had coverage before your move).

Irrespective of whether you purchase insurance through the exchange or off-exchange, the annual open enrollment window applies, and special enrollment periods are necessary to enroll at any other period of the year.

In 2016, HHS tightened up the rules concerning eligibility for special enrollment periods, and they further tightened the rules in 2017, as part of the market stabilization rule. Consequently, the rules are being followed much more closely than they were in previous years, and in most states, anyone enrolling during a special enrollment period is needed to provide proof of the qualifying event that they experienced.

Resources and References:

• Qualifying Life Events
• Medicaid