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What Is Open Enrollment?

Selecting the right health insurance plan is an important decision, one that takes careful thought and planning. And timing—because (with limited exceptions, see below) you can only purchase health insurance or modify existing insurance during Open Enrollment.

 

What is Open Enrollment?

Open Enrollment is a specific time frame each year during which you can freely select a new health plan or make changes to your existing plan. If your employer offers health benefits, you will know the dates of your company’s Open Enrollment period. Most times Open Enrollment happens in the fall, but it can vary from company to company.

If you don’t receive health benefits through work, you can buy insurance through the federal health insurance Marketplace at HealthCare.gov. This year Open Enrollment is from November 1 to December 15, and the plan you purchase during that time would take effect on January 1, 2019.

 

Why is Open Enrollment important?

Because it’s the only time during the year when you can change your health insurance coverage. If you don’t purchase a new plan or alter your existing one during Open Enrollment, you won’t get another chance to buy insurance until next year’s Open Enrollment period.

The only exception to this rule is if you have a qualifying life event. This is a major change in your life that might require a change to your coverage. In most cases, the event must have happened during the past 60 days. Visit healthcare.gov for a complete list of qualifying life events and additional information. But some examples include:

  • Getting married.
  • Having a child.
  • A loss of your existing health coverage (possibly due to a change in employment).
  • A permanent change of residence to a location where different health plans are available.
  • Turning 26 years old and losing coverage on a parent’s plan.

That last event is an important one to remember. Dependents under age 26 can be covered by parent or guardian’s plan. In some cases, the dependent can remain on their parent’s/guardian’s plan through the remainder of the year they turn 26. But those who are about to turn 26 should check with their current insurer to learn how long they will remain covered by that policy after their birthday.

 

What should I do next?

If you receive health insurance through your employer, be sure to watch for Open Enrollment details and dates. If you have questions about your current coverage, costs, or any changes you’re considering, contact your insurer.

And if you want to learn more about choosing an insurance plan with full, in-network access to UPMC doctors and hospitals, call the UPMC Health Plan Open Enrollment helpline at 1-855-409-8762 or visit upmchealthplan.com.