Is Open Enrollment Only Once a Year?

Health insurance enrollment occurs during Open Enrollment, a specific period each year. This timeframe allows individuals to select, renew, or change health coverage for the upcoming year. While an annual period is standard for many health plans, exceptions and alternative pathways exist for securing coverage outside this window. Understanding these enrollment opportunities is essential for continuous health protection.

The Standard: Annual Open Enrollment

For most individuals seeking health insurance through the Affordable Care Act (ACA) Marketplace, an annual Open Enrollment period is in place. This period generally runs from November 1 to January 15 in many states. During this time, individuals can explore health plans, enroll in a new policy, switch existing plans, or re-enroll for the following year.

To ensure coverage begins January 1, enrollment must be completed by December 15. If enrollment occurs between December 16 and January 15, coverage becomes effective on February 1. Participating in this annual window helps avoid gaps in health coverage, as enrollment outside these dates is restricted.

Exceptions: Special Enrollment Periods

Individuals can enroll in or change health plans outside of the standard Open Enrollment period through a Special Enrollment Period (SEP). An SEP is triggered by a “qualifying life event,” a significant change in circumstances. For Marketplace plans, individuals have a 60-day window before or after the qualifying event to enroll.

Common qualifying life events include losing existing health coverage (e.g., job-based insurance), aging off a parent’s plan at 26, or losing eligibility for Medicaid or CHIP. Changes in household composition also qualify, including marriage, the birth of a child, adoption, or divorce or legal separation that results in a loss of coverage. Moving to a new primary residence in a different ZIP code or county where new health plans become available can also create an SEP.

Other events that may trigger an SEP include changes in income that affect eligibility for subsidies, becoming a U.S. citizen, or gaining or becoming a dependent due to a court order. Leaving incarceration also qualifies for an SEP. When applying for an SEP, documentation is required to verify the qualifying event and confirm eligibility.

Other Avenues for Coverage

Not all health insurance options adhere to the same Open Enrollment timeline as the ACA Marketplace. Enrollment for Medicaid and the Children’s Health Insurance Program (CHIP) is available year-round. Individuals who meet income and eligibility requirements can apply for these programs at any time, and if qualified, coverage can begin immediately.

Medicare, the federal health insurance program for individuals aged 65 or older and certain younger people with disabilities, operates on its own enrollment schedule. The Initial Enrollment Period (IEP) is a seven-month window around an individual’s 65th birthday. The Medicare Annual Enrollment Period (AEP), running from October 15 to December 7, allows changes to Medicare Advantage and prescription drug plans. A General Enrollment Period (GEP) from January 1 to March 31 exists for those who missed their IEP for Medicare Part B.

Employer-sponsored health plans also have their own enrollment rules. While employers set their annual Open Enrollment periods, these plans also provide special enrollment opportunities for qualifying life events. These events are similar to those for Marketplace plans, though the enrollment window is often 30 days. New employees have an initial enrollment period, and waiting periods before coverage begins cannot exceed 90 days.