Obamacare Open Enrollment Period and Qualifying Life Events

The new Open Enrollment Period, during which you can begin shopping for newly reformed health insurance plans, will run from November 15, 2022, to December 15, 2022. The federal government mandates insurers to accept applications from qualified individuals seeking a health insurance plan during the Open Enrollment Period. 

If you don’t purchase a health plan during the open enrollment, you will fall outside the government’s guaranteed eligibility period. As a result, it may be more challenging to purchase it later unless you have a qualifying life event. Without insurance coverage, you could encounter tax penalties and significant medical expenses if you get sick or injured.

Open Enrollment Period

Health insurance agencies and state regulations may introduce additional open enrollment periods. However, the new government guidelines guarantee only one annual Open Enrollment Period, during which you can apply for any individual Marketplace plan. The government requires exchanges to allow citizens to sign up for coverage beginning on or after January 1, 2023, during the open enrollment period (from November 1 to December 15, 2022). But it is essential to note that individual states and insurers may authorize certain people to register for health plans at different times of the year. 

2022 Schedule for Obamacare Enrollment and Effective Insurance Coverage

In most cases, an enrollment application submitted between the first and fifteenth day of any month is for coverage beginning on the first day of the following month. Furthermore, if you apply for coverage between the sixteenth and the last day of any month. In that case, your program will take effect on the first day of the second following month. For example, 

Life Events that Qualify for SEPs (Special Enrollment Periods)

According to the Affordable Care Act, people can enroll in the Special Enrollment Period at any time of the year. A Special Enrollment Period refers to a qualifying life event that makes you eligible for a Qualified Health Plan outside of the annual enrollment period. 

What is a Qualifying Life Event?

A qualifying event is an occasion in your life that qualifies you for a SEP under the applicable regulations.

The following are some examples of qualifying life events:

• Loss of Health Insurance Coverage. If you or any dependent loses health insurance that meets minimum government standards.
• Change in Family Structure. If you get a dependent or become dependent due to marriage, a death in the family, and the birth or adoption of a child. 
• Experience Government Error. If you change, lose, or register in coverage due to the error committed by an Exchange officer, agent, employee, or the Department of Human and Health Services, as determined by the Exchange.
• Change in Citizenship Status. If you become a U.S legal resident, national, or gain lawful status in the U.S. 
• Change in Subsidy Eligibility. If you are determined to be newly eligible or ineligible for subsidies (advance payments of the premium tax credit or cost-sharing reductions).
• Relocate to a New Service Area. It occurs when you permanently move to a new state and gain access to new qualified insurance plans.

Frequently Asked Question about Obamacare Enrollment Period

When is the Obamacare Open Enrollment Period?

The next annual enrollment period for individual and group health insurance plans under the Affordable Care Act (ACA) will begin on November 1, 2022, and end on January 15, 2023.

What is an Open Enrollment Period?

The Affordable Care Act’s Open Enrollment Period authorizes consumers (and small companies) to obtain health plans that include ACA health reform provisions and required benefits. Coverage under these plans will begin on January 1 of the following year. The ACA’s provisions allow consumers to purchase an insurance policy with ten essential health benefits, receive government subsidies, and enroll without fear of being denied due to pre-existing medical conditions. 

Who is Required to Apply for Health Insurance During Open Enrollment?

The ACA’s Open Enrollment Period is crucial for individuals and families who do not qualify for an exemption or have no qualifying coverage, such as employer-sponsored health insurance. However, if you have employer-provided health insurance, you are not required to sign up for a new plan during the Affordable Care Act’s Open Enrollment Period. 

Instead, you can keep your employer’s group plan – if you do, make sure to take advantage of any open enrollment period your company announces for your employer’s plan. 

What if I Don’t Purchase a Health Plan During the Open Enrollment Period?

Your ability to apply for health insurance outside of the open enrollment may vary by state. But it will typically be limited to times when you have a “qualifying life event,” as defined by the government. These events include:

i) Loss of employer-provided coverage

ii) Marriage or divorce

iii) Permanent move to a new state

iv) Child’s birth or adoption.

What Happens if I Miss Annual Enrollment and Don’t Have a Qualifying Event?

You might be able to purchase short-term health insurance plans. But they won’t meet the standards of the Affordable Care Act and will provide limited health coverage benefits.

Where Do I Shop for a Health Insurance Plan During the Open Enrollment Period (OEP)?

During the annual enrollment period, families and individuals can shop for ACA-compliant programs, including those that qualify for subsidies, at government-operated health insurance marketplaces such as healthcare.gov or private health insurance websites such as InsuranceShopping.com.