FAIR Health Consumer Access

Fall Is Open Enrollment Season

Now that fall is here, it’s a good time to think about health insurance. That’s because fall is open enrollment season—the time of year when you can sign up for a health plan or make changes to the plan you have.

Job-Based Health Plans
If you receive your health insurance through your employer, you probably signed onto your health plan when you were hired. But that doesn’t mean you have to stay with it forever. If your employer offers a choice of plans, during open enrollment season you have a chance to reconsider which plan is best for you. You can review plan materials, ask questions about plan choices, choose a different plan, sign up for new plan offerings and add or drop dependents. If your employer offers flexible spending plans, such as a flexible spending account or health savings account, you can enroll in one of those to help you stretch your healthcare dollars.

Many businesses have their open enrollment season in the fall, with coverage to become effective at the start of the new year. The window for making changes may last only a few weeks, so ask your human resources department or manager when your company’s open enrollment season will take place. That’ll give you more time to think about your options.

The Health Insurance Marketplace
The federal government and many states operate a Health Insurance Marketplace or Exchange. Those are websites that offer one or more health plans in which individuals can enroll themselves and their families. They’re worth considering if your employer doesn’t offer health coverage or you don’t like the coverage your employer offers. They also may be of interest if you’re self-employed or unemployed.

When you apply for a Marketplace plan, you’ll find out if you qualify for subsidies to reduce the cost of coverage. You’ll also see whether you’re eligible for Medicaid, the government health insurance program for people with limited incomes.

Open enrollment for the federal Health Insurance Marketplace runs from November 1, 2024, to January 15, 2025. If you want to choose or change a federal Marketplace plan for 2025, you have to do so during that period. If you want your coverage to start January 1, 2025, you have to enroll by December 15, 2024. Check here to find out if your state has an exchange and what its open enrollment period is.

Medicare, Medicaid and CHIP
When you turn 65, you can enroll in the government’s Medicare program. (You may also qualify for Medicare if you have a disability or certain illnesses.) Click here for information on when and how to apply for Medicare.

Every year, Medicare has its own open enrollment period, from October 15 to December 7. During this period, you can make changes to your Medicare coverage. For example, you can join a new Medicare Advantage plan, which lets you get your Medicare benefits from a private health plan. Or you can enroll in a new stand-alone prescription drug plan. For more information, contact Medicare or visit Medicare Interactive.

To learn more about Medicare, see our article on What You Need to Know about Medicare.

If your income is under certain limits, you may qualify for Medicaid or the Children’s Health Insurance Program (CHIP). If you qualify, you can enroll at any time of the year. Check here to see if you qualify.

Preparing for Open Enrollment
It pays to prepare for open enrollment. You may have choices to make, and not much time to make them. To help you choose among plans, read our article on Types of Health Plans in this issue. Are you going to apply for coverage through the Health Insurance Marketplace? If so, here’s a checklist of information you may want to gather in advance.

If you miss open enrollment, you still may have opportunities to change your coverage before next year’s open enrollment period. Most employers let you make changes to your coverage for certain life events, whenever they happen. Those events may include the birth of a child or loss of coverage under a spouse’s plan. The Health Insurance Marketplace allows “special enrollment periods” for similar sorts of events. Even so, open enrollment season is your best chance to sign up for or change your health coverage.