Open Enrollment
What is open enrollment?
Open enrollment is the period of time during which you can make changes to your health insurance coverage. Most open enrollment periods are once per year.
Whether your health insurance comes from your employer, the federal marketplace or another federal program, you will most likely have an annual open enrollment period during which you can enroll in or make changes to your coverage. If you miss the open enrollment period, you may not be able to make changes to your insurance plan until the next year, unless you meet certain requirements, such as starting a new job, getting married or other life changes.
When is open enrollment?
Employer Plans
Employers set their own open enrollment periods. Many companies hold open enrollment in the fall of the year with changes taking place on Jan. 1. Check with your human resources department or benefits administrator for specifics for your workplace.
Medicare & Medicare Advantage
Medicare open enrollment happens each year from Oct. 15 through Dec. 7. During this period, you may:
- Switch from Original Medicare to a Medicare Advantage plan
- Switch from a Medicare Advantage plan to Original Medicare
- Change Medicare Advantage plans
- Add, change or drop Part D prescription drug coverage
If you are already enrolled in a Medicare Advantage plan, you may make changes from Jan. 1 through March 31. During this period, you may:
- Switch to another Medicare Advantage plan
- Drop your Medicare Advantage plan and return to Original Medicare
Check with medicare.gov for official guidance on Medicare or Medicare Advantage enrollment. You may also talk to an insurance agent or adviser for help understanding your options.
Tips for Comparison Shopping Medicare Advantage plans
Open enrollment is a good time to give your benefits a check-up. Costs and coverage can change from year to year, as can your individual circumstances and medical needs. To ensure your coverage meets your needs, follow these tips:
Search by Hospital
Once you have found the plans open to you, enter your preferred hospital network information to further narrow the list to only plans that consider your hospital in network.
Search by Physician(s)
Just as you did with hospitals, enter your preferred physician(s) to find the plans accepted by your health care providers.
Search by Prescription Drug(s)
For either Medicare Advantage or Part D prescription drug coverage, you can comparison shop using a list of your current medications to find the best fit.
HealthCare.gov Federal Marketplace
Open enrollment for Federal Marketplace plans has two phases:
- For coverage to begin Jan. 1, enroll between Nov. 1 and Dec. 15.
- For coverage to begin Feb. 1, enroll between Dec. 16 and Jan. 15.
You may apply for coverage outside of these dates if you have a qualifying life event, such as:
- Losing your existing health insurance
- Adding or removing people in your household
- Moving to a new area
More information on open enrollment and qualifying life events is available at healthcare.gov
Please Note
NMHS' participation with any product or insurance plan is subject to change without notice. Additionally, insurance companies offer a variety of plans and may change the names and benefits at any point. Your level of coverage depends on the specific benefits outlined in your level of coverage and your plan. To ensure that NMHS and its providers are in-network, it is your responsibility to verify that NMHS is a participating provider and your benefit plan allows you access as of the day of a visit and/or admission. Please contact your insurance plan to obtain this information.
Your NMHS patient access specialist (PAS) can help answer questions about insurance and communicate with your insurance company. In most cases, you will be able to connect with a PAS at the hospital, clinic or facility where you are receiving care.