ACA Open Enrollment: Dates, Deadlines and How to Apply

When is ACA open enrollment?

Open enrollment is the one period each year when anyone can buy Marketplace coverage, regardless of health history or job situation. Sign up early enough in the window and your coverage generally starts on January 1.

[VERIFY: confirm the exact start and end dates for the current plan year, including state-based exchange deadlines and any special extensions that have been announced.]

What is a special enrollment period?

A special enrollment period (SEP) is a window outside open enrollment that opens after a qualifying life event. In most cases you have 60 days from the event to apply, though the exact window depends on the event.

Because the window is tied to the date of the event, applying late is the most common way people lose access to subsidized coverage until the following November.

• Losing qualifying health coverage, including a job-based plan
• Moving to a new state or a new ZIP code with different plan options
• Getting married, entering a domestic partnership or divorcing
• Having a baby, adopting or placing a child for adoption
• Turning 26 and aging off a parent's plan
• A change in household income or family size that affects subsidy eligibility
• Gaining lawful presence or being released from incarceration

How do you apply for Marketplace coverage?

Applying takes about 15 to 30 minutes if you have your information together. You can apply yourself on HealthCare.gov or your state exchange, or have a licensed agent complete the application with you while you are on the phone.

• Gather Social Security numbers for everyone applying, or document numbers for lawfully present immigrants
• Have your most recent tax return and current income details ready
• List every employer and income source in the household, including self-employment
• Enter every household member who needs coverage, even if only some are applying
• Compare plans by total cost — premium plus deductible plus out-of-pocket maximum
• Confirm your doctors, hospitals and prescriptions are in the plan's network before you enroll

How much does coverage cost during open enrollment?

Your premium depends on your age, where you live, your household size, tobacco use and the plan tier you choose. Premium tax credits are calculated from your projected household income relative to the federal poverty level, and cost-sharing reductions are only available on silver plans.

[VERIFY: current income thresholds and average premium ranges you want to publish, reviewed each plan year.]

Common mistakes to avoid

Most of these are avoidable in a single conversation. An agent can price the plans you qualify for, check your providers and enroll you the same day.

• Estimating income carelessly — advanced credits are reconciled on your tax return
• Choosing the lowest premium without checking the deductible and out-of-pocket maximum
• Assuming your doctors are in network without verifying the exact plan
• Letting a special enrollment window expire by waiting more than 60 days
• Buying a short-term plan when a subsidized ACA plan would cost about the same