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Open enrollment 101

New to open enrollment? Read this first.

Just like pumpkin spice, well, everything, open enrollment only comes once a year. And while it may not be as eagerly anticipated as other seasonal events, what you do during open enrollment will impact your whole year and could have an even bigger influence on your pocketbook and your health than sneaking in a few extra lattes or cupcakes. 

If you’re new to open enrollment — or have been pretending for years that you understand it, even though you don’t — you’ve come to the right place. This brief guide will give you the deets you need to head into your open enrollment period with confidence.

What the heck is open enrollment, anyway?

Open enrollment is (with some exceptions) your one chance each year to sign up for or change your health insurance coverage — it doesn’t matter if you get health insurance through your job, buy your own or are on Medicare. So virtually every adult needs to know about it.

During open enrollment, individuals can:

  1. Sign up for new medical and/or dental insurance coverage
  2. Make changes to their existing medical and/or dental coverage
  3. Add or remove dependents from their coverage, like a spouse or child

Open enrollment is also often the time when employers allow employees to make choices about other benefits like life insurance and long-term disability coverage. This all depends on whether your job offers those kinds of benefits. 

Sounds important. When is it?

The short answer is, “it depends.” Another important thing to know about open enrollment is this: Even though we talk about it as if it’s one thing, “open enrollment” is actually just a term to define the time period that different employers and insurers set as the time eligible folks can choose or change their health insurance. 

Like pumpkin spice, open enrollment periods are usually an autumn event. But not always! If you get your health insurance through your job, simply ask your human resources department when Open Enrollment is. 

You might think that if you are buying insurance yourself, you don’t have to worry about any particular window of time. But that’s no longer true. You can only buy new health coverage during your state’s open enrollment periods. 

In Washington State, the open enrollment period is Nov. 1- Dec. 15, if you want your coverage to begin Jan. 1 the following year. If you miss that deadline, though, the state health exchange offers some breathing room, allowing you to purchase coverage from Dec. 16-Jan. 15 that will take effect Feb. 1.

To purchase individual insurance or see if you qualify for subsidized health care, go the Washington Healthplan Finder where you can browse and compare available plans.

Medicare’s open enrollment period is from Oct. 15 to Dec. 7 when you can add or drop Part D coverage, switch from traditional Medicare to Medicare Advantage or change your Medicare Advantage plan. Note that Medicare is only available for adults 65 or older, as well as to some younger individuals with disabilities. 

You said there were exceptions?

Yes! A few things can happen that allow you to make changes outside of open enrollment, like changing jobs, having a baby or getting married. These are often referred to as “qualifying life events.” (Getting out of jail or prison or becoming a U.S. Citizen are also qualifying life events.)

You can also often sign up outside of the standard open enrollment time period if you lose your current health insurance coverage due to job loss or other reasons outside of your control. If your finances change and you’re eligible for Medicaid, you can sign up at any time of the year.

In general, though, unless you have one of these life-changing events, you will have to live with your Open Enrollment choices for a full year.

Now what?

Follow these steps to get the most out of your open enrollment:

  1. Find out when your specific open enrollment period is.
  2. Research and read all the details about the insurance plans and other open enrollment benefits that are available to you. Even if you’ve been in the same job for years and getting your insurance coverage through your employer, health care plans can change every year. 
  3. Collect any paperwork or documents you need to sign up for the plans you want.
  4. Complete all the required forms by your open enrollment deadline!

Wherever you get your health care coverage, mark your open enrollment period on your calendar. It might not be as much fun as the other traditional fall and winter activities, but it can give you peace of mind and protect you and your family for the coming year.