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The enrollment period for health insurance in 2022 commences on November 1, 2021, and ends on January 15, 2022, across most states.
Open enrollment is a period that occurs each year when one can sign up for Affordable Health Insurance West Virginia or change an existing plan (In case the plan is provided by an employer).
Moreover, open enrollment is an opportunity for dis enrollment if you no longer want coverage. Since there is a period for open enrollment, one will have to probably wait until next year if he/she misses the current year’s open enrollment period (Unless you experience a qualifying event).
If you are eligible for a health policy and apply during the open enrollment, the health plan must insure you. The insurer is not allowed to use medical underwriting or solicit evidence of insurability.
Types of Health Insurance that use open Enrollment Periods
Open enrollment periods exist for most types of health insurance such as:
- Medicare
- Job-based health insurance
- Individual market health insurance (i.e. coverage that people buy personally as opposed to getting from an employer), as a result of the Affordable Care Act (enrollment windows apply both in the health insurance exchanges and outside the exchanges.
When is Open Enrollment?
The time of year for open enrollment depends on the insurance plan you choose:
- Medicare open enrollment (for Medicare Advantage and Part D plans) runs from October 15 to December 7 every year. There is a separate enrollment period from January 1 to March 31 for people who already have Medicare Advantage.
Note that the Medicare open enrollment periods ‘DO NOT’ apply to Medigap plans since they do not have an annual open enrollment period.
Medigap plans are only available without medical underwriting during the initial enrollment period or during one of the very limited special enrollment periods that apply to those plans.
However, a few states have rules that allow Medigap enrollees to make changes to their plans on an annual basis.
- Job-based health insurance OEPs are set by your employer and can happen at any time of the year. However, it is a common occurrence when employers have their open enrollment period in autumn. It is so that the new coverage begins on January 1 of the next year.
- However, some employers choose to have a health plan year that does not align with the calendar year. One might find that the employer provides enrollment in June, with a new plan year that commences in August.
- Open enrollment in the individual market (on and off-exchange) runs between November 1 and December 15 in most states. The District of Columbia and 14 other states have greater flexibility with their open enrollment periods. Most of them tend to offer longer enrollment windows.
Washington DC, Colorado, and California have permanently extended their enrollment windows, while a few other state-run exchanges have announced extensions to the open enrollment period for 2021 individual market health plans.
Note: Native Americans have the option of enrolling in individual market health plans through the exchange all year long. They are not limited to the regular enrollment period.
Before 2014, enrollment was available year-round in the individual market. However, in most states insurers determined eligibility based on an applicant’s medical history, which meant people with pre-existing medical conditions could be denied coverage. However, that no longer happens, courtesy of the ACA.
Special Enrollment is an Exception
Insurance companies that use an open enrollment system also have an exception that allows the insured to enroll outside of open enrollment. It can be done under extenuating circumstances known as qualifying life events.
When an individual experiences a qualifying event, he is eligible for a special enrollment period. It allows a person to sign up for health insurance outside of open enrollment. Qualifying life events include a variety of circumstances such as:
- Involuntarily losing other health insurance coverage that may result from losing or quitting a job, aging of a parent’s health plan, COBRA insurance expiring, getting divorced, etc.
- Moving out of your old plan’s service area, or to an area where different health plans are available.
- Getting married
- Having a new baby or adopting a child
An individual will not be eligible for special enrollment if the reason for losing the previous health insurance was a failure to pay monthly premiums or if he voluntarily canceled prior coverage.
So, stay aware of the open enrolment period for Affordable Health Insurance West Virginia and choose a health plan that matches your criteria.
