What is open enrollment? And how does it work

It’s that time of year again.

Open enrollment is when you can sign up for health insurance, change your plan, or cancel your plan—whether that plan is through your job, Medicare, or the Affordable Care Act (ACA) marketplace. It’s important to be prepared for this because it only happens once a year, and if you miss it, you may have to wait until next year if you want to adjust your health insurance plan.

Here’s everything you need to know about open enrollment.

How long does an open entry last?

The open enrollment period depends on where you get your insurance. For ACA Marketplace plans, open enrollment runs from November 1, 2024 through January 15, 2025 in most states (some states have different periods). For Medicare plans, it runs from October 15, 2024 to December 7, 2024. The open enrollment period for employer-sponsored insurance plans varies, but typically begins in the fall and lasts several weeks.

How do I prepare for open enrollment?

Before making changes to your plan, be sure to review your existing plan. Think about your current medical needs and evaluate if there is anything you need that your plan doesn’t cover.

Try to think about what medical needs you may have in the coming year. Obviously, situations will arise that you cannot predict, but if you know that you will, for example, have medical procedures or need medication, take this into account.

Who should choose a high deductible plan?

High-deductible health plans (HDHPs), no matter how they sound, have higher annual deductibles than other health insurance plans—meaning you’ll have to pay more out-of-pocket expenses before your insurance starts covering your medical expenses. However, many HDHPs fully cover in-network preventive services before you even reach your deductible, so you won’t have to pay out of pocket for those types of services (such as a routine annual physical), but you will have to pay out of pocket for non-preventive care, for example visiting emergency services, IIf you haven’t reached your deductible. HDHPs also have lower monthly premiums, which is the amount you pay each month for health insurance.

Generally speaking, if you are relatively healthy and don’t expect to have many medical needs (for example, if you usually only go to routine medical appointments or preventive screenings), an HDHP may be a good option for you.

Who shouldn’t choose a high deductible plan?

For some, the downside to an HDHP is that you’ll have to pay out of pocket for non-preventative care until you reach your deductible. If you expect to have more non-preventive care needs (for example, you are planning to have a child soon or you have a chronic condition for which you are being treated), an HDHP may not be the best option for you. Additionally, if you know you won’t be able to afford the plan’s full deductible if you have a medical emergency early next year, you may want to consider other health insurance plans instead.

What is FSA?

FSA stands for Flexible Spending Account (sometimes Flexible Spending Arrangements), which is an employer-owned savings account that allows employees to reserve a portion of their pre-tax income for qualified medical expenses. Some employers may also contribute to your FSA.

The money in the account usually must be used within your health plan year, but employers sometimes provide a grace period that can last up to two and a half more months or allow you to carry over up to $640 to the next year.

The amount of money you choose to contribute to your FSA will be available for use once your plan begins. But typically, you can’t change the amount of money in the account until the next plan year. There is also a limit on the amount you can contribute to your FSA per year, which can change from year to year.

What is an HSA?

HSA stands for Health Savings Account. Like an FSA, an HSA allows you to save pre-tax money to pay for medical expenses. To contribute to an HSA, you must be eligible for an HDHP. Your employer can also contribute to your HSA. But unlike an FSA, an HSA is employee-owned, meaning it will stay with you even if you change jobs. The money in your HSA also stays there even if you don’t use it up by the end of the plan year, allowing you to save for medical needs that may arise later.

Unlike an FSA, the funds in your HSA accumulate over the course of the plan year, so you can only use the amount you’ve contributed to date. However, you can change the contribution amount at any time during the year. An HSA also has a limit on how much you can contribute per year, depending on a variety of factors.

When can I sign up for Medicare?

Most people enroll in Medicare (Part A, which is hospital insurance, and Part B, which is health insurance) when they first become eligible, usually at age 65. This is called the initial enrollment period. The initial enrollment period lasts seven months, usually starting about three months before you turn 65 and ending about three months after your 65th birthday. You can check your date of birth on the Social Security Administration website to see the earliest date you can enroll.

If you miss the initial enrollment period, you will also be able to sign up for Medicare without paying a penalty during a special enrollment period in certain qualifying situations, such as if you have or had health insurance through your job (learn more about the special enrollment period on the web Medicare website).

If you miss both of these periods, you can sign up for Medicare during the general enrollment period, January 1 to March 31 each year, although doing so may incur some monetary penalty.

What are the requirements for Medicare?

To be eligible for Medicare, you must be over 65, disabled, have end-stage kidney disease, or have ALS (also known as Lou Gehrig’s disease). Medicare also has residency requirements, but people who are not US citizens may still be eligible if they meet certain requirements.