Affordable Care Act

Affordable Care Act (Obamacare) Open Enrollment Guide

BY Carly Plemons Published on July 03, 2024

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The Affordable Care Act, colloquially known as Obamacare, gives people a chance to buy health insurance on an open marketplace. People can get ACA-compliant coverage on the Health Insurance Marketplace if they are not insured through their employer, the government, or a similar source.

However, there are limitations on when you can and can’t sign up for coverage, causing many to ask, “when is open enrollment for Obamacare?” In this guide, we’ll go over the Obamacare open enrollment dates, exceptions to the rule, and more, so you can be prepared when you’re ready to sign up for healthcare coverage.

What is Obamacare open enrollment?

The Open Enrollment period is an annual window when you can sign up for or adjust your health insurance for the following plan year. This timeframe offers a crucial opportunity to either select a new health insurance plan or make changes to your existing coverage to better suit your needs for the upcoming year.

Obamacare open enrollment dates for 2025

For those planning to enroll for health insurance coverage in 2025 through the federal healthcare exchange, this period typically begins on November 1, 2024 and ends on January 15, 2025. Mark your calendar to ensure you don’t miss the chance to review and choose your options for 2025 health insurance.

  • November 1: Open Enrollment starts. 
  • December 15: Enroll for coverage that starts January 1. 
  • January 15: The last day to enroll; Open Enrollment for 2025 coverage ends. 

State deadlines for Obamacare open enrollment

In 2024, the open enrollment deadlines for health insurance coverage varied significantly across the United States, depending on whether the state used the federal HealthCare.gov platform or operated its own exchange. Here’s a comprehensive breakdown:

States using HealthCare.gov with a January 16, 2024, deadline:

  • Alabama
  • Alaska
  • Arizona
  • Arkansas
  • Delaware
  • Florida
  • Georgia
  • Hawaii
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Louisiana
  • Michigan
  • Mississippi
  • Missouri
  • Montana
  • Nebraska
  • New Hampshire
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • West Virginia
  • Wisconsin
  • Wyoming

States with their own exchanges that followed the January 16 deadline:

  • Kentucky
  • Maine
  • New Mexico
  • Vermont
  • Virginia

States with different deadlines:

  • California: Extended to February 9
  • Colorado: January 15 (with completion allowed until January 17 via call center)
  • Connecticut: January 15
  • District of Columbia: January 31
  • Idaho: December 15
  • Maryland: January 15
  • Massachusetts: January 23
  • Minnesota: January 15
  • Nevada: January 15
  • New Jersey: January 31
  • New York: Extended to May 31
  • Pennsylvania: January 19
  • Rhode Island: January 31
  • Washington: January 15

Each state sets its deadlines based on various factors, including accommodating residents’ needs and aligning with federal holidays. This diverse landscape of deadlines ensures that each state can provide optimal access to health insurance for its residents, reflecting local preferences and requirements.

Eligibility for Obamacare open enrollment

To qualify for enrollment in the ACA’s Marketplace, you must meet the following criteria:

  • Residency: You need to reside in the United States.
  • Citizenship Status: You must be a U.S. citizen or national, or be lawfully present in the U.S.
  • Incarceration Status: Individuals who are incarcerated are not eligible to enroll.
  • Medicare Enrollment: You cannot be currently enrolled in Medicare.
  • DACA Recipients: Historically, individuals under the Deferred Action for Childhood Arrivals (DACA) program were not eligible to enroll. However, starting from November 2024, due to a policy change by the Biden administration, DACA recipients will be allowed to enroll through the Marketplace.

There was a previous expectation that only people who were uninsured could participate since that was the case with some states who launched their own COVID special enrollment periods (SEPs). These states included Maryland, Massachusetts, New York, and Washington, D.C.

However, once the Centers for Medicare & Medicaid Services announced the details for the Obamacare open enrollment, it was clear they wanted to cast a wide net and allow as many people as possible to enroll in or switch their coverage.

And, as mentioned, the annual fall open enrollment is different from a special enrollment period. Anyone can use this time frame to sign up for or make changes to their coverage. You don’t need to have a qualifying life event to participate.

Learn more about how Obamacare works.

Understanding your health insurance options

Understanding your health insurance options is essential to making informed decisions that best suit your needs and budget. Each type of plan offers different levels of coverage, cost-sharing, and network restrictions, which can significantly impact your healthcare experience and expenses. Familiarizing yourself with the details of various plans—such as HMOs, PPOs, EPOs, and more—allows you to weigh the benefits and drawbacks of each option effectively. Moreover, being knowledgeable about your health insurance choices ensures that you can select a plan that not only covers your regular healthcare needs but also provides adequate support in case of unexpected medical issues. This proactive approach minimizes the risk of surprise costs and helps you optimize your healthcare spending, leading to better overall health management and financial security.

Types of plans available

During open enrollment, you have the opportunity to choose from a variety of health insurance plans, each designed to meet different needs and budgets. Here’s a breakdown of the types available:

  • Plan Categories: Health insurance plans are typically categorized into four metal tiers: Bronze, Silver, Gold, and Platinum. These categories indicate the division of costs between you and the insurer. Bronze plans have the lowest monthly premiums and highest out-of-pocket costs, making them ideal for those who expect low medical expenses. Silver plans offer moderate premiums and lower out-of-pocket costs compared to Bronze. Gold and Platinum plans have higher premiums but offer the lowest out-of-pocket costs, suited for those who anticipate needing more medical care.
  • Catastrophic Plans: These are designed for people under 30 or those who qualify for a hardship exemption. Catastrophic plans have very low monthly premiums but very high deductibles. They are intended to protect you from worst-case scenarios, like serious illness or injury. To be eligible, you must either be under 30 years old or have a hardship exemption that waives the requirement to purchase a standard health plan.
  • Differences in Coverage and Benefits: The major differences among these plans lie in their premium costs, deductible amounts, and the percentage of medical expenses the plan covers after the deductible is met. Higher-tier plans like Gold and Platinum offer more comprehensive coverage and lower out-of-pocket expenses, which can be beneficial if you frequently need medical care or expensive prescriptions. On the other hand, lower-tier plans like Bronze and Silver have higher out-of-pocket costs but can be more cost-effective if you rarely seek medical care.

Choosing the right plan involves assessing your health needs, financial situation, and understanding the balance between monthly premiums and out-of-pocket costs. Each type of plan offers a different level of coverage and directly affects your healthcare spending throughout the year.

Participating health insurance carriers

All health insurance plans available through the federal exchange are participating in the Obamacare open enrollment reopening period. However, specific health plan options and insurance companies may vary by state.

How to enroll in a health plan during ACA open enrollment

In states without their own platforms, Affordable Care Act (ACA) insurance is purchased through the Health Insurance Marketplace website. To sign up there, you first create an account on the site. Then, you enter your location, and the site will show you the plans available in your state and county. You can filter the results to only show the types of health plans you want, plans from a specific insurance company, monthly premiums, or any of several other features. Once you find a plan you like, click the button that indicates that you want to enroll in it.

If your state has its own ACA website, sign up through it instead of the federal version. Each state’s site will have its own specifics for the process of enrolling.

You can also sign up through sites like eHealth. With eHealth, you can easily find and compare plans that are available in your area to find coverage that both meets your needs and fits your budget.

Options if you miss the Obamacare open enrollment deadline

With very few exceptions, missing the deadline means you can’t sign up until the next open enrollment period. However, there may be some exceptions:

Special Enrollment 

If specific circumstances change in your life, you may qualify for a special enrollment period. Qualifying changes include moving to another county, getting married or divorced, having or adopting a child, losing your health insurance coverage, or having your income drop below a specific threshold, to name a few.

If you need health care coverage outside of the standardized dates, find out if you might be able to qualify for special enrollment. With special enrollment, you get a 60-day period to sign up for healthcare after you’re approved.

Short-Term Health Insurance 

Short-term health insurance is a limited policy that offers fewer benefits and federal protections compared to more comprehensive health insurance options available on HealthCare.gov. It may exclude coverage for preexisting conditions such as diabetes, cancer, stroke, arthritis, heart disease, and mental health and substance use disorders. Additionally, the policy might not cover essential health services including prescription drugs, preventive screenings, maternity care, emergency services, hospitalization, pediatric care, and physical therapy. There is often no cap on what you pay out-of-pocket for care, and you won’t qualify for federal financial assistance to help with premiums and out-of-pocket costs. Furthermore, this type of insurance does not need to meet federal standards for comprehensive health coverage. You can use eHealth to find and compare short-term health insurance options.

These plans have limited coverage, so it is important to do your research before signing up.

Healthcare Through Your Job

If your employer provides your health insurance, the enrollment period will depend on what the company’s plan dictates. You will sign up for these plans through your employer instead of the Health Insurance Marketplace.

Medicaid

Medicaid offers health insurance coverage for low-income individuals and families. Those who qualify for Medicaid can sign up for it at any time of the year.

Find coverage that fits your needs with eHealth

If you have questions about the ACA Open Enrollment reopening or want to compare plans available in your area, give us a call or check out individual and family health insurance plans today. At eHealth, you’ll never pay more for health coverage with us than you would elsewhere since healthcare costs are regulated.

Our trusted and knowledgeable licensed insurance agents would be happy to walk you through your options and find coverage that fits your needs. Or, if you’d prefer to browse at your own convenience, you can use our simple-to-use plan finder tool to start looking at plan options now. Just enter your ZIP code into the tool to get started.

For more information, review our other Affordable Care Act resources.

FAQs about Obamacare open enrollment

Which states provide additional state subsidies?

The ACA provides federal subsidies for insurance to those who qualify, but 39 states added their own subsidies to make it even easier for low-income people to be insured. These extra subsidies come from Medicaid expansion. Here is a list of states that have implemented this expansion.

What happens if my income changes during the year?

If your income changes during the year, it can affect your eligibility for health insurance subsidies or the amount of subsidy you receive. It’s important to report any income changes to the health insurance marketplace as soon as possible. This ensures that your premium tax credit can be adjusted appropriately, either increasing or decreasing based on your new income level. Failing to report these changes could result in having to pay back any excess subsidies you received when you file your annual tax return.

Are there penalties for not having health insurance?

As of 2021, there is no federal penalty for not having health insurance in the United States. However, some states have their own health insurance mandates, and you could face a state-level penalty if you live in one of those states and don’t have coverage. These states include Massachusetts, New Jersey, California, Rhode Island, and the District of Columbia. It’s important to check your state’s laws to understand if there are any penalties applicable to you.

Short-Term Notice 2024