Every fall, the Health Insurance Marketplace opens its doors for a few weeks, and every fall the letters, emails, and ads start piling up. Here’s the short version, the way tu prima who works at a clinic would explain it.
The dates that matter
- November 1: Open enrollment starts on HealthCare.gov and in most states.
- December 15: Enroll or switch plans by this date to have coverage starting January 1.
- January 15: Open enrollment closes in most states. If you sign up between December 16 and January 15, coverage usually starts February 1.
Some states run their own marketplace with different deadlines. Check your state’s marketplace site if you’re not sure which one you use.
What can change from year to year
Even if you love your plan, don’t let it renew on autopilot. Any of these can change:
- Premiums: what you pay each month.
- Financial help: the tax credits that lower your premium depend on your income and household for the coming year. If you got a raise, lost hours, had a baby, or someone moved in or out, update your application.
- Doctors and pharmacies: plans can drop or add providers. Check that your doctor and your medicines are still covered.
- Deductibles and copays: a cheaper monthly premium can mean paying much more when you actually need care.
What doesn’t change
- You can’t be turned down for a pre-existing condition. Diabetes, asthma, pregnancy: plans must cover you.
- Medicaid and CHIP enrollment is open all year. If your income is low, you may not have to wait for open enrollment at all.
- Official enrollment help is free. You never have to pay someone to help you enroll.
Mixed-status families
Many families include people with different immigration statuses. In general, applying for coverage for an eligible family member does not require information about the immigration status of relatives who aren’t applying. If you’re unsure what to share, ask a certified assister before you apply.
Where to get free help, in English or Spanish
- Marketplace Call Center: 1-800-318-2596, open 24 hours a day with help in Spanish.
- In-person help: search localhelp.healthcare.gov for certified assisters near you.
- CuidadoDeSalud.gov, the Spanish-language version of HealthCare.gov.
Before you start, gather your most recent pay stubs, any letters about your current coverage, and a list of your medicines and doctors.
