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Home Knowledge CenterHealth Insurance Open Enrollment and Special Enrollment
Learn more about enrolling in a plan or making changes to your current plan.
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There are certain times during the year when you can buy a health plan directly through Cigna or on the Health Insurance Marketplace. These periods of time are called the Open Enrollment and the Special Enrollment periods.
When to shop for health insurance on the Marketplace
Open Enrollment
The Open Enrollment Period is the time when individuals and families can buy a new health plan or make changes to their current health plan directly through Cigna or on the Health Insurance Marketplace. Plans that are effective on January 1 have an Open Enrollment Period from November 1-December 15 of the year before, in most states.
For example, if you wanted to enroll or make changes to a plan with an effective date of January 1, 2022, your Open Enrollment Period would run from November 1-December 15, 2021.
Some states may have a longer Open Enrollment Period.
If you recently lost your health insurance coverage for any reason (including COVID-19) in the past 60 days or you expect to lose coverage in the next 60 days or had a major life event, you may qualify for a Special Enrollment Period.
Qualifying major life events include:
- You lose your health insurance plan at work
- You get married or divorced
- You have or adopt a child
- You're no longer a dependent on someone else's policy
- You gained or became a dependent through marriage, birth, adoption, or placement for adoption
- You lose Medicaid or CHIP coverage
- Your insurance carrier made a mistake on your insurance contract or made an enrollment error
- You have a Marketplace plan and your status for getting help to pay for your plan changes
- You moved and need to pick another plan based on the insurance coverage area
- Your immigration status changes
- And other qualifying life events
If you voluntarily dropped your coverage, you cannot qualify for a Special Enrollment Period unless you also had a decrease in household income or a change in your previous coverage that made you eligible.
During the Special Enrollment Period, you may qualify for both a premium tax credit and a cost-sharing reduction to help lower your health insurance premium and total out-of-pocket costs.
In certain instances, the Open Enrollment Period may be extended, or the eligibility requirements for the Special Enrollment Period may change.
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Plans are insured by Cigna Health and Life Insurance Company or its affiliates: For Arizona residents, health plans are offered by Cigna HealthCare of Arizona, Inc. For Georgia residents, health plans are offered by Cigna HealthCare of Georgia, Inc. For Illinois residents, health plans are offered by Cigna HealthCare of Illinois, Inc. For North Carolina residents, health plans are offered by Cigna HealthCare of North Carolina, Inc.
Key takeaways
Q. What is the deadline to enroll in 2022 ACA-compliant health insurance coverage in the individual market?
A. Open enrollment for 2022 health coverage started nationwide on November 1, 2021 (in New York, it began on November 16). In most states, it ended on January 15, 2022 (and in most states, enrollments completed between December 16 and January 15 took effect February 1).
The January 15 end date includes a one-month extension that was added by the Biden administration. For the past several years, open enrollment had ended on December 15, but the January 15 deadline will be used from now on.
The new rules clarify that states that run their own exchanges are still free to set their own enrollment deadline, as long as it’s not earlier than December 15. For 2022 coverage, New Mexico, Maine, and Kentucky have fully state-run exchanges, joining the 15 that already operated as of 2021. So there are 18 fully state-run exchanges that had the option to set an open enrollment deadline other than January 15.
Several of them did so, but most of those enrollment windows closed by the end of January. Maryland’s open enrollment period was extended through the end of February due to the Omicron COVID surge. And New York has opted to extend open enrollment for 2022 coverage through the end of the COVID public health emergency.
As noted below, DC has extended a special enrollment period for uninsured residents through the end of the District’s COVID public health emergency. But as of March 2022, New York is the only state where general open enrollment for 2022 coverage is ongoing.
In the rest of the country, open enrollment ended in January (or mid-December, in the case of Idaho), and enrollments now require proof of a qualifying life event. This includes the 33 states that use HealthCare.gov, as well as the rest of the state-run exchanges: Idaho, Connecticut, Maine, Minnesota, Nevada, New Mexico, Pennsylvania, Washington, Vermont, Massachusetts (open enrollment ended January 23 in Massachusetts), and California, the District of Columbia, Kentucky, Rhode Island, and New Jersey (in those last five, open enrollment ended January 31).
Although these are not an extension of full open enrollment, there are some widespread opportunities to obtain coverage in some areas:
Medicaid and CHIP enrollment is available year-round to eligible residents.
Year-round enrollment is also available in the Basic Health Programs in New York and Minnesota. Enrollment is also available year-round for the ConnectorCare program in Massachusetts, for people who are newly eligible or who haven’t enrolled before.
Native Americans and Alaska Natives can enroll year-round in plans offered in the exchange. Applicants who are eligible for Medicaid or CHIP can also enroll year-round. This is true every year, not just in 2021.
And CMS has finalized a new rule that allows people with income up to 150% of the poverty level to enroll year-round, as long as the American Rescue Plan’s subsidy enhancements remain in effect. This is currently in place through the end of 2022, but might be extended by Congress. This special enrollment period is optional for state-run exchanges, although several of them had already rolled it out as of early 2022. This special enrollment opportunity will be available on HealthCare.gov by late March 2022, but was available as of February for people who used the HealthCare.gov call center to enroll.
California, Colorado, and DC have permanently extended ACA open enrollment
As noted above, most of the fully state-run exchanges extended open enrollment for 2022 coverage until at least January 15, 2022. And some, like New York, have consistently extended open enrollment until the end of January. But three have specifically implemented regulations or legislation to codify an extended open enrollment period:
- California: November 1 – January 31. California enacted legislation in 2017 and again in 2019 that permanently establishes different enrollment dates within the state, both on and off-exchange. Open enrollment for 2022 health plans began November 1, 2021, and continues through January 31, 2022. California’s enrollment schedule had varied in previous years, but this three-month window, from the beginning of November through the end of January, will be the permanent enrollment period going forward.
- Colorado: November 1 – January 15. Colorado’s Division of Insurance has also permanently extended open enrollment. The state finalized regulations in late 2018 that call for an annual special enrollment period, running from December 16 to January 15, that is added to the end of open enrollment each year. After HHS extended open enrollment for HealthCare.gov states through January 15 (starting with the 2022 plan year), Colorado updated its regulations to clarify that open enrollment simply runs from November 1 through January 15. Plans selected between December 16 and January 15 must take effect no later than February 1.
- DC: November 1 – January 31. DC’s exchange board voted unanimously to permanently implement an open enrollment window that runs from November 1 to January 31. DC has also announced that enrollment will continue to be available through the end of the pandemic emergency period. COVID-related special enrollment periods were widespread for much of 2021, and continued through the end of 2021 in a few states. But DC’s blanket extension is the longest in the nation.
State-run exchanges have some flexibility on open enrollment schedule
The 2017 market stabilization rule noted that the November 1-December 15 open enrollment period would apply in every state in the fall of 2017. However, they also noted that some state-based exchanges — there are 15 of them as of 2021, and an anticipated 18 as of 2022 — might have experienced logistical difficulties in getting their systems ready for the new schedule on a fairly tight timeframe.
As such, the market stabilization rule clarified that state-based exchanges could use their own flexibility to “supplement the open enrollment period with a special enrollment period, as a transitional measure, to account for those operational difficulties.” Since then, the majority of the state-based exchanges have opted to extend open enrollment for most years, and they continue to have flexibility with the enrollment schedule going forward.
HHS had previously defined open enrollment as the window from November 1 to December 15, but state-run exchanges have had the option to offer special enrollment periods before or after that window, in order to effectively extend open enrollment.
For coverage effective in 2022 and future years, HHS has changed the enrollment window for HealthCare.gov. It’s now November 1 through January 15. But instead of requiring state-run exchanges to use an enrollment window at least that long, HHS has given them the option of keeping an earlier deadline, as long as it’s not before December 15. This is why Idaho was allowed to implement a December 22 deadline for enrollment in 2022 coverage. But all of the rest of the state-run exchanges opted to extend their enrollment deadlines to January 15 or later.
As noted above, New Mexico, Maine, and Kentucky now have their own enrollment platforms, bringing the number of fully state-run exchanges to 18. Fully state-run exchanges are the only ones with the ability to extend open enrollment on their own (in the other states, the decision has to come from CMS, since the extension has to be issued via HealthCare.gov), and most of them have been choosing to do so each year. But now that HHS has extended the HealthCare.gov deadline to January 15 for 2022 and future years, many of the state-run exchanges are using that date rather than issuing additional extensions.
Outside of ACA’s open enrollment window, enrollment’s only available with a qualifying event
After open enrollment ends, people can normally only purchase coverage if they have a special enrollment period triggered by a qualifying event such as:
Regardless of whether you purchase insurance through the exchange or off-exchange, the annual open enrollment window applies, and special enrollment periods are necessary in order to enroll at any other time of the year.
Open enrollment schedule has varied over time
Although open enrollment is now set at November 1 – January 15 in most states, it has varied quite a bit over the years. In the federally-run marketplaces, the following enrollment windows have been used (with some last-minute extensions, and with somewhat different schedules used by the state-run marketplaces):
- 2014 coverage: October 1, 2013 through March 31, 2014
- 2015 coverage: November 15, 2014 through February 15, 2015
- 2016 coverage: November 1, 2015 through January 31, 2016
- 2017 coverage: November 1, 2016 through January 31, 2017
- 2018 coverage: November 1, 2017 through December 15, 2017
- 2019 coverage: November 1, 2018 through December 15, 2018
- 2020 coverage: November 1, 2019 through December 15, 2019
- 2021 coverage: November 1, 2020 through December 15, 2020
- 2022 coverage: November 1, 2021 through January 15, 2022
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health insurance marketplace updates are regularly cited by media who cover health reform and by other health insurance experts.