Q: What are the Affordable Care Act enrollment periods and when can I enroll outside of the open enrollment period?
Open enrollment for 2017 will begin in the fall of 2016. In the proposed Benefit and Payment Parameters for 2017, HHS proposed keeping the same November – January open enrollment schedule that was used for 2016 (ie, November 1, 2016 to January 31, 2017, with effective dates starting January 1, 2017).
But that’s still under consideration, and HHS might end up moving open enrollment back so that it ends before the end of 2016. The final guidelines should be released in February or March 2016.
Special enrollment periods
Regardless of whether you purchase insurance through the exchange or off-exchange, the annual open enrollment window applies. Nevada is an exception – coverage is available there outside the exchange year-round, albeit without subsidies and with a 90 day waiting period before coverage becomes effective. But in the rest of the country, you cannot enroll outside of open enrollment unless you have a qualifying event, such as:
- Becoming a U.S. citizen,
- Birth or adoption,
- Involuntary loss of other health coverage (this includes loss of coverage when health plans exit the market, as was the case with 12 CO-OPs in 2015)
- Permanent move to an area where new health plans are available
- Here’s a full list of qualifying events and their associated special enrollment periods.
Native Americans and Alaska Natives can enroll year-round. Applicants who are eligible for Medicaid can also enroll year-round.