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ACA Open Enrollment 2023 Guide

Everything you need to know to enroll in an affordable individual-market health insurance plan during the annual open enrollment period

What is ACA open enrollment?

Open enrollment is the annual window during which individuals and families may sign up for ACA-compliant individual and family health insurance – or make changes to their existing coverage. It’s the only time during the year – other than a special enrollment period – that Americans can sign up for a plan or switch to a different health plan.

During the open enrollment period for 2022 coverage, enrollment reached a record high, with more than 14.5 million people signing up for coverage through the exchanges (marketplaces). The record-high enrollment was driven in large part by the subsidy enhancements created by the American Rescue Plan (ARP).

The ARP's improvements to the ACA's subsidy structure have allowed an unprecedented number of Americans to qualify for premium tax credits that are larger than they used to be. And the Inflation Reduction Act, signed into law in August 2022, extends the current subsidy enhancements through 2025.

So during the open enrollment period for 2023 coverage, the enhanced subsidies will still be available. And depending on the price of coverage, subsidies will still be available to households with income above 400% of the poverty level.

For 2022, additional insurers entered or expanded their presence in the marketplaces, increasing health plan options for consumers around the country. For 2023, we're seeing a bit of a mix: In some areas there are new insurers joining the marketplace or expanding their coverage area, but there are also some insurers that are exiting the marketplaces in some states. Insurer exits and entries can result in changing benchmark premiums, which can change premium subsidy amounts. Here’s what you need to know about how that works.

When is open enrollment for 2023 health coverage?

Open enrollment for 2023 health coverage begins nationwide on November 1, 2022 (note that New York generally delays the start of open enrollment until mid-November but then has an extended deadline for the end of the enrollment period). In the majority of the states, open enrollment for 2023 coverage will run through January 15, 2023.   

Enrollments in most states need to be completed by December 15, 2022 in order to have a plan that takes effect on January 1. But it’s common to see extensions for this deadline, particularly among states that run their own exchanges (there are 18 of those; the rest of the states use HealthCare.gov and do not have leeway to offer state-specific enrollment flexibility).

In nearly every state, enrollments completed after December 15 but before the end of open enrollment will have a February 1 effective date, although there are generally a few states where a March effective date is possible during the latter part of open enrollment.

For most Americans, open enrollment is the only opportunity to enroll in an ACA-compliant health plan without needing a qualifying life event.


Discuss your ACA coverage options – and your eligibility for money saving subsidies – with a licensed agent today. Call 1-866-687-1089.

 

State Open Enrollment Period for 2023 Coverage
AlabamaNovember 1, 2022 - January 15, 2023
AlaskaNovember 1, 2022 - January 15, 2023
ArizonaNovember 1, 2022 - January 15, 2023
ArkansasNovember 1, 2022 - January 15, 2023
CaliforniaNovember 1, 2022 - January 31, 2023
ColoradoNovember 1, 2022 - January 15, 2023
ConnecticutNovember 1, 2022 - January 15, 2023
District of ColumbiaNovember 1, 2022 - January 31, 2023
DelawareNovember 1, 2022 - January 15, 2023
FloridaNovember 1, 2022 - January 15, 2023
GeorgiaNovember 1, 2022 - January 15, 2023
HawaiiNovember 1, 2022 - January 15, 2023
IdahoOctober 15, 2022 - December 15, 2022
IllinoisNovember 1, 2022 - January 15, 2023
IndianaNovember 1, 2022 - January 15, 2023
IowaNovember 1, 2022 - January 15, 2023
KansasNovember 1, 2022 - January 15, 2023
KentuckyNovember 1, 2022 - January 15, 2023
LouisianaNovember 1, 2022 - January 15, 2023
MaineNovember 1, 2022 - January 15, 2023
MarylandNovember 1, 2022 - January 15, 2023
MassachusettsNovember 1, 2022 - January 23, 2023
MichiganNovember 1, 2022 - January 15, 2023
MinnesotaNovember 1, 2022 - January 15, 2023
MississippiNovember 1, 2022 - January 15, 2023
MissouriNovember 1, 2022 - January 15, 2023
MontanaNovember 1, 2022 - January 15, 2023
NebraskaNovember 1, 2022 - January 15, 2023
NevadaNovember 1, 2022 - January 15, 2023
New HampshireNovember 1, 2022 - January 15, 2023
New JerseyNovember 1, 2022 - January 31, 2023
New MexicoNovember 1, 2022 - January 15, 2023
New YorkNovember 1, 2022 - January 31, 2023
North CarolinaNovember 1, 2022 - January 15, 2023
North DakotaNovember 1, 2022 - January 15, 2023
OhioNovember 1, 2022 - January 15, 2023
OklahomaNovember 1, 2022 - January 15, 2023
OregonNovember 1, 2022 - January 15, 2023
PennsylvaniaNovember 1, 2022 - January 15, 2023
Rhode IslandNovember 1, 2022 - January 31, 2023
South CarolinaNovember 1, 2022 - January 15, 2023
South DakotaNovember 1, 2022 - January 15, 2023
TennesseeNovember 1, 2022 - January 15, 2023
TexasNovember 1, 2022 - January 15, 2023
UtahNovember 1, 2022 - January 15, 2023
VermontNovember 1, 2022 - January 15, 2023
VirginiaNovember 1, 2022 - January 15, 2023
WashingtonNovember 1, 2022 - January 15, 2023
West VirginiaNovember 1, 2022 - January 15, 2023
WisconsinNovember 1, 2022 - January 15, 2023
WyomingNovember 1, 2022 - January 15, 2023

Frequently asked questions
about ACA open enrollment

Open enrollment for 2023 coverage will start November 1, 2022 (you can still enroll in 2022 coverage for the remainder of the year if you experience a qualifying life event). You can enroll in a health insurance plan online, over the phone, or in-person.

Regardless of the method, if you’re enrolling in a plan through the exchange, you’re going to need to have the following information on hand for each enrollee:

  • Payment information that the insurer will be able to use to charge your premiums (this will generally be bank account information, but some insurers will allow automatic payments by credit card).
  • A list of medications taken by anyone who will be covered under the policy. Each insurance plan has its own formulary (covered drug list), so you’ll want to check to see which one will best cover the medications you need.
  • Your doctors’ names and zip codes, so that you can check to make sure they’re in-network with the health plans you’re considering.
  • Coverage details and premium for any employer-sponsored plan that’s available to your household (regardless of whether you’re enrolled in that plan or have declined it).
  • If you want to enroll in a catastrophic plan and you’re 30 or older, you’ll need hardship exemption (note that premium subsidies cannot be used with catastrophic plans, so these are generally only a good idea if you don’t qualify for a premium subsidy, but can meet the requirements for a hardship exemption).

In most cases, your coverage selected during open enrollment takes effect on January 1. But in most states, enrollments completed after December 15 will have coverage effective February 1. And in states where open enrollment continues into the latter half of February, it’s possible to have coverage effective March 1. 

If you are already enrolled in an individual-market plan and you pick a different plan during open enrollment (in most cases, by December 15), your current plan will end on December 31 and your new plan will take effect seamlessly on January 1 (assuming you pay all of your premiums when they’re due).

If you’re currently uninsured and have to wait until January for a plan to take effect, a short-term medical plan can bridge the gap for you, as long as you’re fairly healthy. Short-term plans are available in most states, and the coverage can take effect as soon as the day after you purchase your plan. So a short-term plan can provide peace of mind just in case you end up with an unexpected emergency before your new coverage takes effect. (You can select your state on this page to see how short-term plans are regulated and which options are available to you).

But note that short-term plans should not be thought of as a viable replacement for regular individual major medical coverage. If you’re relying on one temporarily, you’ll definitely want to sign up for an ACA-compliant plan during open enrollment.

If you enroll during the open enrollment period but you also have a qualifying event, you may be able to get coverage before the start of 2023. For example, if you get married and apply for coverage in November, you could have a December 1 start date if you use your special enrollment period, whereas you’ll have a January 1 effective date if you just enroll under the normal open enrollment period rules.

So if your special enrollment period overlaps with open enrollment, you might want to utilize your special enrollment period in order to get an earlier effective date. But keep in mind that the plan will then renew on January 1, which means you’ll have a nearly immediate rate change and potential benefits change for the new year. 

If you don’t enroll in an ACA-compliant health insurance plan by the end of open enrollment (January 15, 2023 in most states), your buying options will be limited until the next open enrollment starts in the fall of 2023.

Depending on the circumstances, there are various options for obtaining coverage, even after open enrollment ends:

Medicaid enrollment is year-round

Medicaid and CHIP enrollment are available year-round for those who qualify. If your income drops to a Medicaid-eligible level later in the year, you’ll be able to enroll at that point. Similarly, if you’re on Medicaid and your income increases to a level that makes you ineligible for Medicaid, you’ll have an opportunity to switch to a private plan at that point, with the loss of your Medicaid plan serving as the qualifying event that triggers a special enrollment period.

(Note that until the end of the COVID public health emergency, states are not disenrolling people from Medicaid unless the enrollee requests it. The public health emergency is expected to continue until at least early 2023.)

Monthly enrollment opportunity if your household income doesn’t exceed 150% of the poverty level

In September 2021, the Biden administration finalized a new monthly enrollment opportunity for people who are subsidy-eligible and whose household income doesn’t exceed 150% of the federal poverty level. This enrollment opportunity will remain in place for as long as the American Rescue Plan’s subsidy structure (which grants premium-free benchmark plans to people at this income level) remains in place. That’s at least through the end of 2025, thanks to the Inflation Reduction Act, which was enacted in August 2022.

Native Americans can enroll year-round

Native Americans can enroll in plans through the marketplace year-round. Here’s more about special provisions in the ACA that apply to Native Americans.

Special enrollment period if you have a qualifying event

If you have a qualifying event during the year, you’ll have access to a special enrollment period (SEP). Qualifying events include marriage (assuming at least one spouse already had coverage prior to the marriage), the birth or adoption of a child, loss of other minimum essential coverage, or a permanent move to a new geographical area where the available health plans are different from what was available in your prior location (assuming you already had coverage prior to your move).

Here’s a full guide to all of the qualifying events that trigger special enrollment periods in the individual market, including details about the specific rules that apply to each of them.

Short-term health insurance

Under general federal rules, short-term health insurance plans can have initial terms of up to 364 days and a total duration of up to 36 months, including renewals. But the majority of the states have more restrictive limits on the availability of short-term plans, and those state limits supersede the federal rules.

You can visit our short-term health insurance page to check your state’s guidelines.

There is no federal government penalty for being uninsured in 2023, but you still need coverage!

The ACA’s federal individual mandate penalty has been $0 since the start of 2019, and that will continue to be the case for 2023. People who are uninsured do not face a penalty, unless they’re in a state that has its own individual mandate and a penalty for non-compliance. Four states and DC impose tax penalties for not having health insurance:

  • Massachusetts
  • New Jersey
  • California
  • Rhode Island
  • District of Columbia

Yes! In every state, you can browse the available plans anonymously before you create an exchange account. If you want to see rates and plan options, the information is available – online, in-person, and by phone. Here are some tips for finding it:

  • Get a quote here at healthinsurance.org. Pricing for 2023 plans should be available by late October 2022. You’ll want to select the option for “Affordable Care Act plans” when you’re using the shopping tool. But as noted above, if you’re also in need of a short-term plan to cover you until the end of December, you can also get quotes for those plans if you select the option for “short-term plans and alternatives” (keeping in mind that these should be thought of as a bridge plan until your ACA-compliant plan takes effect, rather than a replacement).
  • ‘Window shop’ anonymously on your state exchange (if you’re in DC or one of the 17 states that run their own exchanges) or HealthCare.gov’s plan browsing page (if you’re in one of the other 33 states). The window shopping tools that are available through the exchanges are anonymous and do not require you to enter any identifying information; they offer a quick and easy way to get a good idea of what’s available to you. You can enter an estimate of how much you expect to earn in 2023, and the shopping tools will show you the amount of premium subsidy (premium tax credit) you’ll be eligible to receive (here’s how household income is calculated under the ACA).
  • Consult with a trained advisor. Set up an appointment with a Navigator or broker in your area who will be able to help you sort through the available options and figure out which one will best meet your needs. (See below for more information about the enrollment assisters who can help you.)
  • Talk with your health care providers. This is helpful especially if you’re considering a policy change during open enrollment. You’ll want to know which provider networks include your doctors, and whether any network changes are planned for the coming year.

There are several states that offer additional subsidies beyond the federal benefits provided by the Affordable Care Act. Some of these state subsidies reduce the premiums that people pay for their coverage, and some reduce out-of-pocket costs. Here’s a summary of what’s available for 2023:

  • Colorado (additional cost-sharing reductions for some consumers, and premium subsidies for some enrollees who don’t qualify for federal subsidies)
  • Connecticut (free coverage and medical care for some consumers)
  • Maryland (additional premium subsidies for some young adults)
  • New Jersey (additional premium subsidies for most enrollees)
  • Massachusetts (additional premium and cost-sharing subsidies for some consumers)
  • Vermont (additional premium and cost-sharing subsidies for some consumers)
  • Washington (additional subsidies for standardized plan enrollees with modest incomes)

If you are already enrolled in an ACA-compliant health plan through your state’s marketplace, can you just let that plan automatically renew for 2023? In most cases, yes, assuming your plan continues to be available. But letting your plan auto-renew is not in your best interest.

Auto-renewal is an option for nearly all exchange enrollees for 2023, although there are some enrollees whose existing plan will no longer be available (for example, enrollees with Oscar Health in Colorado and Arkansas, and Bright Health enrollees in Illinois, New Mexico, Oklahoma, South Carolina, Utah, and Virginia).

If you have a plan through the exchange that will no longer be available in 2023, the health plan or the exchange (if the insurance company is exiting the area altogether) will likely select a new plan for you. This is better than becoming uninsured, but it’s always best to select your own replacement plan, rather than relying on an algorithm that an insurer or the exchange will use.

And even if your health plan will continue to be available, relying on auto-renewal is not in your best interest. No matter how much you like your plan, it pays to shop around during open enrollment and see if a plan change is worth your while.

Here is why:

  • In most states, you’ll have limited opportunities to pick a new plan after your coverage is auto-renewed. The auto-renewal process happens right after December 15, for people who haven’t manually renewed or selected a new plan. Since open enrollment now extends into January in nearly every state, enrollees in most states have until at least January 15 to pick a new plan if they ended up deciding that the auto-renewed option wasn’t the best choice after all. If you decide to make a change in the latter part of open enrollment, your auto-renewed plan will cover you in January, and your new plan will take effect in February. But after January 15, in most of the country, you will not have another chance to change your coverage until the following year, unless you experience a qualifying event.
  • Your subsidy amount will generally change from one year to the next. If your subsidy gets smaller, auto-renewal could result in higher premiums next year. If the cost of the benchmark plan changes, premium subsidy amounts in that area will also change. The benchmark plan for 2023 may or may not be the same plan that held the benchmark spot in 2022. In some areas there are different insurers that will offer plans for 2023, and regular annual price changes can result in fluctuations in terms of which plan occupies the benchmark spot. Shopping around for a different plan — as opposed to letting your plan auto-renew – might result in substantial savings. This article illustrates examples of how this works, based on real enrollees’ experiences with 2021 and 2022 coverage. And this article is another example of how subsidy changes can have a drastic impact on net premium changes, and why comparison shopping is so important.
  • If you receive a subsidy, auto-renewal could be dicey even if the subsidy amount isn’t declining. If you rely on auto-renewal (as opposed to manually renewing and completing the financial eligibility determination process for the coming year), the exchange can renew your plan without a premium subsidy in certain circumstances. This includes situations in which you didn’t give the exchange permission to access your financial information in subsequent years, or if you failed to reconcile your premium subsidy on the prior year’s tax return.
  • Auto-renewal might result in a missed opportunity for a better value. Even if the plan you have in 2022 represented the best value when you selected it, there may be different plans available for 2023. Provider networks and benefit structures can change from one year to the next, as can premiums. You might still decide that renewing your 2022 plan is the best option for 2023. But it’s definitely better to actively make that decision rather than letting your plan auto-renew without considering the other available options.

Health insurance is complicated, and many people want or need personal assistance with the application process and with ongoing insurance utilization questions. To fill this need, there are a variety of assisters nationwide who are trained to guide people through the process of researching and enrolling in health plans, and some can provide ongoing support after the plan is purchased.

Health insurance navigators

The health insurance Navigator role was created for the purpose of providing impartial education and outreach about the exchanges and exchange health plans, helping applicants determine whether they qualify for subsidies or Medicaid, and assisting them in the enrollment process. Standards and regulations for the Navigator program are outlined in 45 CFR 155.210 and CFR 45 155.215.

In early 2016, HHS laid out enhanced requirements for Navigators – most of which took effect for 2018 – including targeted assistance for underserved and uninsured populations, as well as post-enrollment assistance (on issues such as eligibility appeals and health insurance utilization). The enhanced requirements are detailed in 45 CFR 155.210(e)(9).

In the guidelines for 2020, HHS reversed course somewhat on this, making those duties optional, rather than required, for Navigator organizations. But HHS has pivoted once again on this, with new rules for 2022 and beyond that once again require Navigator organizations to provide assistance with post-enrollment issues like subsidy reconciliation and eligibility appeals.

And the Biden administration has also greatly increased funding for Navigator organizations, resulting in far more Navigators available to help people sort out their coverage.

Navigators are not permitted to recommend one plan over another or direct consumers towards a particular policy. Instead, their job is to provide general information that consumers can use to understand what’s available to them. Navigators are paid by state and federal grant programs, and they cannot be compensated by the insurance companies.

Certified application counselors (CACs)

Certified application counselors (CACs) can also provide assistance with the enrollment process. They are similar to Navigators, but their role is more limited and their focus tends to be strictly on helping people enroll, without the more extensive assistance that some Navigators can provide.

The exchange designates local “CAC organizations” (health centers, faith-based organizations, colleges, etc.) and people who are affiliated with or employed by those organizations are eligible to serve as CACs. Navigators are funded through the exchange, but certified application counselors are not. Funding for the CAC program can come from a variety of state and federal sources though, including existing public health appropriations. And CACs themselves are often volunteering their time to help people enroll in health coverage.

Insurance brokers and agents

Insurance brokers and agents who are certified by the exchanges can also explain plan details and help consumers determine subsidy or Medicaid eligibility, but – and this is a key difference – they can also make plan recommendations based on a client’s particular situation.

Agents and brokers continue to assist their clients after the plan is purchased, helping them sort out questions and problems regarding billing, utilization, claims, and appeals. Brokers and agents also generally carry errors and omissions insurance, and are licensed by their state department of insurance (this is in addition to their certification with the exchange; Navigators and CACs are trained and certified by the exchange, but are not licensed by the state insurance department).

For health insurance purposes, independent agents and brokers are virtually the same thing, although brokers may represent more carriers or offer different types of insurance products.

ACA consumer protections apply to all individual major medical policies, regardless of whether the coverage is sold in the exchange. And the same open enrollment window – November 1 to January 15 in most states – applies regardless of whether the plan is sold in the exchange or outside the exchange.

But the ACA’s premium subsidies and cost-sharing reductions are only available if you buy a plan in the exchange. If you purchase the exact same plan directly from the insurance company (ie, off-exchange), you’ll have to pay full price, there will be no cost-sharing reductions available, and you won’t have an option to claim the premium tax credit when you file your tax return the following year. If you think that you might be subsidy-eligible, the exchange is definitely where you want to shop.

However, if your employer is offering you an Individual Coverage Health Reimbursement Arrangement (ICHRA) benefit and also offering to let you payroll deduct your portion of the premium that isn’t covered by the ICHRA, you’ll need to select an off-exchange plan in order to fully take advantage of your employer’s offer.

If you’re curious about off-exchange health plans, this FAQ offers a more in-depth look at how they’re regulated and the reasons some people choose off-exchange plans.

If your health insurance policy is not grandfathered but was in effect prior to 2014, your plan is considered a transitional health plan or “grandmothered policy.” These plans are not fully ACA-compliant, and were purchased between March 23, 2010 – when the ACA was signed into law – and the end of 2013.

This page offers a detailed overview of how grandmothered/transitional health plans are regulated and the specific rules that apply in each state.

Transitional health plans can remain in force indefinitely if states and insurers allow it

Transitional health plans were initially slated to end in 2014. But extensions have been granted by the federal government every year, allowing these plans to remain in force if the state agrees and if the insurer still wants to renew the plans. The latest extension allows transitional health plans to renew indefinitely, until if and when HHS decides otherwise (or until a state or insurer opts to terminate them).

Transitional individual/family health plans still exist in 29 states. (In the remaining states, these plans were either required to terminate or insurers voluntarily terminated them and replaced them with ACA-compliant coverage.)

Carefully consider the new plans available to you before you decide to renew your transitional plan

If your insurer offers to renew your grandmothered/transitional plan for 2023, you have the option to keep your plan for another year. But it’s definitely in your best interest to carefully compare your plan with the new options that are available in the ACA-compliant market for 2023.

You might find that you’re eligible for premium subsidies, even if that wasn’t the case in the past. This is particularly true if you were previously limited by the “subsidy cliff,” as that has been eliminated through at least the end of 2025.

And the ACA-compliant plans available now are likely to provide more robust coverage – including all of the essential health benefits – than the plan you purchased prior to 2014.

Would ACA subsidies lower your health insurance premiums?

Use our 2022 subsidy calculator to see if you’re eligible for ACA premium subsidies – and your potential savings if you qualify.

Obamacare subsidy calculator *

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Add ages of other family members to be insured.

3

Include yourself, your spouse, and children claimed as dependents on your taxes.

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Modified Adjusted Gross Income (MAGI)

For most taxpayers, your MAGI is close to AGI (Line 7 of your Form 1040 in 2018, and Line 8b in 2019).

Estimated annual subsidy

Provide information above to get an estimate.

* This tool provides ACA premium subsidy estimates based on your household income. healthinsurance.org does not collect or store any personal information from individuals using our subsidy calculator.

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Learn about health insurance coverage options in your state.

Our state guides offer up-to-date information about ACA-compliant individual and family plans and marketplace enrollment; Medicaid expansion status and Medicaid eligibility; short-term health insurance regulations and short-term plan availability; and Medicare plan options.

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