A state-by-state guide to extended open enrollment periods

You can't sign up for health insurance coverage whenever you want. For Marketplace health insurance, there's typically one window of time to sign up, known as the open enrollment period. During this period, you can purchase a new health insurance plan or make changes to your current health plan.

During 2024 open enrollment, 21.4 million¹ individuals selected or reenrolled in a Marketplace plan. While most of the country follows the same open enrollment time frame, several states extend their open enrollment periods. This allows more people in those states to sign up for health plans.

In this article, we'll share the states with extended open enrollment windows. We'll also explain how you can secure coverage if you miss open enrollment for health insurance.

In this blog post, you'll learn:

• Why the open enrollment period exists.
• Which states don't end open enrollment on January 15.
• How to qualify for a special enrollment period if you miss your open enrollment deadline.

When can you get health insurance?

Following the enactment of the Affordable Care Act (ACA), the federal government introduced open enrollment and public health insurance exchanges. Open enrollment is an annual opportunity for Americans to sign up for, renew, or change their health insurance plans. This stops people from buying coverage only when they're sick to save money on medical costs.

Open enrollment dates differ based on where you live. But for the majority of states, the open enrollment period begins on November 1 and ends on January 15. Coverage becomes active on January 1 of the following year if you enroll by December 15 and pay your first monthly premium.

Where can you purchase a health insurance plan?

When deciding on a health plan, you have many health insurance options to explore. You can choose to shop for individual or family health coverage on either a public or private exchange. Health insurance companies, licensed brokers, or insurance agents run the private exchanges. Public exchanges consist of both federal and state marketplaces.

When comparing plans, focus on coverage that matches your needs and budget. Compare the level of coverage, provider networks, and monthly premiums of each policy.

Depending on your income and household size, you may qualify for federal premium subsidies, also known as premium tax credits. This financial assistance can help offset the cost of health insurance premiums for marketplace plans. If you want to take advantage of any tax credits you may be eligible for, you must shop for coverage on a public exchange.

States with extended open enrollment windows

Several states have longer open enrollment periods for health plans than the federal Health Insurance Marketplace.

It’s important to note that some of these dates may be in flux. In early 2024, the Centers for Medicare & Medicaid Services, Department of Health and Human Services, and Department of the Treasury issued new final rules² on the ACA exchanges.

Among these changes are the following new requirements for all state-based exchanges:

• Open enrollment must start on November 1
• Open enrollment can’t end before January 15
• States can choose to extend their open enrollment period beyond January 15
• Only states that previously started before November 1 can continue to do so

Some states haven’t released their open enrollment period for 2025 yet. Below is a state-by-state chart for extended open enrollment periods based on 2024 open enrollment and the new rules:

What happens if you miss the deadline for open enrollment?

If something unexpected happens, you can still avoid a lapse in coverage. A special enrollment period (SEP) allows you to make changes to your health insurance outside of open enrollment due to qualifying life events.

There are four basic types of qualifying events for special enrollment opportunities:

• Loss of health insurance coverage. When you lose employer-sponsored coverage, student health plan coverage, or eligibility for Medicaid or CHIP, it's a loss in coverage. Aging out of your parent's plan at 26 means losing dependent status and access to their plan. If your current coverage or individual marketplace plan is no longer available, you also qualify for an SEP.
• Offer of a new health benefit. If your employer offers a new health benefit like a health reimbursement arrangement (HRA) for the first time, you can enroll in marketplace coverage within 60 days.
• Changes in the household. This includes getting married, having a baby, adopting, or placing a child in foster care. Divorce or legal separation that results in loss of coverage also qualifies. If a family member dies and you lose coverage, that counts as a household change. Keep in mind that rules for domestic partnership situations differ by state.
• Changes in residence. Relocating counts as a qualifying life event. This includes moving to a new ZIP code or to the United States from another country or U.S. territory. Students moving to or from where they attend school can also enroll or change their health coverage. Seasonal workers who move to or from their place of residence and work are also eligible.

If you missed enrolling due to a natural disaster or emergency, you may also qualify for a special enrollment opportunity. For example, during the COVID-19 public health emergency, people could apply for health coverage outside of open enrollment.

There's also a low-income SEP that helps those in need find affordable health coverage at any time.

Conclusion

Signing up for health insurance can be tricky, with different rules in each state. Extended open enrollment periods offer a valuable opportunity for individuals to secure coverage outside of the usual timeframe. For more details on signing up for coverage during these extended periods, check out your state's health insurance marketplace website or contact them directly.

1. https://www.cms.gov/files/document/health-insurance-exchanges-2024-open-enrollment-report-final.pdf
2. https://www.federalregister.gov/documents/2024/04/15/2024-07274/patient-protection-and-affordable-care-act-hhs-notice-of-benefit-and-payment-parameters-for-2025