Open Enrollment vs. Special Enrollment
What Is Open Enrollment?
The Open Enrollment Period (OEP) is an enrollment event that happens annually. You can pick a new plan or update your individual and family health insurance during Open Enrollment without going through a life change. Normally, Open Enrollment begins November 1 and ends January 15. The plan you enroll in during Open Enrollment will keep you covered for the upcoming year.
Get Open Enrollment shopping tips.
What Is Special Enrollment?
If you go through a life change that impacts your plan's cost, network or covered dependents, you can enroll in a new plan or update your coverage during a Special Enrollment Period (SEP). Some common life changes include:
- Having, adopting or fostering a child
- Mudarse
- Getting married or divorced
- Losing or changing your job
- Cumple 26 años
This list doesn't include everything. If you've gone through a different life event, you may still qualify for Special Enrollment.
Special Enrollment lasts year-round - there's no start date or end date. You normally have 60 days before or after your life event to pick a new plan or update your coverage. You may have to show proof of your event, like a birth certificate, marriage license or letter from your employer. If proof is needed, make sure you have it ready before you start shopping.
Más información sobre un Período especial de inscripción.
Important Open Enrollment and Special Enrollment Dates and Deadlines:
During Open Enrollment, keep these important dates in mind:
- Nov. 1: the date Open Enrollment typically begins
- Dec. 15 - Jan. 15: New Mexicans will have to shop for a plan through the New Mexico Health Insurance Marketplace, beWellnm.com
- Jan. 15: the date Open Enrollment typically ends
During Special Enrollment, keep these important deadlines in mind:
- 60 days: you normally have a 60-day deadline to enroll in a plan after going through a life event. In some cases, you can enroll up to 60 days before your life event.
- 24/7, 365: if you've gone through a qualifying life event and didn't miss your 60-day deadline, you can enroll any day of the year
If you miss your Special Enrollment deadline, you may have to go without coverage until Open Enrollment.
How often do these enrollment periods occur?
The Open Enrollment Period happens once a year, every year. The Special Enrollment Period happens anytime you go through a life change that qualifies you to pick a new plan or update your coverage.
Eligibility Requirements: SEP vs OEP
The difference in eligibility is a big part of what separates Open Enrollment from Special Enrollment. During Open Enrollment, anyone can enroll in an individual and family health insurance plan. Between November 1 and January 15, you're automatically eligible to compare your options and choose a health insurance plan.
During Special Enrollment, you can only enroll if you've gone through a qualifying event within the last 60 days (or, in some cases, have a life event coming up in 60 days or less). Special Enrollment exists to help you update your plan when your life and needs change. If your life event causes you to lose coverage, like turning 26 or getting let go from your job, you may have to submit documents proving the date of your life event. Check our list of valid documents.
When Will Your Health Insurance Coverage Start?
In most cases, your health insurance coverage won't start the day you enroll in a plan. If you're enrolling during Open Enrollment:
- Make sure you enroll by December 15 for coverage on January 1 of the upcoming year.
- If you enroll between December 15 and January 15, your coverage will begin February 1.
If you're enrolling during Special Enrollment:
- In most cases, your health plan's coverage will start on the first day of the month after you enroll.
- There are a few life events, like birth, adoption, fostering or court order, that allow coverage to start on the day of your life event.