Navigator Guide FAQs of the Week: Wrapping Up Open Enrollment

Open enrollment for the Affordable Care Act’s Marketplaces is coming to a close. In most states, January 16 is the last day to sign up for a 2024 plan (absent special circumstances). This week, we’re highlighting frequently asked questions (FAQs) from CHIR’s Navigator Resource Guide concerning the end of open enrollment.

If I buy a plan during open enrollment, when does my coverage start?

Open enrollment is from November 1, 2023 to January 16, 2024 in most states. If you enroll by December 15, 2023, and if you make your first premium payment by the due date specified by your plan, your new coverage will start on January 1, 2024. If you enroll on January 16 and pay your first month’s premium payment, your new coverage would start on February 1.

To find out if your state has a different open enrollment period, visit our state fact sheets. (45 C.F.R. § 155.410.)

What if I sign up for a plan and change my mind? Can I switch my plan during open enrollment?

Yes, you can change plans for the 2024 benefit year anytime during the open enrollment period, but be aware that, for the federally facilitated Marketplace, that period lasts only from November 1, 2023 to January 16, 2024 for coverage starting in 2024. Some states have longer open enrollment periods, so check your state’s Marketplace. After open enrollment, you can only change plans once your coverage has taken effect if you have a change in circumstance qualifying you for a special enrollment period, unless you are an American Indian or Alaskan Native or, in most states, your income is below 150 percent of the federal poverty level. (45 C.F.R. § 155.420.)

I’ve picked the plan I want. Now do I send my premium to the Marketplace?

No, you will make your premium payments directly to the health insurance company. Once you’ve selected your plan, the Marketplace will direct you to your insurance company’s website to make the initial premium payment. Insurance companies must accept different forms of payment and they cannot discriminate against consumers who do not have credit cards or bank accounts. The insurance company must receive and process your payment at least one day before coverage begins. Make sure you understand your insurance company’s payment requirements and deadlines and follow them so your coverage begins on time. Your enrollment in the health plan is not complete until the insurance company receives your first premium payment.

If you have qualified to receive a premium tax credit and have chosen to receive it in advance, the government will pay the credit directly to your insurer and you will pay the remainder of the premium directly to the insurer.

(45 C.F.R. §§ 147.104, 155.305.)

Consumers in most states have until January 16 to enroll in a Marketplace plan for 2024 (the Marketplaces in some states have set a different deadline). Check out our Navigator Resource Guide for more FAQs, state-specific information, and other helpful resources.