What Happens If You Miss Open Enrollment For Individual Health Insurance?

Open Enrollment is the dedicated period for individuals to enroll in individual health coverage. However, the annual Open Enrollment Period occurs during a busy time of the calendar year, so it may not be uncommon for it to pass you by. Realizing you’ve missed the Open Enrollment deadline can be stressful, but you’re not entirely out of coverage options.

This guide will walk you through what Open Enrollment is, what happens if you miss it, and the next steps you should take. We’ll also outline helpful tips for staying on top of future enrollment deadlines so you can avoid gaps in coverage.

In this blog post, you’ll learn:

• What Open Enrollment is, and why it’s an important time to review or choose a new health plan.
• What to do if you miss the Open Enrollment Period, including alternative ways you can get health coverage.
• Practical tips to stay organized and avoid missing future Open Enrollment deadlines so you can maintain active coverage year-round.

What is Open Enrollment?

Open Enrollment is the set time each year when families and individuals can sign up for a new individual health insurance policy, renew their current coverage, or make changes to their policy. The Affordable Care Act (ACA) established this annual window along with the Health Insurance Marketplace and state-run exchanges. These public exchanges allow consumers to browse, compare, and purchase coverage all in one place.

So, why can’t individuals and families sign up for health insurance at any time of year? Making Open Enrollment generally the only time people can enroll in or change their current policy helps maintain the stability of the individual market and gives insurance companies time to prepare. It also prevents individuals from waiting until they get sick to buy coverage or switching to a higher metal level plan before an expensive medical procedure to cover their out-of-pocket healthcare costs.

With the passage of the ACA, Open Enrollment was able to offer all Americans a consistent opportunity to review their options and select their preferred plan for the upcoming year.

When is Open Enrollment?

Open Enrollment occurs annually, but its exact dates vary depending on your location. However, in most states, Open Enrollment currently begins on November 1 and ends on January 15. If you sign up for coverage by December 15 and pay your first premium on time, known as a binder payment, your new health insurance will typically begin on January 1 of the following year.

If you miss the December 15 deadline but sign up before January 15, your coverage will likely begin on February 1.

Due to a new federal rule, all states using the federal Health Insurance Marketplace for Open Enrollment will have a consistent window running from November 1 through December 15. State-based marketplaces must also close their enrollment periods by December 31. These changes will take effect starting with the 2026 Open Enrollment Period for 2027 coverage¹.

What are your options if you miss the Open Enrollment Period?

If you miss the annual Open Enrollment window, your next steps depend on your situation. If you already have an ACA plan, your insurance company may automatically renew it for the following year. This isn’t the case in every state, however. But if you don’t have coverage, you typically won’t be able to enroll in a new plan until the next Open Enrollment Period—unless you qualify for a special circumstance. Here are a few ways you may still be able to get covered.

1. Special enrollment periods

A special enrollment period (SEP) allows you to sign up for or change your health insurance outside of the annual enrollment window. However, this is only the case if you’ve experienced a qualifying life event. If you do have a life event that qualifies for a special enrollment period, you’ll have a 60-day window to choose a new plan through the federal Marketplace or your state-based exchange.

Common life-changing qualifying events include:

1. Losing existing medical coverage
   1. This includes aging off a parent’s health insurance policy, losing your employer-sponsored plan, or the end of your COBRA coverage. Loss of eligibility for Medicaid, Medicare, or the Children’s Health Insurance Program (CHIP) also qualifies.
   2. Losing coverage because you missed Open Enrollment or didn’t pay your premiums doesn’t qualify as an SEP.
2. Household changes
   1. This includes situations such as getting married, divorced, having a baby, adopting a child (including gaining a foster child), or losing coverage due to separation.
3. Moving
   1. You’ll qualify if you relocate to a new ZIP code, county, or state that’s outside your current plan’s coverage area. If you move to a new location within your current rating area, you likely won’t qualify for an SEP.
4. Gaining access to a new health benefit
   1. For example, suppose your employer begins offering a stand-alone health reimbursement arrangement (HRA) at your company. In that case, you can trigger a special enrollment period to obtain qualifying coverage to participate in the health benefit.

If you qualify for a special enrollment period, collect documentation proving your qualifying life event. Then, you can apply for coverage online at HealthCare.gov or through your state marketplace². However, if you miss your 60-day SEP window, you have to wait until the next Open Enrollment Period to make changes to your policy or get new coverage.

2. Short-term health insurance

If you don’t qualify for an SEP, you can look into short-term health insurance, sometimes called temporary or gap coverage. Private health exchanges, such as brokers and insurance companies, sell short-term health plans. Essentially, these types of policies provide limited protection if you’re between jobs, waiting for new coverage to start, or otherwise uninsured.

However, it’s important to understand their limitations. Short-term plans don’t meet ACA requirements and don’t offer minimum essential coverage (MEC). They can also exclude pre-existing conditions, cap covered services, and use medical underwriting to set insurance rates.

While insurers can’t use medical underwriting on health plans sold on public exchanges, short-term coverage isn’t ACA-compliant. This means insurance carriers can use this method and consider your current health status, gender, and other factors when you apply for coverage, which may affect your premium rate.

Because they provide fewer protections than ACA plans, five states and D.C. prohibit the sale of short-term health policies entirely, and seven more states restrict them³. Between bans and restrictions, there are no short-term plans available in 14 states. Even so, people who qualify can enroll in short-term insurance as a viable and temporary option until permanent coverage becomes available. However, if your employer offers you an HRA, short-term coverage won’t count as qualifying coverage.

Former President Biden limited the duration of short-term health plans to a maximum of four months. However, on August 7, 2025, the Trump administration released a statement saying they don’t intend to enforce these rules⁴. So, it’s possible that individuals could enroll in these short-term plans for longer than four months.

KFF analyzed short-term plans in 36 states in 2025 and found that⁵:

• 40% of short-term plans don’t cover mental health services
• 48% don’t cover outpatient prescription drugs
• 94% don’t cover adult immunizations

3. Federal government programs

If you don’t want to get a short-term plan and you haven’t experienced a qualifying life event, you may still be able to get coverage through a federal health insurance program. The government sponsors a few programs for people who meet specific criteria to obtain affordable health coverage at any time of the year. In most cases, these programs support older adults, individuals with disabilities, or households with limited income.

Here are the three main programs:

1. Medicare. This health insurance program is for individuals age 65 and older and some younger individuals with disabilities or severe health conditions like ESRD or ALS. It helps cover hospital care, doctor visits, and prescriptions through different plan types (categorized by letter and arranged into parts: A, B, C, and D). Some people are automatically enrolled, while others must apply manually when they become eligible.
2. Medicaid. Often confused with Medicare, Medicaid offers individuals and families with limited income or resources free or low-cost health coverage. Jointly funded by both federal and state governments, Medicaid provides essential services, including doctor visits, hospital stays, and preventive care. If you qualify, coverage often begins right away, and, in some cases, you can apply it retroactively.
3. Children’s Health Insurance Program (CHIP). CHIP offers affordable coverage for children and pregnant women in families with incomes too low to afford individual health insurance but too high to qualify for Medicaid coverage. Each state manages its own CHIP program in accordance with federal guidelines. Covered services usually include medical, dental, and preventive healthcare.

If you’re eligible for Medicaid or CHIP, you can apply and enroll any time of the year; there’s no need to wait for the annual Open Enrollment window.

Tips on how to avoid missing the annual Open Enrollment deadline

Missing the Open Enrollment Period can leave you unexpectedly without coverage or limit your available insurance options until the next enrollment window rolls around. Luckily, there are a few things you can keep in mind to ensure you don’t miss your chance to select a plan and make the healthcare enrollment process as smooth as possible.

Here are some tips to keep in mind:

1. Mark your calendar early. As soon as your state announces its Open Enrollment dates, add a reminder to your calendar and set alerts leading up to the deadline. You can set an annual reminder starting with the 2026 Open Enrollment Period if your state uses the federal Health Insurance Marketplace, as the set dates will be November 1 through December 15.
2. Review your current coverage. Review your plan details and carrier information before enrollment begins to determine if your current policy still meets your needs. If you feel you don’t need to change your plan, you can ask if your insurer will automatically renew it for you.
3. Gather necessary documents. Before the enrollment window opens, collect any necessary personal information, income details, and dependent data ahead of time to make the process as quick and easy as possible.
4. Check with your employer. If you have an employer-sponsored plan, confirm your company’s specific enrollment window with your human resources (HR) team, as it may be different from the federal enrollment period.
5. Sign up as soon as possible. Don’t wait until the final week to browse the ACA marketplace. Enrolling early gives you time to research insurance carriers, compare health plans, qualify for federal subsidies, and ask any questions you may have before the deadline.

Conclusion

Missing the annual Open Enrollment Period can feel scary. But don’t panic; there are still ways to get coverage so you can keep protecting your health. Staying organized and understanding your options in case of emergency, such as reviewing the qualifying life events that trigger a special enrollment period and researching short-term health insurance carriers, is the best way to avoid a coverage gap and prepare for the next Open Enrollment window.

1. Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability

2. HealthCare.gov

3. Finalized federal rule reduces the total duration of short-term health plans to 4 months

4. Statement of the U.S. Departments of Labor, Health and Human Services, and the Treasury regarding short-term, limited-duration insurance

5. KFF - Examining short-term limited-duration health plans on the eve of ACA Marketplace Open Enrollment