Open Enrollment Period
The annual window (November 1 to January 15 federally) during which individuals can enroll in or change ACA-compliant individual health plans outside special enrollment.
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Practice This Concept
During the Medigap open enrollment period, which begins when a beneficiary turns 65 and enrolls in Medicare Part B, an insurer may:
Not deny a Medigap policy or condition its issuance on health status — The Medigap open enrollment period begins on the first day of the month the beneficiary is both age 65 or older and enrolled in Medicare Part B, and it lasts for six months. During this window, insurers must sell a Medigap policy to the applicant and may not deny coverage, impose preexisting condition waiting periods in most cases, or charge more because of health status. California law, CIC Section 10192.11, enforces this protected enrollment right. After the window closes, beneficiaries may face medical underwriting and higher or denied rates.
CA-specific example
The Medicare Supplement open enrollment period:
Begins when the person is age 65 or older and enrolled in Medicare Part B, and lasts six months — The Medicare Supplement (Medigap) open enrollment period is a six-month window that begins when the person is both age 65 or older and enrolled in Medicare Part B. During this period, insurers cannot deny coverage, condition coverage on health, or charge higher premiums due to health status. (A limited pre-existing condition waiting period of up to six months may still apply under CIC 10192.11(c), offset by prior creditable coverage.) This guaranteed-issue window is crucial because after it ends, insurers may medically underwrite and deny coverage for health conditions.
National insurance concept
- State RegulationsDuring the Medigap open enrollment period, which begins when a beneficiary turns 65 and…
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- Medical ExpenseA beneficiary who missed the initial enrollment period for Medicare Part B and has no o…
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