Guide Frequently Asked Questions about Open Enrollment Waivers

Do you have questions about the open enrollment waiver process? See below for a list of our most frequently asked questions.

If you did not purchase health insurance during the last open enrollment period, you may still be eligible to buy health insurance by requesting a waiver from the Office of Patient Protection (OPP).

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Questions about open enrollment

Individuals and families can buy or enroll in health insurance during the open enrollment period from November 1 through January 23 without a waiver.

What is the open enrollment period?

The open enrollment period is a specific time of year when consumers can buy health insurance. This open enrollment period is set by state and federal law and may change each year. Consumers who receive health insurance benefits from their employer may have a separate designated period when they can make plan selections.

Can I enroll in health insurance outside of the open enrollment period?

If you have a qualifying life event—like getting married, losing a job, having a child, or losing health insurance—you may be able to enroll in health insurance outside of the open enrollment period without requesting a waiver. To learn more about qualifying life events, visit the Connector.

Also, you can enroll any time of year if:

  • You qualify for MassHealth.
  • You now qualify for a ConnectorCare Plan through the Health Connector after not having qualified in the past, or after applying for the first time.
  • You are applying for dental insurance.
  • You are a member of a federally recognized tribe or Alaska Native shareholder.

I am losing my current health insurance. Do I have to wait until open enrollment to enroll in a new health insurance?

Typically, losing health insurance is considered a qualifying life event. This includes losing health insurance through a job, becoming ineligible for MassHealth or ConnectorCare, or aging out of your parent’s plan when turning 26. You have 60 days from the date when you lose your health insurance to enroll in new health insurance.

Additional Resources for Questions about open enrollment

Questions about eligibility

Who can request an open enrollment waiver?

  • Massachusetts residents who missed the last open enrollment period and have not experienced a qualifying life event may request an open enrollment waiver. The Office of Patient Protection reviews waiver requests and typically grants open enrollment waivers to individuals and families who:

    • Are uninsured and did not intentionally forgo enrollment in health insurance, or

    • Lost health insurance but did not find out until after 60 days had passed.

Can I enroll in employer-sponsored health insurance by requesting an open enrollment waiver?

No. If you are seeking to enroll in employer-sponsored health insurance or other insurance obtained as a member of a group, you are not eligible for an open enrollment waiver. Your employer may limit health insurance enrollment to certain times during the year. You should talk to your employer about your needs.

I am new to Massachusetts. Should I request an open enrollment waiver to sign up for insurance?

Moving to Massachusetts from another state or another country is considered a qualifying life event. Therefore, you may be able to buy insurance without a waiver.

Additional Resources for Questions about eligibility

What is an open enrollment waiver?

OPP will respond to you within 30 days of receiving your waiver form. If OPP asks you for any additional information, please send it back as quickly as possible.

An open enrollment waiver is a letter from OPP that allows you to enroll in health insurance outside of the open enrollment period. If you are granted an open enrollment waiver by OPP, health insurance companies may not deny you enrollment on the basis of being outside open enrollment. Massachusetts residents who have a qualifying life event -like getting married, losing a job, having a child, or losing health insurance – do not need to request a waiver.

Is there a fee to request an open enrollment waiver?

No, there is no fee to request an open enrollment waiver.

What happens if OPP denies my request for an enrollment waiver?

If you do not qualify for an open enrollment waiver, you will need to wait to buy insurance until the next open enrollment period.

If OPP grants my request for an open enrollment waiver, must I then enroll with the health insurance company that initially denied my application?

Yes. If granted an open enrollment waiver by OPP, you must seek to enroll in health insurance from the health insurance company that initially denied your enrollment. If you enrolled through the Connector or a broker, you should return to the Connector or the broker who issued your initial enrollment denial.

Does my open enrollment waiver expire?

Yes. The open enrollment waivers may only be used within 30 days from the date on the letter. If you did not use your open enrollment waiver to enroll in health insurance within 30 days, please contact OPP.

Accessibility and other assistance

Where can I ask questions or get help with the open enrollment waiver form?

Please review the information on the Office of Patient Protection (OPP) website, or contact OPP at 800-436-7757 or hpc-opp@state.ma.us for assistance. Please do not send personal health information or other confidential information to OPP by email because OPP cannot guarantee the confidentiality and security of information sent to OPP by email.

I do not speak English. Can I get help in another language?

Yes. Contact the Office of Patient Protection by calling 800-436-7757. An interpreter will help translate the conversation.

I have a disability. How can I request accommodation?

If you need an accommodation to complete the open enrollment waiver request form, please contact OPP at hpc-opp@state.ma.us or at 800-436-7757.

I could not afford to purchase health insurance until now. Can I get an open enrollment waiver to enroll now and avoid any additional penalty?

You may request an open enrollment waiver, but you will need to explain why you did not buy health insurance during the last open enrollment period.

If you could have applied for health insurance coverage during open enrollment and did not do so, then you may have to wait for the next open enrollment period to buy insurance.

Will I get an open enrollment waiver if I can prove that I need medical care?

No. The Office of Patient Protection is unable to consider health conditions when reviewing an open enrollment waiver request.

Where can I get a waiver of the state or federal tax penalty for not having insurance?

The Office of Patient Protection does not issue tax penalty waivers. Please contact the following for information:

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