Open enrollment is the annual window when you can enroll in, change, or drop health insurance coverage. Miss it, and you're locked into your current plan — or uninsured — until next year (unless you qualify for a Special Enrollment Period).
Health Insurance Open Enrollment: What to Do and When
Source: Concerning Reality
When Is Open Enrollment?
- ACA Marketplace (HealthCare.gov): November 1 – January 15 (coverage starts January 1 if enrolled by December 15)
- Employer-sponsored plans: Varies by employer — typically October–November for January 1 coverage
- Medicare: October 15 – December 7 (Annual Enrollment Period)
- Medicaid/CHIP: Year-round enrollment for those who qualify
Open Enrollment Checklist
- Review your current plan: Did your premiums, deductibles, or network change? Insurers often make changes at renewal.
- Assess your healthcare usage: How many doctor visits, prescriptions, and procedures did you have this year? What do you expect next year?
- Check if your doctors are in-network: Networks change annually. Verify your doctors are still covered.
- Review your prescriptions: Check the formulary (drug list) for your medications. Tier changes can significantly affect your costs.
- Compare plan options: Run the total annual cost math for each option (premiums + expected out-of-pocket).
- Consider an HSA: If you're healthy, an HDHP + HSA can save significant money.
- Update your beneficiaries and dependents: Life changes (marriage, divorce, new child) affect your coverage needs.
- Check subsidy eligibility: If you buy on the ACA Marketplace, verify your income for premium tax credits.
Most Expensive Open Enrollment Mistakes
- Auto-renewing without reviewing: Your plan may have changed significantly. Always review before renewing.
- Only looking at premiums: A low-premium plan with a high deductible can cost more if you use healthcare regularly.
- Not checking your doctors' network status: Your doctor may have left the network. Verify before enrolling.
- Ignoring the formulary: Your prescriptions may have moved to a higher tier, costing you hundreds more per year.
- Missing the deadline: You'll be locked out until next open enrollment unless you have a qualifying life event.
- Underestimating your income for ACA subsidies: If you earn more than estimated, you'll owe the excess subsidy back at tax time.
Special Enrollment Periods (SEPs)
If you miss open enrollment, you can still enroll if you have a qualifying life event:
- Loss of other health coverage (job loss, aging off parents' plan)
- Marriage or divorce
- Birth or adoption of a child
- Moving to a new coverage area
- Gaining citizenship or lawful presence
SEPs typically give you 60 days from the qualifying event to enroll.
ACA Marketplace vs. Employer Coverage
If you have access to employer-sponsored health insurance, it's usually your best option — employers typically pay 70–80% of the premium. However, if your employer's coverage is expensive or limited, compare it to ACA Marketplace plans.
You can only use ACA subsidies if your employer's coverage is considered "unaffordable" (costs more than 9.02% of your household income in 2026) or doesn't meet minimum value standards.
