Compare and find affordable health insurance
Key takeaways
- The Open Enrollment Period (OEP) is the time each year when you can sign up for, renew, or change health insurance plans under the Affordable Care Act (ACA), also known as “Obamacare”. For most states, OEP runs from November 1, 2025, to January 15, 2026. Use HealthCare.gov to learn more.
- State-run marketplaces set slightly different dates, so it’s important to confirm your state’s timelines.
- In most states, enrolling in January means your coverage won’t begin until February 1.
- OEP is your main chance each year to enroll in a new plan, renew your current coverage, or make changes unless you qualify for a Special Enrollment Period (SEP) due to major life events like moving, losing coverage, or having a baby.
- Example: The monthly SEP for lower-income individuals (those that make up to 150% of the federal poverty level) is set to expire at the end of 2025, so those who qualify will need to enroll during the main OEP window instead.
- For 2026, some SEP rules and subsidies are changing, so check your eligibility carefully.
- The biggest changes for 2026 involve costs and eligibility.
- If Congress doesn’t act, the enhanced subsidies (or extra financial help) many people received since 2021 will end, which could raise monthly premiums.
- You may also need to verify your income, re-enroll in $0 premium plans if you qualify, or meet stricter SEP rules to keep coverage.
- Example: If you qualify and you’re currently in a $0 premium plan, you’ll have to re-enroll for 2026 or you could lose coverage or be given a new monthly premium.
Intro: What is Open Enrollment?
Open Enrollment is the yearly period when you can sign up for health insurance or update your existing plan through the Health Insurance Marketplace (also called the Exchange).
This is your one guaranteed chance to review your options, compare plans, and choose coverage that fits your needs and budget. Outside of Open Enrollment, you can usually only change plans if you qualify for a Special Enrollment Period (SEP) due to major life events like getting married, moving, or losing other health coverage.
During OEP, you can:
• Choose a health plan that fits your household
• Review costs, coverage, and providers
• Lock in coverage for the upcoming year
Important dates for OEP 2026
Let’s look at the key dates to mark on your calendar for this health insurance Open Enrollment period:
- November 1, 2025: Open Enrollment begins in all states except Idaho, which begins early on October 15.
- December 15, 2025: Deadline to enroll for coverage that starts January 1, 2026, (you must also pay your first monthly premium by this date).
- January 15, 2026: Final deadline in most states (but not all) to enroll, renew, or change coverage for 2026.
- February 1, 2026: Coverage begins for people who enroll in January, in states that offer this option.
Note: Some state-run marketplaces have extended deadlines. For more information and to check your state’s dates, view this article on 2026 Open Enrollment dates by state.
Coverage options available during Open Enrollment
During Open Enrollment, you have different health insurance options. Understanding the types of coverage available can help you choose the plan that best fits your needs.
1. Employer-Sponsored Plans
What they are:
Health plans offered by your job, usually for full-time workers.
How it works:
- • Sign up, renew, or make changes during your employer’s OEP.
• Choose from different plan types (like HMO, PPO, or high-deductible plans with HSAs).
• Select a coverage level: just you, you + spouse, or your whole family.
Why it matters:
• Your employer may pay part of the premium.
• Review deductibles, copays, and out-of-pocket limits to find your best option.
2. Individual and Family Plans
What they are:
Plans you buy yourself — either through the Marketplace or private insurers.
Coverage levels:
Every individual or family Marketplace plan falls into one of four “metal tiers”: Bronze, Silver, Gold, or Platinum. The tiers don’t describe the quality of care — all plans must cover the same set of essential health benefits under the ACA.
The tiers show how you and your insurance company share healthcare costs:
- Lower tiers (like Bronze) → lower monthly premiums, but higher costs when you actually get care.
- Higher tiers (like Platinum) → higher monthly premiums, but lower costs when you get care.
Think of the tiers as a trade-off: pay more each month vs. pay more when you need care.
Metal Tier Comparison
| Tier | Monthly Premiums | Out-of-Pocket Costs | Best For | Extra Notes |
| Bronze | Lowest | Highest | People who are generally healthy, rarely visit the doctor, and want the lowest monthly payment. | Covers about 60% of healthcare costs on average; you pay about 40%. May come with high deductibles. |
| Silver | Moderate | Moderate | A balanced option for those who need occasional care. | Covers about 70% of costs on average. If your income qualifies (100–250% FPL), you may get cost-sharing reductions that lower your deductible, copays, and coinsurance — but only for Silver plans. |
| Gold | Higher | Lower | People who visit the doctor regularly, use prescriptions, or want more predictable costs. | Covers about 80% of costs on average. Deductibles and copays are usually lower than Bronze or Silver. |
| Platinum | Highest | Lowest | Individuals with frequent healthcare needs who want the most comprehensive coverage. | Covers about 90% of costs on average. Rare on the Marketplace, but best for those expecting high medical expenses. |
Individual vs. Family:
• Individual: Covers one person
• Family: Covers two or more under one plan, with a combined deductible
Things to consider:
• High- vs. Low-Deductible Plans: High-deductible plans may pair with HSAs, which help you save for medical expenses tax-free — but it’s always best to check with a tax professional to be sure.
• Prescription Coverage: Check if your medications are included.
• Provider Networks: Make sure your doctors and hospitals are in-network to avoid extra costs.
Key Changes for OEP 2026
Several updates for 2026 could significantly affect how much you pay, which plans you can choose, and how you enroll. Understanding these changes can help you plan ahead and avoid surprises.
- Enhanced subsidies may expire:
- The premium tax credits that have helped lower monthly payments for those who qualify since 2021 could end unless Congress acts.
- This means millions of people may see higher monthly premiums in 2026, especially those who rely on subsidies to make health insurance affordable.
- If you currently qualify for a subsidy, it’s important to estimate your potential costs for next year and consider your plan options carefully.
- Tighter SEP rules & income checks:
- States must verify at least 75% of new Special Enrollment Period enrollments.
- Additionally, certain SEPs that were available for lower-income individuals (those making up to 150% of the federal poverty level) are set to expire at the end of 2025.
- What this means: Some people who previously could enroll at any time due to low income will now need to wait for the main Open Enrollment Period or meet specific eligibility criteria.
- No automatic re-enrollment for $0 premium plans:
- Previously, individuals in $0 premium plans could be automatically re-enrolled for the next year.
- In 2026, you must actively re-enroll or you could face a minimum monthly premium of $5.
- Missing this step could lead to gaps in coverage or unexpected costs.
- DACA recipients lose eligibility:
- Starting August 25, 2025, DACA recipients can no longer buy Marketplace plans or get subsidies.
- Alternatives may include employer coverage, Medicaid (if eligible), or private insurance.
- Higher out-of-pocket maximums:
- The maximum amount you could pay out-of-pocket for covered services in an individual Marketplace plan rises to $10,600 in 2026.
- This includes deductibles, copays, and coinsurance.
- Understanding this new limit is important if you anticipate high healthcare needs, so you can plan for potential medical expenses.
What to know about Special Enrollment Periods (SEPs)
SEPs allow for enrollment outside the main Open Enrollment Period or window due to qualifying life events such as:
- Losing other health insurance coverage
- Getting married or divorced
- Moving to a new state
- Having a baby or adopting a child
Note: In 2026, certain income-based SEPs for lower-income individuals are no longer available. Always verify eligibility before attempting to enroll outside OEP.
How to Prepare for OEP 2026
Open Enrollment is your once-a-year opportunity to ensure your health coverage meets your needs and budget. Whether enrolling in an employer-sponsored plan or an individual/family Marketplace plan, remember to:
- Mark your calendar: Set reminders for November 1 and December 15.
- Review your current coverage: Consider what worked well, what didn’t, and whether your doctors and prescriptions are covered.
- Check your eligibility: Confirm subsidy eligibility and anticipated costs if enhanced subsidies expire.
- Gather your documents: Having your income info, household details, and Social Security numbers will make enrollment faster.
- Compare plans carefully: Don’t assume your costs will remain the same — shop around to find the best fit.
- Seek expert help: A licensed insurance agent can answer questions, guide plan comparisons, and help you enroll correctly.
Careful planning now can help you avoid surprises, manage your healthcare spending, and secure coverage that works for your household in 2026.
MMR-3695-2025