Open enrollment 2025-2026: Key dates, deadlines & how to prepare

Open enrollment 2025 is here—learn key dates, expert tips, and what to consider before choosing or updating your health coverage plan.

Emma Diehl

Written by

Emma Diehl

Jeremy Wolf

Reviewed by

Jeremy Wolf

Jim Kazliner

Edited by

Jim Kazliner

A guide to open enrollment 2025
20 min read
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TL;DR:

  • Open enrollment (Nov 1, 2025 – Jan 15, 2026) is when individuals must enroll in ACA-compliant plans—a requirement to use an ICHRA.

  • If an employer offers an ICHRA outside open enrollment, it triggers a 60-day Special Enrollment Period to buy individual coverage.

  • Missing both windows means employees can’t use their ICHRA until the next enrollment period—so timing and education are critical.

Open enrollment is a critical window in the U.S. health insurance calendar. It’s the one time each year when most people can sign up for or change their health insurance plans.

Health insurance options can be selected, modified, or renewed during a designated time each year, known as open enrollment. Because this is a tight window, it’s important for employers and individuals to be prepared for open enrollment 2025.

Life gets busy, and amidst the chaos, it’s easy to miss this important window. But, keep in mind that making changes outside of open enrollment can be difficult. According to a recent KFF survey on employer health benefits, 75% of those eligible for health benefits at their company choose to enroll.

While that figure is encouraging, it still leaves a significant number of people without the health coverage they need. So, when is open enrollment for health insurance in 2025, and what should you do to prepare? Let’s break it down.

What is open enrollment?

Open enrollment is the annual period when individuals can enroll in a health insurance plan, switch plans, or apply for premium subsidies. It applies to:

  • Health insurance plans purchased through the federal or state marketplaces (like Healthcare.gov)

  • ICHRA users, who must be enrolled in a qualified individual health plan to receive reimbursements

  • Most job-based and COBRA plans

If you don’t sign up during open enrollment, you’ll need to wait until next year—unless you qualify for a Special enrollment Period (SEP) triggered by a life event like marriage or losing other coverage.

 When is open enrollment for 2026?

  • Start: November 1, 2025

  • End: January 15, 2026  

Coverage start dates can differ depending on when employees enroll. Learn more in our guide to open enrollment. You can also go to Healthcare.gov for more info and fine print on open enrollment dates and deadlines.  

When does open enrollment for health insurance start in 2025-2026?

Open enrollment through the Healthcare.gov marketplace opens on Nov. 1 and typically runs through Jan. 15 in most states. Open enrollment typically lasts a few weeks, beginning in the fall and ending at the start of the new year.

Although the exact dates for open enrollment 2026 aren’t available yet, they’ll likely follow a similar timeline. Most health insurance plans bought through the marketplace follow these dates:

DateAction

Nov. 1, 2025

Open enrollment begins

Dec. 15, 2025

Final day to enroll or change coverage for plans starting Jan. 1, 2026

Jan. 1, 2026

Coverage begins for those who enrolled between Nov. 1 and Dec. 15, 2025

Jan. 15, 2026

Final day to enroll or change coverage for plans starting Feb. 1, 2026

Feb. 1, 2026

Coverage begins for those who enrolled between Dec. 16, 2025, and Jan. 15, 2026

Deadlines via Healthcare.gov

Open enrollment dates for employer-sponsored coverage can vary, so the HR department should communicate these exact dates to employees.

The federal government sets open enrollment dates for the marketplace, but employers determine their own open enrollment dates if they offer employee coverage.

Finally, if someone is enrolled in the marketplace or through an employer-sponsored healthcare plan and doesn’t elect to make any changes during open enrollment, they’ll typically be enrolled in the same plan in the new year.

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When is the Affordable Care Act’s open enrollment period?

In most states, ACA open enrollment for 2025 health insurance coverage begins on Nov. 1 and ends on Jan. 15th. This is the time to enroll in a new plan, renew a plan, or make changes to coverage through the Health Insurance Marketplace.

However, some states operate their own state-based marketplaces and may set different open enrollment deadlines, sometimes expanding their enrollment window beyond the federal one. Check if your state runs its own exchange so that you have the most accurate dates for the enrollment period.

The following states have enrollment dates that differ from the standard period:

StateEnrollment Start DateEnrollment End Date

California

Nov. 1, 2024

Jan. 31, 2025

Idaho

Oct. 15, 2024

Dec. 16, 2024

Massachusetts

Nov. 1, 2024

Jan. 23, 2025

New Jersey

Nov. 1, 2024

Jan. 31, 2025

New York

Nov. 1, 2024

Jan. 31, 2025

Rhode Island

Nov. 1, 2024

Feb. 28, 2025

Washington DC

Nov. 1, 2024

Jan. 31, 2025

(KFF.org)

What happens if you miss open enrollment?

If you miss both open enrollment and your ICHRA-triggered SEP, you typically won’t be able to enroll in a qualified plan until the next open enrollment period.

That means:

  • You can't use your ICHRA to get reimbursed for premiums or medical expenses

  • You may want to seek alternative short-term coverage

  • Your employer can’t make tax-free reimbursements until you’re enrolled in eligible coverage

Exceptions include triggering another SEP (marriage, birth, job loss, etc.), but those are case-specific.

When is Medicare open enrollment for 2025?

Medicare differs from the previous options because it’s a federal health insurance program that is only available to people 65 or older or individuals with disabilities. There are several different enrollment periods, depending on whether you already have coverage and the type of coverage you have.

These are the key enrollment dates to keep in mind. They’re the same every year, so it’s easy to plan ahead:

Type of EnrollmentEnrollment Start DateEnrollment End DateInsurance Coverage Start Date

First-time enrollment due to turning 65 years old

Three months before your 65th birthday

Three months after your 65th birthday

The coverage start date will vary by when you sign up within the enrollment period.

Annual enrollment period

Oct. 15

Dec. 7

Jan. 1

General enrollment period

Jan. 1

Mar. 31

Jul. 1

Medicare Advantage Open Enrollment Period

Jan. 1

Mar. 31

Your coverage will start the month after you make your changes.

(Medicare.gov)

Who is eligible for health insurance during open enrollment?

To be eligible for health coverage through the Health Insurance Marketplace during health insurance open enrollment periods, you must:

  • Reside within the United States

  • Be a U.S. citizen, a U.S. national, or a lawfully present noncitizen

  • Not currently incarcerated

  • Not already be enrolled in Medicare

The types of changes and adjustments available to an individual’s existing coverage will vary depending on where they get their insurance.

During open enrollment, health insurance marketplace users can choose any plan available in their area. Coverage may come in tiers, including Bronze, Silver, Gold, and Platinum. A person or family may be eligible for subsidies or financial assistance depending on household income and size.

However, note that if someone accepts subsidies or assistance, they must decline their ICHRA.

Employer-sponsored plans could include various options, ranging from HMOs and PPOs to high-deductible plans. Similarly, open enrollment could be a time to enroll in additional benefits offered by an employer, including dental or vision coverage.

If an employer opts for nontraditional health care coverage like an Individual Coverage Health Reimbursement Arrangement (ICHRA), employees shop for coverage in the marketplace with an allowance granted by their employer. In that case, they can pick any plan that is available to them.

What happens if you miss open enrollment?

Missing the open enrollment window means users will have to wait until the next enrollment period to sign up for health insurance coverage.

Those using the Health Insurance Marketplace typically wait until the fall unless they qualify for a Special Enrollment Period due to a major life event.

Those who miss the deadline may still explore Medicaid or CHIP (if eligible) or consider short-term health plans, though these often provide limited benefits. Without insurance, they may face high out-of-pocket medical costs and limited access to care.

The process differs slightly for employer-sponsored insurance. Companies can adjust their health plans outside of open enrollment, but they have to provide sufficient notice to employees about any changes.

Who can enroll outside of open enrollment?

Depending on what type of coverage a person is seeking, they may be able to enroll year-round.

Individuals in these groups may qualify for healthcare coverage programs that allow year-round open enrollment:

Further, applicants for state health programs such as the following may also qualify for year-round open enrollment:

However, those getting healthcare through the marketplace or work can only change their coverage during open enrollment or a Special Enrollment Period, typically involving a Qualifying Life Event.

In addition, offering an ICHRA to employees for the first time at any time of the year counts as a Special Enrollment Period.

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Who qualifies for a Special Enrollment Period?

To learn how to get health insurance after open enrollment, enrollees will first have to see if they qualify to enroll in a healthcare plan during a Special Enrollment Period.

It’s important to note that those who qualify for a Special Enrollment Period will likely be asked to present documents supporting their claim. What documents will be required and by what date will depend on the qualifying event.

To qualify, one of these qualifying life events must apply:

Changes in Household Changes in ResidenceLoss of Health CoverageEmployer-Sponsored Coverage Changes Other Qualifying Changes

Marriage

Moving to a new ZIP code or county

Losing job-based coverage

Employer offering an Individual Coverage HRA or QSEHRA

Gaining membership in a federally recognized tribe or ANCSA Corporation

Birth, adoption, or foster placement of a child

Moving to the U.S. from a foreign country or U.S. territory

Losing individual health coverage

Becoming a U.S. citizen

Divorce or legal separation with loss of health insurance

Moving to/from a school location (students), a place of work (seasonal workers), or a shelter or transitional housing

Losing Medicaid or CHIP (past 90 days)

Leaving incarceration

Death of a household member causing loss of coverage

Losing coverage through a family member

Starting or ending AmeriCorps service

Affected by an unexpected event or natural disaster (e.g., hurricane, flooding, earthquake)

(Healthcare.gov)

Special considerations for Medicare, Medicaid, and other special groups

While the open enrollment period is a crucial time for most Americans to choose or change their health insurance coverage, those enrolled in Medicare, Medicaid, or who have dual eligibility may have different enrollment timelines and requirements.

Medicaid enrollment is available year-round for those who qualify based on income, disability, or other specified criteria. Those enrolled in Medicaid will usually have to go through the renewal process every 12 months. State Medicaid agencies conduct periodic eligibility reviews to determine whether individuals continue to qualify for coverage.

Medicare Open Enrollment happens every year from Oct. 15th to Dec. 7th. During the enrollment period, individuals can:

  • Enroll in, leave, or change to another Medicare Advantage plan

  • Move from Original Medicare to a Medicare Advantage plan

  • Or make changes to their Medicare prescription drug coverage

Meanwhile, Medicare Advantage open enrollment follows a separate schedule. This period runs from Jan. 1st to Mar. 31st and is only for those who are already enrolled in a Medicare Advantage plan. During this time, they can:

  • Move to another Medicare Advantage plan

  • Go back to Original Medicare

People with dual eligibility or certain chronic conditions have the option to enroll in Special Needs Plans (SNPs). There are several options that fall under this umbrella, including Dual Special Needs Plans (D-SNPs) for those who qualify for Medicare and Medicaid, and Chronic Condition Special Needs Plans (C-SNPs) for those with specific health conditions like diabetes or heart disease.

These types of plans offer more tailored coverage, making them a valuable option for those with more complex health profiles. The enrollment window for SNPs aligns with the Medicare Advantage enrollment period, unless there is a case for a Special Enrollment Period.

Open enrollment with ICHRA

ICHRA may not follow the same industry dates as open enrollment, but an employer can kick off a SEP for their team the first time they offer the coverage.

When it comes to open enrollment under an ICHRA, employees can access many healthcare plans on the ACA marketplace. With an ICHRA, employers can grant employees an allowance to pick the best plan that works for them.

Want to give employees the freedom to enroll in the coverage that best suits them? Thatch is democratizing the healthcare process. Learn how to offer better benefits for less with an ICHRA. How open enrollment affects ICHRAs

If your employer offers an ICHRA (Individual Coverage HRA), you must be enrolled in a qualified individual health plan to receive tax-free reimbursements.

This means open enrollment is your opportunity to secure coverage that makes your ICHRA usable. If you miss it, you may lose access to your employer's contribution for the rest of the year.

To use an ICHRA, your health plan must be:

  • Individual (not a group plan)

ACA-compliant (covers essential health benefits)

How to prepare for open enrollment

Open enrollment can sneak past employees if they aren’t properly prepared. Here are some tips to share with your employees, even if they’re not certain they’ll switch plans,

  1. Analyze your healthcare spending. Take a look at your healthcare expenses in the past year. Are you paying too much out of pocket? For example, you may be paying for therapy out of pocket, or your budget for prescription medication might’ve risen considerably. Look at these pain points and costly transactions--this might influence your decision to choose a new plan.

  2. Review the existing plan. Is your coverage helping you achieve your health goals? Or are expensive co-pays keeping you from visiting specialists? If you’re unhappy with elements of your plan, it may be time to visit alternative coverage.

  3. Compare plans. Before you apply for health insurance, you can browse the different plans available to you and get estimates on their prices. If you have the option of multiple plans to choose from, compare your existing plan’s coverage with other plans. Take a look at premiums, deductibles, co-pays, and eligible networks to determine if a similarly-priced plan might offer better benefits. Do similar plans reduce any costs you’ve incurred in the past year?

  4. Look forward. Are there plans for next year that require more robust coverage? For example, someone might be trying for a baby or electing to have surgery in the next 12 months. Those life events could call for more expensive premiums that have better coverage down the line. While we can’t always predict the future, you might want a plan with more comprehensive coverage if you anticipate health costs rising in the next year.

How to apply for health insurance through the Marketplace

If you’re ready to enroll in a new healthcare plan, you can start the process by visiting healthcare.gov or your state’s Marketplace website to set up an account. You’ll need to provide personal details, including your name, address, and Social Security number. From there, you will:

1. Complete the application

Fill out the Marketplace application with details about your income, household members, and any current health coverage. This information helps determine eligibility for subsidies and cost-sharing reductions.

2. Compare plans

Once your application is processed, you can review available health plans. Compare costs, coverage options, provider networks, and out-of-pocket expenses to choose the best fit for your needs.

3. Select a plan

After comparing plans, select the one that best meets your healthcare and budgetary needs.

4. Submit your enrollment

Finalize your selection and submit your enrollment. If eligible, you’ll see any financial assistance applied to lower your premiums.

5. Pay your first premium

Your coverage doesn’t begin until you pay your first month’s premium. Make sure to complete this step by the insurer’s deadline, or you risk lapsing your coverage.

6. Receive confirmation and coverage details

Once enrolled, you’ll receive a confirmation letter or email with policy details, including your insurance card and coverage start date.

Financial assistance for employees

Even if they are eligible to enroll, the cost can discourage your employees from taking advantage of your health care plan. Luckily, financial assistance for health insurance is available through several different avenues.

Advanced Premium Tax Credits (APTC) and cost-sharing reductions (CSR) can help lower-income individuals and families afford coverage. APTC reduces monthly premium costs based on income and household size, while CSR lowers out-of-pocket costs like deductibles and copays for those enrolled in Silver plans. Eligibility depends on income levels relative to the federal poverty level.

These subsidies can be accessed by applying through the Health Insurance Marketplace®, where applicants provide financial details to determine qualification. Some states also offer additional programs to further assist with healthcare expenses.

You can also improve affordability by offering an employer stipend for health insurance to your employees. Employer stipends are a flexible way to help employees cover healthcare costs without offering a traditional group plan. These taxable allowances can be used for individual health insurance premiums, out-of-pocket medical expenses, or wellness-related costs.

Employers may offer general health stipends or specific ones for medical, dental, vision, prescription drugs, mental health, or wellness expenses. While stipends provide autonomy, they lack tax advantages — both employers and employees pay taxes on the funds, reducing their overall value.

Despite this, they remain a great option for small businesses seeking cost-effective ways to support employees’ healthcare needs.

Help and resources for Open Enrollment 2025

Navigating health insurance can feel overwhelming, but you don’t have to go it alone. Whether you're enrolling through the ACA marketplace, picking a plan offered by your employer, or helping your employees find a plan, there are experts ready to help you through the process.

Here are a few resources that can make enrollment easier:

  • Navigators: These are trained professionals funded through the ACA to provide free help. They can guide you through your options, help you complete your application, and answer questions about eligibility and subsidies. You can find a Navigator near you at healthcare.gov.

  • Certified Application Counselors (CACs): Similar to Navigators, CACs often work at hospitals, community health centers, or nonprofit organizations. They’re trained to assist with enrollment and can help you understand plan details and financial assistance options.

  • Licensed health insurance brokers: These are licensed professionals who can recommend and enroll you in a plan. They’re a great resource if you want advice on comparing different plan types (like HMOs vs. PPOs) or if you’re using an employer benefit like an ICHRA to shop for individual coverage. Brokers can offer both virtual and in-person support and typically don’t charge for their services — the insurance company pays them.

  • State marketplace call centers and in-person help: Most states offer phone lines and walk-in centers where you can get real-time support from trained reps during the open enrollment window.

  • Financial counselors: If you have specific healthcare needs — like managing a chronic condition or navigating high medical bills — some hospitals and nonprofits offer financial counselors who can help you understand costs, eligibility for programs like Medicaid or CHIP, and how to budget for care.

While ICHRAs don’t always follow the same timeline as traditional plans, open enrollment in 2025 remains a critical time for most employees to review their healthcare options and make important coverage decisions. Missing this window could mean waiting another year unless a qualifying event triggers a Special Enrollment Period.

That’s why giving employees more flexibility, like the ability to choose the plan that fits them best, can make all the difference. Thatch is democratizing the healthcare process. Learn more about how you can offer your employees custom ICHRA health plans with Thatch.

Frequently asked questions about open enrollment

What is open enrollment in the US?

Each year, there’s a set window when individuals can review, update, or enroll in health insurance coverage. This period — known as open enrollment — applies to a range of plans, including those offered through the ACA Marketplace, employer-sponsored plans, and Medicare.

For most states, the ACA Marketplace open enrollment runs from Nov. 1 to Jan. 15. Medicare and job-based insurance plans follow their own timelines. Outside the open enrollment window, changes are typically only allowed with a Qualifying Life Event, such as marriage or job loss.

When is open enrollment for health insurance 2025-2026?

Open enrollment for 2026 coverage for Affordable Care Act (ACA) marketplace plans, including ICHRA-connected plans, runs from Nov. 1, 2025, to Jan. 15, 2026. Some states with their own exchanges may have different deadlines.

Employer-sponsored group plans and Medicare have separate enrollment periods.

When is Medicare open enrollment for 2026?

For those turning 65, the initial enrollment window opens three months before their 65th birthday and closes three months after, giving them a seven-month period to sign up. If you're already on Medicare, the Annual Enrollment Period should run from Oct. 15 to Dec. 7, 2025, for 2026 coverage. There's also a General Enrollment Period and a Medicare Advantage Open Enrollment Period, both running from Jan. 1 to Mar. 31 each year.

Emma Diehl Thatch writer
Written by
Emma Diehl /Writer

Emma Diehl is an award-winning writer and content strategist with years of experience researching, writing, and covering healthcare industry news. She's passionate about helping readers discover the right information to help them make informed decisions.

Connect with Emma

This article is for general educational purposes and is not legal advice. The opinions shared here belong to the author and are not official statements from Thatch. For legal and tax questions, please feel free to consult with a qualified professional.

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