A guide to open enrollment 2025-2026: Key dates and how to prepare

Life gets hectic, and amidst the chaos, it's easy to overlook one important task each year: open enrollment.

Even if you’re happy with your healthcare coverage, knowing when open enrollment is can be important to getting the most out of your healthcare program. And if you miss the window, making a change midyear can be challenging. 

So, when is open enrollment for health insurance, and what should you do during it? Read on to learn more.

When is open enrollment for health insurance 2025-2026?

Can you switch health insurance at any time? As a refresher, open enrollment is the annual period during which people can make changes to their healthcare coverage or enroll in coverage. It applies to both people purchasing plans on the marketplace and employees enrolled in employer-sponsored plans. How long is open enrollment for health insurance? 

For employer-sponsored healthcare coverage, the open enrollment period can vary widely by employer and plan type. For traditional group plans, the open enrollment period typically occurs for a few weeks in November and will depend on enrollment deadlines set by insurance providers. For employers that offer ICHRAs, where individuals purchase their own plan on the health insurance marketplace, the open enrollment period is more flexible for employees. Under current federal guidelines, open enrollment for individual plans is between November 1st and January 15th each year. Please note that there is no federally mandated open enrollment period for group plans — these periods are determined by the individual employer. This article is intended to provide general information about open enrollment and how it pertains to plans purchased on the individual marketplace. We recommend seeking further guidance if you have any questions.

Open enrollment typically lasts a few weeks, beginning in the fall and ending at the start of the new year. The federal government sets open enrollment dates for the marketplace, but employers determine their own open enrollment dates if they offer employee coverage.

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.

When does healthcare open enrollment typically start? 

Deadlines via Healthcare.gov

While dates can vary by state, in most cases, open enrollment is between November 1 to January 15 of the following year. 

Open enrollment begins on November 1, and people can enroll or change their existing coverage. If they enroll or make changes before December 15, their new plan will begin at the start of the new year. Any changes or enrollment made after December 15 will not take effect until February 1.  

Open enrollment ended on January 15, 2025. What are the consequences if someone misses their chance to enroll during this period? Once that date has passed, people typically can’t change their healthcare coverage unless they qualify for a Special Enrollment Period. 

The following life events can qualify you to enroll in a healthcare plan during the Special Enrollment Period.

(Healthcare.gov)

For example, if an employee decided to change to different coverage under their employer-sponsored plan on November 20, 2025, their new plan would begin January 1, 2026. However, if they made the change on December 17, 2025, they wouldn’t begin new coverage until February 1, 2026. 

It’s similar to a person enrolled in the marketplace. If they changed their coverage on December 1, 2025, they would see the change reflected in their coverage on January 1, 2026. If they didn’t choose a new plan until January 14, 2026, it would not go into effect until February 1, 2025.

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. 

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. 

Plan eligibility

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. Depending on household income and size, a person or family may be eligible for subsidies or financial assistance. 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 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.

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:

• People applying for low-cost or free coverage through Medicaid or CHIP (Children’s Health Insurance Program)

• Applicants eligible for the low-income Special Enrollment Period

• American Indians and Alaska Natives

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

• Basic Health Program users in Oregon, New York, or Minnesota

• Massachusetts residents enrolling in the ConnectorCare program

• People eligible for Connecticut’s CoveredCT

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 SEP.

Key considerations for open enrollment 2025

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:

• 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.

• 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. 

• Compare plans. 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?

• 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. 

Enrollment process

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:

• 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.

• Compare plans: Once your application processes, 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.

• Select a plan: After comparing plans, select the one that best meets your healthcare and budgetary needs.

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

• 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.

• 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 make a difference in affordability by offering an employer stipend to your employees. Employer stipends for health insurance 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 or picking a plan offered by your employer, 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.

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.

Frequently asked questions about open enrollment

What is open enrollment in the US?

Open enrollment is an annual period during which individuals can sign up for or change their health insurance plans. It applies to marketplace plans under the Affordable Care Act (ACA), employer-sponsored coverage, and Medicare. Outside this window, changes are typically only allowed with a qualifying life event, such as marriage or job loss.

When can I apply for health insurance for 2025-2026?

Open enrollment for 2026 coverage for Affordable Care Act (ACA) marketplace plans, including ICHRA-connected plans runs from November 1, 2025, to January 15, 2026.  Some states with their own exchanges may have different deadlines. [NOTE: On March 19, 2025, the Department of Health and Human Services published a proposed rule that, if adopted, would limit open enrollment periods for all marketplace plans to November 1 through December 15.] Employer-sponsored group plans and Medicare have separate enrollment periods.

What does it mean when enrollment opens?

When enrollment opens, individuals can sign up for new health insurance, renew existing coverage, or switch plans. If they miss the deadline, they will have to wait until the next enrollment period unless they qualify for a special enrollment period at any given time throughout the year.