What is open enrollment? It's the annual period to change or enroll in healthcare coverage. Learn key dates and tips for preparing for health insurance open enrollment 2025.
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.
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:
| Date | Action |
|---|---|
| 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 |
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.
Create the healthcare experience your employees deserve
Thatch works for companies of all sizes and takes minutes to set up.
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:
| State | Enrollment Start Date | Enrollment 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)
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.
Open enrollment through an employer
The enrollment period for employer-sponsored healthcare plans can change based on the employer and the plan type they offer. 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 Nov. 1 and Jan. 15 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 provides 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.
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 disabled individuals. 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 Enrollment | Enrollment Start Date | Enrollment End Date | Insurance 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. |
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 be 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:
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
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 Special Enrollment Period.
See how Thatch makes it easy to provide great benefits
Create the healthcare experience your employees deserve
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 Residence | Loss of Health Coverage | Employer-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) |
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.
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,
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. 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?
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.
Navigate Open Enrollment with an ICHRA
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.
