Health Insurance Open Enrollment, Explained

When the windows open

• Marketplace (ACA) plans: November 1 through January 15 in most states — some state-run marketplaces extend their windows
• Medicare Advantage and Part D (Annual Enrollment): October 15 through December 7, with coverage starting January 1
• Medigap: an initial enrollment window that lasts six months after you turn 65 and enroll in Medicare Part B
• Employer plans: each employer sets its own dates, usually in the fall

Why the window matters

Outside Open Enrollment, you generally can't buy or switch individual plans unless you experience a qualifying life event — losing coverage, moving, marriage, a new baby, and a few others. If you do nothing during Open Enrollment, your current plan often auto-renews — but auto-renewing without checking is how people end up overpaying or losing their doctor.

What to check each year

• Did your plan's premium, deductible, or out-of-pocket maximum change?
• Are your doctors still in its network?
• Are your medications still covered at the same tier?
• Did your income change — and with it, your subsidy?

Medicare members: don't confuse the windows

Medicare's Annual Enrollment (October 15 – December 7) is when you can switch between Original Medicare and Medicare Advantage or change Part D drug plans. There's also a separate Medicare Advantage Open Enrollment from January 1 through March 31. Which window applies to you depends on your coverage, so it's worth a five-minute conversation with us before you act.