Quick summary: Open Enrollment 2026 requires early attention — changes to subsidies, rising premiums, and possibly tighter documentation mean you should review your health insurance options now. Use this guide to understand key dates, eligibility, what's changed for 2026, and download a printable checklist to keep you organized.
November 1, 2025 — General start of Open Enrollment for Marketplace plans (individual & family).
December 15, 2025 — Common deadline to enroll for coverage effective Jan 1, 2026 (state deadlines may vary).
January 15, 2026 — Many states allow enrollments up to this date for coverage effective Feb 1, 2026 (check your state).
Employer plans — Your employer sets its own annual enrollment window; confirm dates with HR.
Pro tip: Don’t rely on memory. Add calendar reminders, and even set an earlier personal deadline to compare plans.
Marketplace (individual & family): U.S. citizens and lawfully present individuals who live in the state where they enroll are eligible to shop. Eligibility for premium tax credits depends on household income and size.
Employer-sponsored plans: Eligibility is based on your employer’s rules (e.g., full-time status, waiting period).
Other programs: Medicaid/CHIP eligibility varies by state; Medicare has different enrollment rules (this guide focuses on Marketplace and employer options).
Special Enrollment Periods (SEPs): Qualifying life events (marriage, birth, job loss, move, loss of other coverage) may trigger an SEP outside the standard window.
When evaluating your options this year, consider these common choices:
Compare levels (Bronze, Silver, Gold, Platinum) based on your expected usage.
Check provider networks and formularies.
Verify if you qualify for premium tax credits and how changes for 2026 might affect them.
Employer contributions often reduce your monthly premium — compare total out-of-pocket cost vs. individual plans.
Review any changes your employer made to deductibles, copays, or networks.
If you may qualify for Medicaid or CHIP, contact your state agency.
If you’re 65+ (or otherwise Medicare-eligible), consult Medicare enrollment timelines (not covered here in detail).
1. Subsidy (premium tax credit) uncertainty — The enhanced pandemic-era tax credits are set to expire at the end of 2025 unless Congress extends them. That means many households could see higher monthly premiums in 2026.
2. Premium increases — Proposed rate filings and early analyses indicate across-the-board premium increases for many insurers in 2026. Plan accordingly.
3. Verification & documentation — Exchanges are increasing income and eligibility verification efforts; keep your Marketplace account information current to avoid lost subsidies.
4. State-level differences — Some states may set their own enrollment windows, deadlines, or additional consumer supports — always confirm with your state exchange.
5. Employer plan changes — Employers may tweak plan designs, employee contribution levels, or provider networks during their annual renewal.
Follow these steps to be ready:
1. Estimate your 2026 income and household size — this affects subsidy eligibility.
2. Gather documents — pay stubs, W-2/1099, prior tax return, Social Security numbers for dependents.
3. Review your 2025 medical usage — prescriptions, procedures, office visits.
4. Consult with a professional — review all your options with a trusted Health Trust Financial agent.
5. Check provider networks — ensure your doctors and hospitals are in-network for any plan you’re considering.
6. Compare total costs — premium + deductible + co-insurance + out-of-pocket maximum. The lowest premium isn’t always the best value.
Visit HealthCare.gov or your state exchange beginning Nov 1, 2025, or use your employer’s benefits portal.
Update income & household information in the portal.
Run side-by-side plan comparisons (use the plan’s Summary of Benefits and Coverage).
Enroll and pay your first premium by the applicable deadline.
Save enrollment confirmations and plan documents.
Watch for your ID card and welcome packet.
Immediately report any income or household changes to your Marketplace to avoid subsidy reconciliation surprises.
Download the printable checklist: [Download PDF — Open Enrollment 2026 Checklist]
Mark calendar: Nov 1, 2025 (start) and Dec 15, 2025 (common deadline).
Gather pay stubs, tax return, SSNs.
Review current plan performance and out-of-pocket history.
Compare provider networks & drug formularies.
Estimate 2026 income & check subsidy eligibility.
Enroll and pay first premium by deadline.
Save confirmations and welcome materials.
Q: If I’m happy with my current plan, do I still need to do anything?
A: Yes. Plan premiums, networks, and drug coverage often change year to year — you should still review and confirm your plan.
Q: What happens if subsidies expire after 2025?
A: If enhanced subsidies aren’t extended, many enrollees will see higher monthly premiums. Assess whether a different plan level or employer-based plan is more cost-effective.
Q: Can I change plans later if I miss open enrollment?
A: Only if you qualify for a Special Enrollment Period (qualifying life event). Otherwise, you’ll generally need to wait for the next open enrollment window.
The beauty of working with Health Trust Financial (HTF) is that they genuinely follow the Ramsey approach, helping families choose what’s best for them, not what’s most profitable to sell. If your family is healthy and can comfortably handle a higher deductible, they’ll recommend that. If you have ongoing health needs, they’ll guide you toward the right plan for that situation.
HTF has access to over 200 products, so their advisors can evaluate all the options for you. There’s no fee for their service, and because they’re not incentivized by any one company, their advice is completely unbiased.
Life changes, and so do your healthcare needs—having an expert review your options each year ensures you’re always getting the best value and coverage for your family.
Need help comparing health insurance options or estimating subsidy impact for 2026?
Request a free quote today!