Open Enrollment 2026: What Is Open Enrollment and Why It Matters

Many Americans with health insurance have coverage through their workplace. According to the U.S. Census Bureau, over half the population had employer-based coverage for some or all of 2024. If you use your employer’s health plan for coverage, you typically get a notice from your company telling you when to make changes or choose coverage.

Not everyone has a job that gives them health insurance. Many Americans get health insurance through the federal healthcare marketplace or a state-run healthcare marketplace. 

And many go without. Millions of Americans are uninsured. If you're uninsured or have recently lost your medical insurance coverage, don’t give up hope. You may have options for coverage. 

Open enrollment is for insured as well as uninsured people. 

No matter your situation, you can benefit from knowing the ins and outs of open enrollment. Read on to learn how the process works, important deadlines, and why open enrollment matters.

What Is Open Enrollment: The Basics

What is open enrollment, anyway? It’s a window for people to make changes to their existing health insurance plans or enroll in new coverage. 

Open enrollment takes place for a set time that varies by plan type. Whether you need insurance or want to make changes to your insurance plan, it's essential to know the open enrollment timelines so you can take action before the deadline.

Not all healthcare programs have open enrollment periods. For example, if you’re eligible for Medicaid or the Children’s Health Insurance Program (CHIP), you can get covered at any time.

During open enrollment, you may start, stop, or change your health insurance coverage for the upcoming calendar year as long as you do it by the deadline. There are some exceptions to meeting the deadline if you’ve experienced significant life changes.

How open enrollment works with employer coverage

If you qualify for coverage through your employer, they’ll tell you about the open enrollment period and coverage alternatives.You can do the following during your company’s open enrollment period: 

• Enroll in new benefits

• Make changes to existing coverage

• Switch coverage levels, like switching from individual to family coverage. 

• Add or remove dependents 

• Adjust flexible spending account (FSA) or health savings account (HSA) contributions

• Switch between plan types, such as health maintenance organizations (HMOs), preferred provider organizations (PPOs), and high-deductible health plans (HDHPs)

Types of Health Insurance Coverage During Open Enrollment

Most insurance providers have an open enrollment period. This includes programs like Medicare, individual marketplace plans, and employer-sponsored plans.

If you’re considering switching health insurance plans, the many insurance plan types can make it seem confusing. Here’s a quick summary of insurance plans: 

• HMO plans. Your care is limited to the doctors, healthcare providers, clinics, and hospitals in a plan's network.

• PPO plans. They provide a network of providers, clinics, and hospitals. These plans also allow you to receive care from any provider, in- or out-of-network, without a PCP or referrals.

• HDHP plans. Cost structure is the main point of these plans, which  typically have lower monthly premiums and high deductibles.

When is open enrollment?

Most people with employer-sponsored health insurance can enroll or adjust coverage through their workplace during open enrollment. Open enrollment dates vary by company, but it typically occurs once a year, during a set period, usually in the fall.

If you’re seeking coverage through one of the marketplaces established by the Affordable Care Act (ACA), an individual (private) plan, or through Medicare, take note of the following dates for open enrollment:

• Marketplace, most state exchanges, and individual plans: Nov. 1 to Dec. 15. For a Jan. 1 start date for coverage, you must enroll by Dec. 15.

• Medicare*: Oct. 15 to Dec. 7

• Switch from Medicare Advantage to original Medicare: Jan. 1 to March 31

• Medicare Parts A and B: Jan. 1 to March 31

• Medicaid or CHIP: Applications are accepted year-round 

Certain qualifying life events may enable you to enroll or modify your health insurance coverage outside the regular open enrollment period (more on this below). 

Medicare Open Enrollment

If you’re over 65 and eligible for Medicare, you have slightly different enrollment periods and choices to know about. Medicare has its own processes, rules, and enrollment periods that may seem confusing. 

In short, Medicare has a few different enrollment periods:

• Initial Enrollment. You have seven months to sign up for Medicare Parts A and B. Your enrollment period starts three months before you turn 65, including your birthday month, and ends three months after your birthday.

• Annual Enrollment Oct. 15 to Dec. 7. People currently on Medicare can make changes to their health plan for the upcoming year.

• General Enrollment Jan. 1 to March 31. This is for people who missed their Initial Enrollment and don’t qualify for a Special Enrollment Period. You could be assessed penalties for enrolling late. 

• Medicare Advantage Open Enrollment Jan. 1 to March 31. People who have a Medicare Advantage plan can change to a different Advantage plan or enroll in Original Medicare.

Exceptions to Open Enrollment Deadlines

You may not be limited to open enrollment deadlines this year if you’ve experienced a life-changing event or if your state has opened an extended window for enrollment. Here’s what you need to know about the major exceptions to enrollment deadlines.

Special Enrollment Periods (SEPs)

You may be eligible for a special enrollment period (SEP) if you’ve experienced certain life events that require urgent action, such as:

• Welcoming a new child to your family

• Moving to a new state

• Getting married or divorced

• Losing your coverage

These SEPs generally span 60 days before and 60 days after the date of the qualifying event. In addition, job-based health insurance plans must provide an SEP of at least 30 days after termination.

Did you recently become uninsured? You may qualify to enroll in a health insurance plan outside of open enrollment. You can find out if you’re eligible for a SEP at HealthCare.gov by entering your ZIP code and answering a few questions about your situation.

If you meet the eligibility requirements for Medicaid or CHIP, you can apply at any time. Applications are accepted year-round. 

State-specific exceptions

Some states that run their own marketplaces have expanded their enrollment periods, extending the timeline for when people can add or change their healthcare plans. 

The following states and the District of Columbia have extended open enrollment periods:

• California: Through Jan. 31

• New Jersey: Through Jan. 31

• New York: Through Jan. 31

• Maryland: Through Jan. 15

• Massachusetts: Through Jan. 23

• Rhode Island: Through Jan. 31

• Virginia: Through Jan. 30

• District of Columbia: Through Jan. 31

Note: Idaho’s open enrollment ended Dec. 15, 2025. This is earlier than the nationwide open enrollment deadline of Jan. 15. 

What to Do If Open Enrollment Has Passed

You may still be eligible for coverage if you missed open enrollment. Here are some alternatives to explore: 

• Check if you have a qualifying life event that allows you to enroll in health insurance coverage during a special enrollment period (SEP). Job loss or a change in family status are two examples of qualifying events.  

• Consider a short-term health insurance plan. This may provide a temporary bridge until you can enroll in regular coverage during the next open enrollment. Keep in mind that these plans may have limited coverage and higher out-of-pocket costs.

• Check whether you’re eligible for government-sponsored health insurance, such as Medicaid or CHIP. Both of these programs accept applications year-round for qualifying individuals and families.

How to Prepare for Open Enrollment

You can take steps to prepare before open enrollment so you have the information you need to make informed decisions for your family. Here’s a checklist of what to do to get ready before enrollment opens.   

Know the open enrollment dates

Review open enrollment dates so you don’t miss important deadlines. Set reminders on your phone or make a note on your calendar if you think you might miss the open enrollment period.

Review your current coverage

Review your current coverage to identify what worked well with your plan and what didn't. This could help you know what actions to take moving forward. 

Compare plan costs

Compare all costs for each plan, including:

• Premiums

• Deductibles

• Out-of-pocket maximums

This can help you find the best value for your budget.

Consider your healthcare needs

Consider your family's healthcare needs for the upcoming year. Estimate the types of medical visits you might need and how many visits you expect. Don't forget to estimate prescription needs and costs. You want to be sure your family has adequate coverage.   

Gather documents 

Collect the right documents that will help guide you. Plan to have the following before enrollment:

• Income details

• Dependent information, including birth certificates

• Previous plan summaries

Why Open Enrollment Matters

It's important to stay on top of enrollment deadlines. Here’s more information on why open enrollment matters.

Changing needs

Understanding your coverage possibilities before you experience job loss can be helpful. Being informed could enable you to take swift action if you lose your health insurance.

Open enrollment also matters for those who are employed. If you have job-based health insurance benefits, open enrollment is an opportunity to change your existing plan to better suit your needs and those of your family. Your current needs may differ from when you last chose coverage.

Inadequate coverage 

Having adequate insurance coverage could mean better access to necessary healthcare services. Now is a good time to consider whether you have enough coverage for the upcoming year. Open enrollment offers a chance to explore your options and find a plan that meets your needs and fits your budget.

High deductibles

Paying the monthly minimum amounts on your credit card won’t help you chip away at your credit card debt. Similarly, low monthly health insurance premiums may not be such a great  deal if you can't afford the high deductible that comes with them. 

For example, you may think you’re getting an affordable plan because your healthcare premiums are only $250 per month. But if you’re hospitalized, that one event could cost you thousands of dollars out of pocket before your coverage kicks in.

High-deductible health plan (HDHP) premiums are typically cheaper than other plans. However, HDHPs generally have much higher deductibles—often several thousand dollars. HDHP deductibles have become unaffordable for many. Fewer than half of Americans have cash on hand for emergencies costing more than $1,000.

Get a Handle on Your Financial Well-Being and Health Coverage

Now that you understand the importance of open enrollment, it may also be a good time to learn about dealing with debt, money, and planning for your future.

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