Health Care Marketplace Open Enrollment Options Explained

The health care marketplace open enrollment period is a crucial time for individuals and families to secure affordable health insurance. It typically takes place from November to December each year, with some states offering extended enrollment periods.

You can enroll in a health plan through the marketplace if you're a U.S. citizen or national, or if you're lawfully present in the country. This includes people who are eligible for Medicaid or the Children's Health Insurance Program (CHIP).

During open enrollment, you can choose from a range of health plans, including bronze, silver, gold, and platinum plans. The main difference between these plans is the level of cost-sharing, with bronze plans having the lowest premiums but the highest out-of-pocket costs.

You can also enroll in a catastrophic plan, which is designed for people under 30 or those who are exempt from the Affordable Care Act's requirement to have health insurance.

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The open enrollment period for the Health Insurance Marketplace is a specific time frame during which you can enroll in an Affordable Care Act plan.

The open enrollment period runs from November 1 to January 15, 2026.

If you enroll by December 15, your coverage will start on January 1.

If you enroll by January 15, your coverage will start on February 1.

You can also enroll outside of open enrollment if you experience a qualifying event, such as getting married or divorced, having a baby, or losing health care coverage due to unemployment.

Here are some examples of qualifying events that may allow you to enroll outside of open enrollment:

Choosing a Plan can be overwhelming, but don't worry, I've got you covered. You have access to both standardized and non-standardized plans, so you can pick the right one for your needs. Standardized plans include enhanced pre-deductible coverage for key benefits at every metal level, while non-standardized plans may be better suited for individuals with unique health care needs.

You'll also have the option to compare plans and choose from among at least three insurance issuers. This means you can find a plan that fits your budget and meets your health care needs. Plus, all Marketplace plans cover prescription drugs, doctor visits, urgent care, hospital visits, and more.

Here are some things to keep in mind when choosing a plan:

If you're looking for a plan that includes Aurora Health Care in its network, you're in luck.

Aurora Health Care is part of several health insurance plans. Here are some of the plans that include Aurora:

Common Ground Healthcare Cooperative will no longer offer plans in certain counties, so be sure to check if you're affected.

You deserve exceptional care, and choosing a plan that's right for you can make all the difference. You'll have more choices and locations for primary and specialty care, plus access to plans, programs, and financial assistance options.

Aurora Health Care hospitals have received more Leapfrog "A" grades for patient safety than any other health system in Wisconsin. This means you can trust that you're getting top-notch care.

If you purchased health care insurance through the Marketplace, you'll need to consider the information on your Form 1095-A, Health Insurance Marketplace Statement. This form shows the total monthly health insurance premiums paid to the insurance company you selected through the Marketplace.

You can choose from among at least three insurance issuers on the Marketplace, so you can compare plans and pick the one that works best for you. All Marketplace plans cover prescription drugs, doctor visits, urgent care, hospital visits, and more.

Here are some benefits of Marketplace coverage:

You can purchase health care coverage through the Marketplace, but you need to report any changes in your circumstances, like changes to your household income or family size, to the Marketplace when they happen.

If you enrolled in insurance coverage through the Marketplace, you should report any changes in your circumstances to the Marketplace when they happen. Changes in circumstances may affect your advance payments of the premium tax credit.

To estimate the effect that changes in circumstances may have upon the amount of premium tax credit that you can claim, see the Premium Tax Credit Change Estimator on our Affordable Care Act Estimator Tools page.

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You can visit HealthCare.gov or contact your state-based Marketplace for information about enrollment periods.

Some insurance companies are leaving the exchange or limiting the counties where they are available, so you should consider all alternative coverage options when choosing a plan.

Here are some key things to keep in mind when purchasing coverage and tracking changes:

You can expect to save a significant amount of money on your health insurance premiums during this year's Open Enrollment Period. In 2024, most consumers qualified for $0 premiums or saw annual premium savings exceeding $800.

The Inflation Reduction Act of 2022 extended enhanced Affordable Care Act premium tax credits for three years, significantly reducing premiums for Marketplace enrollees with low/middle incomes. This extension is expected to prevent 13 million people from experiencing an increase in premiums and 3 million people from becoming uninsured.

You might be surprised at how affordable health insurance can be, especially with the help of these tax credits. As a result of the enhanced credits, in 2024, consumers saw similar savings during the last Open Enrollment Period.

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The Health Care Options are numerous and varied, so let's break it down. Individuals and families can find affordable care through the Affordable Care Act, while employers can offer health coverage to their employees through the Small Business Health Options Program Marketplace, also known as SHOP.

You can choose from various health insurance plans that include Aurora Health Care in their networks, such as Anthem, Common Ground Healthcare Cooperative, Health Partners, Molina Healthcare, and UnitedHealthcare. If you're 65 or older, you'll want to sign up for Medicare, the federal program for health insurance coverage.

If you're eligible for Medicaid benefits, you can work with financial advocates to enroll or renew your coverage by calling 800-326-2250.

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Health care coverage through the marketplace is available if you don't have insurance through your job, Medicare, Medicaid, or other qualifying health coverage.

The Health Insurance Marketplace was created as a result of the Affordable Care Act in 2010.

Open enrollment for the marketplace ends, but you can still find coverage if you act quickly.

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We're proud to have a network of healthcare providers that includes Aurora Health Care, a trusted name in the region.

You can choose from several plans that include Aurora in their networks, making it easy to get the care you need.

Anthem, Common Ground Healthcare Cooperative, Health Partners, Molina Healthcare, and UnitedHealthcare are some of the plans that include Aurora in their networks.

If you're 65 or older, you'll want to sign up for Medicare, a federal program for health insurance coverage.

Here are some plans that include Aurora Health Care in their networks:

You deserve exceptional care, and Aurora offers just that with more choices and locations for primary and specialty care.

Aurora's extended hours include evening and Saturday appointments, making it convenient for you to get the care you need.

Their LiveWell with Advocate Aurora Health app and website allow you to easily schedule appointments, view test results, and pay your bills online, anytime and anywhere.

Aurora Health Care hospitals have received more Leapfrog "A" grades for patient safety than any other health system in Wisconsin, giving you peace of mind.

As part of Advocate Health, the third-largest nonprofit integrated health system in the U.S., Aurora is part of a network that's redefining the standard for care with world-class doctors and caregivers.

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The Small Business Program is a great option for businesses with 50 or fewer full-time equivalent employees, who can use the SHOP Marketplace to provide health coverage to their employees.

You can enroll in SHOP any time of year, there’s no restricted enrollment period when you can start offering a SHOP plan.

The SHOP Marketplace offers flexibility, choice, and online application and account management, making it easy to find a plan that meets the needs of your business and your employees.

Businesses that offer health coverage through the SHOP Marketplace may be eligible for the small business health care tax credit.

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During open enrollment, it's essential to have the right contact information to navigate the health care marketplace. You can find this information in the marketplace's website or by calling their telephone number.

For residents of all states not listed below, the contact information is as follows: HealthCare.gov, 800-318-2596, and TTY: 855-889-4325.

If you live in California, you can contact Covered California at 800-300-1506, or use their website. California residents also have a TTY number: 888-889-4500.

In Colorado, you can reach Connect for Health Colorado at 855-752-6749, or use their website. If you need a TTY, you can call 855-346-3432.

Connecticut residents can contact AccessHealthCT at 855-805-4325, or use their website. The TTY number for Connecticut is 855-789-2428.

For District of Columbia residents, you can contact DC Health Link at 855-532-5465, or use their website. The TTY number is 711.

Idaho residents can contact Your Health Idaho at 855-944-3246, or use their website. Unfortunately, there is no TTY number available.

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Kentucky residents can contact KYnect at 855-459-6328, or use their website. The TTY number for Kentucky is 855-326-4654.

Maryland residents can contact Maryland Health Connection at 855-642-8572, or use their website. The TTY number for Maryland is 855-642-8573.

Massachusetts residents can contact Massachusetts Health Connector at 877-623-6765, or use their website. The TTY number for Massachusetts is 877-623-7773.

Minnesota residents can contact MNsure at 855-366-7873, or use their website. The TTY number for Minnesota is 800-627-3529.

Nevada residents can contact Nevada Health Link at 855-768-5465, or use their website. The TTY number for Nevada is 855-853-8100.

New Mexico residents can contact Be Well NM at 855-996-6449, or use their website. The TTY number for New Mexico is 855-889-4325.

New York residents can contact NY State of Health at 855-355-5777, or use their website. The TTY number for New York is 800-662-1220.

Oregon residents can contact OregonHealthCare.gov at 855-268-3767, or use their website. The TTY number for Oregon is 800-735-2900.

Rhode Island residents can contact HealthSource RI at 855-840-4774, or use their website. The TTY number for Rhode Island is 888-657-3173.

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Vermont residents can contact Vermont Health Connect at 855-899-9600, or use their website. The TTY number for Vermont is 888-834-7898.

Washington residents can contact Washington Health Benefit Exchange at 855-923-4633, or use their website. The TTY number for Washington is 855-627-9604.

You can also find this information on the marketplace's website or by searching online.

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The Affordable Care Act is a vital part of the health care marketplace open enrollment process. It provides coverage for individuals and families, as well as employers.

Individuals and families can take advantage of the Affordable Care Act to secure health insurance. Employers also have options under the Act.

If you're a small business or employer, you might be interested to know that the Affordable Care Act has resources available specifically for you. The ALE Info Center is a great place to start.

Health care tax tips are also an important part of the Affordable Care Act. You can find more information on this topic by visiting the tax provisions section.

If you have questions about the Affordable Care Act, you're not alone. The Questions and Answers section is a helpful resource to get clarification on any concerns you may have.

The Affordable Care Act also includes legal guidance and other resources to help you navigate the process.

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