Open enrollment is the time each year when you can sign up for or change health coverage for the coming year. For 2026 there are separate enrollment windows for Medicare and the ACA Marketplace, and there are several important changes to be aware of.
ACA Marketplace Open Enrollment
- Federal enrollment window: For most states, open enrollment for 2026 coverage runs November 1, 2025, through January 15, 2026[23]. Coverage takes effect January 1 if you enroll by December 15; enrollments after December 15 take effect February 1.
- State variations: Some states have longer or shorter enrollment windows. California, New Jersey, New York, Rhode Island and Washington, D.C. run through January 31; Idaho runs from October 15 – December 15; Massachusetts ends on January 23[27].
- What to do: Before enrolling, assess your health needs, preferred doctors and prescriptions. The Blue Cross Blue Shield Association advises comparing premiums, deductibles and provider networks to find a plan that fits your budget[28].
Medicare Open Enrollment
- Medicare Advantage and Part D Open Enrollment: For Medicare, the annual open enrollment period (sometimes called the Annual Election Period) runs October 15 – December 7, 2025[29]. During this time, people with Medicare can switch from Original Medicare to Medicare Advantage, join or change prescription drug plans or return to Original Medicare.
- What changes can you make? Traditional Medicare enrollees can remain in Original Medicare, switch to a new Part D plan or join a Medicare Advantage plan[30]. Medicare Advantage enrollees can remain in their current plan, switch to a different Medicare Advantage plan or return to Original Medicare with a standalone Part D plan[31].
- Plan Finder and counseling: Justice in Aging encourages using the Medicare Plan Finder tool to compare premiums, deductibles, drug formularies and supplemental benefits[32]. Pay close attention to provider networks, drug formularies and pharmacy networks[33]. SHIP counselors (State Health Insurance Assistance Program) offer free local assistance[34].
Key Changes Affecting 2026 Enrollment
- Premium uncertainty: Because enhanced premium tax credits may expire, marketplace premiums could rise sharply. Georgetown researchers estimate that failure to extend the credits could cause premiums to increase by more than 114 % on average, with some families seeing 20‑fold increases[20].
- Eligibility changes: Under recent legislation, some lawfully present immigrants and DACA recipients will lose access to premium tax credits[21]. These changes could affect who qualifies for affordable marketplace coverage in 2026.
- Medicare cost updates: CMS announced that the Part B premium will rise to $202.90 and the annual Part B deductible will be $283 in 2026[5]. The Part A hospital deductible increases to $1,736[11]. Medicare Advantage plans may adjust benefits, and non‑medical perks such as food or transportation programs could be reduced[35].
Tips for a Smooth Enrollment
- Mark your calendar: Know your enrollment window and set reminders so you don’t miss deadlines.
- Review your current plan: Even if you like your current coverage, benefits, provider networks and drug formularies can change each year[36]. Verify that your doctors and medications will still be covered in 2026.
- Use available tools: For Medicare, the Plan Finder helps you compare options[32]. For the Marketplace, healthcare.gov and state exchanges allow you to compare plans side‑by‑side and see if you qualify for financial assistance.
- Seek free assistance: SHIP counselors, marketplace navigators and licensed agents can help you understand your options and enroll at no extra cost[34].
- Plan for higher costs: Given the uncertainty around premium tax credits, budget for possible premium increases and explore lower‑cost plans or subsidies like Medicaid or CHIP if eligible[37].
Bottom Line
Open enrollment for 2026 is shaping up to be unusually complex. Check your eligibility, be mindful of changing costs and take advantage of free resources to choose coverage that fits your needs and budget. Acting early during the enrollment window increases your chances of securing affordable coverage for the coming year.