2025 Open Enrollment for health insurance

When is Open Enrollment for 2025?

Open Enrollment for 2025 ACA Marketplace plans will begin on November 1, 2024, and last through January 15, 2025. Specific dates may vary by state, so you’ll want to check the Open Enrollment dates for the state where you live. Wellpoint is proud to offer ACA Marketplace plans in Florida, Maryland, and Texas.

Their dates for Open Enrollment 2025 are as follows:

How to prepare for health insurance Open Enrollment in 2025

Enrolling in health insurance is a major decision, so choosing the right plan for you and your family is important. To prepare for Open Enrollment, it’s a good idea to familiarize yourself with your coverage options, evaluate your anticipated care needs, and include health coverage as part of your family’s budget. If you’re currently enrolled in ACA health insurance, Open Enrollment is a good time to review the details of your plan to ensure it still meets your care needs and fits into your budget. 

The ACA Marketplace offers a variety of health insurance options, and plans are available in one of four “metal” levels: Bronze, Silver, Gold, and Platinum. Each level offers the same essential benefits but differs in how you and your insurer share the overall cost for care. After you’ve met your plan deductible, the difference in how much you pay and your plan pays is as follows:

Wellpoint offers a range of Bronze, Silver, and Gold metal level health plans. When looking at how the costs are shared between you and your insurer, consider what health services you’ll likely need. For example, if you’re in good health and see your doctor only for routine preventive care, a Bronze plan may fit your budget best with its lower monthly premium. However, you will pay more for out-of-pocket costs if you have an unexpected care need or health emergency. If you require more routine healthcare, including frequent doctor visits and prescriptions, you may prefer a plan where your out-of-pocket costs are more predictable. Silver and Gold plans have a higher monthly premium but lower out-of-pocket costs for care once you have met your deductible. It’s all about finding the balance for your specific needs. 

In addition to understanding ACA metal levels, there are a few other important factors to consider as you prepare for Open Enrollment 2025: 

• Understand Important Insurance Terms: It will be easier to successfully navigate Open Enrollment 2025 if you have an understanding of common insurance terminology. A few of the most important terms include:

  • Premium: The amount you pay monthly for health coverage.
  • Deductible: The amount you pay out-of-pocket annually before your plan begins to pay.
  • Copay: Fixed amount you pay your care provider for each visit. Copays typically do not count toward your deductible.
  • Coinsurance: The percentage of the costs you pay for care once you’ve met your deductible.
  • Out-of-pocket maximum: The most you can expect to pay for care per year. Once you reach the maximum, your plan pays 100% of covered care costs.
     

• Review Your Current Coverage, Care Needs, and Budget: Check your existing health insurance plan to determine if it still meets your needs and budget. Are you comfortable with what you currently pay for out-of-pocket care costs? Does your plan provide enough coverage for the specific healthcare services you use the most? Marketplace plans for individuals and families offer flexibility, so that you can choose a coverage level that aligns with your unique care needs and budget. We encourage you to utilize the ACA Marketplace to weigh the benefits and costs of various insurance plans. In deciding, consider your expected healthcare needs and what you can manage for your monthly premium, deductible, copays, coinsurance, and prescriptions.
   

• Explore Your Options for Financial Help: The Marketplace was established to make health insurance accessible and more affordable for individuals and families who need coverage. The ACA offers financial help, also known as health insurance subsidies, to those who qualify. Subsidies are based on income, household size, and the cost of insurance plans in your area. If you’re eligible, you can lower your monthly premium with an advanced premium tax credit (APTC). And, if you enroll in a Silver plan, you may also be eligible for cost-sharing reductions (CSRs). These are extra savings that can help reduce your deductible, copays, coinsurance, and out-of-pocket maximum. Depending on your eligibility, you may qualify for both CSRs and advanced premium tax credits.
   

• Update Your Information: Ensure that your personal and financial details are up to date when enrolling in health coverage or making changes to your plan. By updating this information, you may find you are eligible for subsidies to help lower your out-of-pocket costs. If you currently receive financial help, updating your information is important to maintain your eligibility and continue receiving subsidies in 2025.
   

• Stay Informed on Enrollment Deadlines: Be familiar with your state’s Open Enrollment deadlines. While the 2025 Open Enrollment Period for most states is November 1, 2024 to January 15, 2025, some states have different enrollment dates.
   

• Explore Your Options for Additional Coverage: Dental and vision benefits are important to your overall health and wellness. Open Enrollment is a good time to consider choosing a health plan that includes dental and vision benefits.

Choosing your insurance plan  

What you pay versus what your insurer pays 

What happens if you miss open enrollment for health insurance?

Missing the Open Enrollment Period could limit your ability to purchase health insurance for the upcoming year. The exception would be if you experience a life event that qualifies you for a Special Enrollment Period (SEP). Qualifying events may include life changes such as marriage, divorce, or the birth or adoption of a child. Also included are loss of coverage if you become unemployed and lose your employer-sponsored insurance and changes in eligibility for government programs like Medicaid or the Children’s Health Insurance Program (CHIP). Most SEPs give you a 60-day window to find and enroll in health coverage, but the length may vary depending on your qualifying event and the state where you live.