Factors to sign up for ACA health insurance by December 15
Open enrollment for 2025 individual/family health and wellness insurance coverage began on November 1. The enrollment window continues until at least January 15 in nearly every state. (Idaho will finish its open enrollment period on December 15, but Idaho also started early, allowing individuals to sign up starting in mid-October.)
For many years, open enrollment ended in mid-December, so the extended open enrollment period provides individuals some extra flexibility during the busy holiday season. However, for many people, December 15 is still the soft target date you’ll want to keep in mind. In most states, that’s the last day you can sign up for coverage that will start on January 1. This is important for several reasons:
- Currently without insurance? Delaying your registration means no coverage in January.
If you’re not currently enrolled in ACA-compliant coverage in 2024, the current open enrollment period is your chance to change that for 2025.
But if you wait until the last minute to sign up, you won’t have coverage in place when the new year starts. Instead, you’ll be waiting until at least February 1 for your coverage to begin.
- Currently without insurance or enrolled in a non-marketplace plan? Delayed enrollment may mean missing out on free money.
If you considered marketplace coverage in the past and found it unaffordable, you may currently be uninsured or enrolled in a plan that isn’t regulated by the ACA. Or, you might have opted to get ACA-compliant coverage outside the exchange if you weren’t eligible for premium tax credits (subsidies) the last time you looked.
Thanks to the American Rescue Plan, many individuals who weren’t eligible for subsidies in previous years will now find that they are. These subsidy improvements have been extended through 2025 by the Inflation Reduction Act, so they remain available. Those subsidies are only available if you’re enrolled in a marketplace/exchange plan, and the current open enrollment period is your chance to switch to a marketplace plan.
In addition to being more widely available, premium subsidies are also larger than they were before the American Rescue Plan. People who didn’t enroll in the past due to cost may find that coverage now fits their budget.
Four out of five people seeking coverage in the 33 states that use the federally-run marketplace (HealthCare.gov) will find that they can get coverage for $10/month or less. And millions of uninsured Americans are eligible for premium-free coverage in the marketplace, but they may not realize this.
Waiting until the last minute to enroll in coverage means you’ll miss out on that financial support for January. You can use our aid calculator to estimate how much your aid will be for 2025. Then, make sure you enroll by December 15 so you’re eligible to claim that aid for all 12 months of the year.
- Letting your plan auto-renew? You could be in for a surprise.
If you currently have coverage through the marketplace in 2024 and are planning to let it auto-renew for 2025, you may wake up on January 1 with coverage and a premium that aren’t what you expected.
Even if you’re completely satisfied with your current plan, you owe it to yourself to spend at least a little time checking out the available options before December 15. The premium your insurance company charges is likely changing for 2025, and your subsidy amount could also change, especially if there are new insurers joining the marketplace in your area (many states have new insurers for 2024, and some insurers are leaving).
Your insurer may also be making changes to your benefits, provider network, or covered medication list—or even discontinuing your plan and replacing it with a new one. Essentially, the plan and cost you have on January 1 could be quite different from what you have now.
This is part of why HHS decided to extend the open enrollment period as of 2024—giving people a chance for a “do-over” if their auto-renewed plan isn’t what they expected. In almost every state, you’ll have until at least January 15 to choose a new plan. But that plan choice won’t be retroactive to January 1 if you enroll in the last couple of weeks of open enrollment.
- Out-of-pocket expenses won’t transfer in February or March.
What if you’re enrolled in a marketplace plan in 2024, let it auto-renew for 2025, and then decide after December 15 that you’d rather have a different plan? Thanks to the extended open enrollment period, you can make that change, and your new plan will take effect in February (or possibly March, if you’re in one of the state-run exchanges with the latest registration deadlines).
However, it’s important to know that you’ll be starting fresh with a new plan in February or March. This means your out-of-pocket costs, which count toward your deductible and out-of-pocket maximum, will reset to $0, even if you’ve already incurred some out-of-pocket expenses in January.
Out-of-pocket costs reset to $0 on January 1 for all marketplace plans, so your auto-renewed policy will start over with a new deductible then. But if you need treatment in January (and have associated out-of-pocket expenses) before your new plan starts in February, you might face higher out-of-pocket exposure for the entire year than you would have if you had chosen your new plan by December 15 and had it start on January 1.
All of this is a reminder that while most enrollees have until at least mid-January to sign up for 2025 coverage, it’s in your best interest to finalize your plan choice by December 15.