Open Enrollment for Health Insurance 2025

Preparing for Open Enrollment 2025

Every fall, Open Enrollment is your primary opportunity to sign up for a health insurance plan or make changes to an existing plan for the upcoming year. During this period, you can review your current ACA health insurance coverage and re-enroll if it still meets your needs and budget. If you're new to the Marketplace, the ACA Marketplace allows you to compare the benefits and costs of different plans and choose coverage that works for you and your family.

Marketplace plans are available in four “metal” levels that each offer the same essential benefits, but differ in how you and your insurer share the overall cost for care.

• Bronze plans have the lowest monthly premium, but the highest deductible. With a Bronze plan, once you’ve met your deductible, you pay 40% for the cost of care, while your plan pays 60%. This metal level is best if you do not anticipate visiting your doctor beyond annual preventive care visits but want protection for unexpected care needs and emergencies.
• Silver plans have a higher monthly premium than Bronze plans, but a lower deductible. Once you’ve met your deductible, you can expect to pay 30% for the cost of care, while your plan pays 70%. If you enroll in a Silver plan and meet certain eligibility requirements, you may also be able to save on your out-of-pocket expenses through cost-sharing reductions: a form of health insurance subsidies that offer financial help to those who qualify.
• Gold plans have a higher monthly premium than Silver plans, but an even lower deductible. Gold plans are often well-suited for those who have routine medical care needs. With a Gold plan, once you’ve met your deductible, you’ll pay 20% for the cost of care, while your plan pays 80%.
  
• Platinum plans have the highest monthly premium with the lowest deductible. While not available in all areas, these may be a good option for those that require frequent medical care and want more predictable out-of-pocket costs. Once you’ve met your deductible, you pay 10% for the cost of care, while your plan pays 90%.
  

To determine the actual cost of your insurance plan, you will need to evaluate the specific monthly premium, annual deductible, copays, and out-of-pocket maximum for each the plans you’re considering. 

Saving on Health Insurance Costs in 2025

With the range of health insurance coverage available within each metal level, you have flexibility to choose a plan with cost-sharing options that fit your budget. Additionally, Marketplace plans offer access to health insurance subsidies that provide financial help to individuals and families who qualify. Eligibility is based on factors including income, household size, and the cost of ACA plans in your area.

ACA health insurance subsidies were established to remove barriers to affordable and quality healthcare by lowering or eliminating out-of-pocket costs for individuals and families. The ACA provides two types of subsidies: Advanced Premium Tax Credits (APTC) and Cost-Sharing Reductions (CSRs). 

• APTCs can be applied to your plan premium, reducing or eliminating the amount you pay monthly for health coverage. 
• CSRs are extra savings that help lower your plan deductible, copays, coinsurance, and out-of-pocket maximum. 

As previously mentioned, you must enroll in a Silver metal level plan to access CSRs. You may also be eligible for both the APTC and CSRs, which can help you save on your annual health plan costs. 

Marketplace Open Enrollment 2025 Dates for States We Serve

While Open Enrollment generally begins in November and ends in January, actual dates can vary by state. Below are the specific dates for Open Enrollment 2025 in the 14 states where Anthem offers Individual and Family Marketplace coverage.

Key Considerations for Open Enrollment 2025

There are a few important factors to consider when preparing to evaluate Individual and Family health insurance plans in 2025 during Open Enrollment.

• Know Your State’s Specific Open Enrollment Dates: While Open Enrollment for most states lasts from November 1 to January 15, several states have specific periods, so it is important to confirm your state’s enrollment dates.   
• Open Enrollment Deadline: If you don't choose a health plan by your state’s deadline, you won't be able to enroll in coverage for 2025 unless you qualify for a Special Enrollment Period (SEP).     
• Think About Your Healthcare Needs: When choosing insurance, think about your anticipated care needs, including doctor's visits, specialized support for ongoing conditions, and prescriptions. Also consider the care needs of any family members who will be on your plan. 
• Consider Additional Coverage: As you evaluate your healthcare needs, you may also want to consider additional aspects of your whole-person health, such as dental or vision care. Open Enrollment is a great time to consider a plan that includes dental or vision benefits or purchasing one or both as standalone plans.
• Update Your Information: As you review plans, update your and your family’s information, including your financial details. By doing so, you can reconfirm your eligibility for financial help and continue receiving health insurance subsidies that can help make coverage more affordable. If there have been any changes to your financial situation, updating this information can also help you discover if you are eligible for subsidies you had not previously qualified for.

What Happens if You Miss Open Enrollment 2025?

If you miss the 2025 Open Enrollment Period, you may not be able to purchase coverage for the year unless you qualify for a Special Enrollment Period (SEP). SEPs are triggered by a qualifying life event that requires a change in your current coverage.

Qualifying events may include life changes like marriage, divorce, the birth of a child, or adoption — or a loss in coverage, such as losing your job. You may also be eligible for an SEP if you no longer qualify for Medicaid or the Children’s Health Insurance Plan (CHIP). Most SEPs are 60 days in length, but may vary depending on your qualifying life event and the state you live in.