Looking Ahead: A Guide to Open Enrollment 2026

It's that time of year again—the season when our thoughts turn to planning for the year ahead. For many of us, that planning includes one of the most important decisions we make for our families: our health insurance.

If you get your coverage through the Affordable Care Act (ACA) Marketplace—which you might know as HealthCare.gov or your state’s exchange—your key window for making these decisions, Open Enrollment, is just around the corner. For 2026 coverage in most states, it begins on November 1, 2025.

This period is your dedicated time to enroll in a new plan, renew your current one, or switch to a plan that better fits your needs. Missing this window can mean being locked out of coverage for the year. Because this window is so important, we wanted to reach out.

This year, it’s especially wise to be prepared. Some significant changes are coming for 2026, so waiting until the last minute might create unnecessary stress.

Let's walk through what to expect.

What’s Changing for 2026 Coverage?

As we look toward 2026, it's clear that the health insurance landscape is shifting. It’s helpful to be aware of these changes now, as they will likely impact your costs, your eligibility, and even the process of signing up.

1. Tax Credits and Costs May Shift

This is perhaps the most significant change, and the one most likely to affect your budget.

The enhanced premium tax credits that have helped lower monthly bills for many families since the pandemic are currently set to expire at the end of 2025 (unless Congress takes action to renew them).

This means that even if you love your plan and change nothing about it, your out-of-pocket premium could go up. We're also seeing proposed premium increases in general as the cost of care rises.

On top of that, new federal rules are adjusting the maximum out-of-pocket (OOP) limit you could face. For 2026, the highest allowable OOP for an individual plan will be about $10,600.

We know any talk of rising costs can be stressful. The best thing we can do is go into this period with our eyes open and a plan to budget for these potential new costs.

2. Enrollment & Eligibility Rules Are Tightening

It's not just about cost; the “rules of the road” for enrollment are changing, too. The old “set it and forget it” approach to renewal may no longer be the safest bet.

Here’s what we're watching:

• Heads-up on $0-Premium Plans: If you currently have a plan with a $0 premium (because your tax credit covers the full amount), simply letting it auto-renew might not work as it has in the past. New rules may require you to actively log in and verify your eligibility to keep that $0 premium. Otherwise, you might see a minimum $5/month charge.

• Documentation is Key: We're seeing a trend toward stricter eligibility verification. This means you'll want to be ready with your proof of income, tax information (like Form 8962), and other documents to qualify for your tax credits.

• Future Timelines: While the 2026 window will likely still run until January 15, please be aware that there is talk of shortening these enrollment periods in future years.

• Special Enrollment: The rules around Special Enrollment Periods (SEPs) and how tax credits apply to them may also be adjusted.

How We're Here to Help (And Your Game Plan for This Year)

We know that reading about these changes can feel unsettling, and we want you to know that you are not in this alone.

Our team has been closely monitoring these developments for months. We've been working hard behind the scenes to find and secure affordable, high-quality plan options for you to choose from. We've also been making enhancements to our enrollment platform and support systems to ensure your experience is as simple, clear, and supportive as possible. We are fully committed to helping you navigate this new landscape and find the very best fit for your family.

Taking an active, thoughtful role is the key this year. With all of this in mind, here's the game plan we recommend as you prepare:

• Review Your Household Situation: Take a moment to think about 2026. Has your income changed? Will your household size be different? Getting this projection right is the key to receiving the correct premium tax credit amount (and avoiding a surprise at tax time).

• Embrace the “Shopping” Process: Even if you've been happy with your plan, it is essential to shop around this year. Your current plan's costs, networks, and benefits might change significantly. A different plan—even from the same carrier—could be a much better fit for your 2026 budget and health needs.

• Gather Your Paperwork: To make enrollment smoother, take a few minutes now to gather your key documents. Think tax returns, W-2s, 1099s, and any proof of recent income.

• Please, Don't Wait: We can't stress this enough. With potential cost increases and new rules, starting early gives you time to think, compare, and make a clear-headed decision without feeling rushed.

• Budget with Awareness: If you receive a premium tax credit now, it's wise to plan as if it might be smaller next year. We hope that's not the case, but it's always better to be prepared.

Why Are These Changes Happening?

It's natural to wonder why all this is changing. It's really a combination of multiple factors.

Those enhanced tax credits were largely temporary measures, and that additional support is winding down. We're also seeing a regulatory shift toward ensuring market stability and verifying that tax credits are distributed correctly. And, of course, the underlying costs of healthcare continue to rise, which puts pressure on premiums.

Our Thoughts as We Head into Enrollment

Here's the bottom line for your 2026 ACA Marketplace planning:

• Mark your calendar: Open Enrollment begins November 1, 2025.

• Be prepared for change: This is not the year to auto-renew without looking. Expect to see different costs and rules.

• Be proactive: A little preparation now—reviewing your income, gathering documents, and thinking about your budget—will make a world of difference.