Open Enrollment Guide
Know exactly when you can enroll, what you can change, and how to make the most of your enrollment window — for Medicare and ACA plans.
2025–2026 Key Dates at a Glance
ACA Marketplace
ACA / Marketplace Open Enrollment
When Is It?
- November 1 – January 15 (federal marketplace)
- Enroll by December 15 → coverage starts January 1
- Enroll January 1–15 → coverage starts February 1
- New Jersey: extended through January 31
What Can You Change?
- Switch to a different plan or metal tier
- Add or remove dependents
- Update your income to recalculate subsidies
- Re-enroll if you missed last year
- Change from off-marketplace to on-marketplace plan
How to Prepare
- Estimate your 2026 household income
- List all medications you take regularly
- Check if your doctors are in-network
- Compare premium vs. out-of-pocket costs
- Have your Social Security numbers ready
New Jersey residents: NJ has its own state marketplace (GetCoveredNJ) with its own rules and often extended deadlines. NJ also provides additional state subsidies on top of federal tax credits. Our agents are licensed in NJ and can help you navigate both federal and state options.
Medicare
Medicare Enrollment Periods
Initial Enrollment Period (IEP)
Your first chance to enroll in Medicare Parts A and B. Enrolling before your birthday month means coverage starts the first of your birthday month. Enrolling late can result in a permanent premium penalty.
- Enroll in Part A (hospital) and Part B (medical)
- Sign up for a Medicare Advantage (Part C) plan
- Add Part D (prescription drug) coverage
Annual Enrollment Period (AEP)
The main window each year for Medicare beneficiaries to make changes to their coverage. Changes take effect January 1 of the following year.
- Switch from Original Medicare to Medicare Advantage (or back)
- Change your Medicare Advantage plan
- Join, drop, or switch Medicare Part D plans
Medicare Advantage Open Enrollment Period (OEP)
If you're already enrolled in a Medicare Advantage plan, you can make one change during this window.
- Switch to a different Medicare Advantage plan
- Drop your Medicare Advantage plan and return to Original Medicare (and add Part D)
- Cannot be used to switch from Original Medicare to Medicare Advantage
Special Enrollment Period (SEP)
Certain life events trigger a Special Enrollment Period outside normal windows. You typically have 60–63 days from the event to act.
- Moving to a new address or out of your plan's service area
- Losing employer or union coverage
- Becoming eligible for Medicaid or Extra Help
- Your plan loses its Medicare contract or leaves your area
- Entering or leaving a nursing home or assisted living
General Enrollment Period (GEP)
If you missed your Initial Enrollment Period and don't qualify for an SEP, the GEP lets you enroll in Part A and/or Part B. Coverage starts July 1. You may face a permanent late enrollment penalty.
- Enroll in Medicare Part A and/or Part B
- A 10% Part B premium surcharge applies for each 12-month period you delayed
- Coverage begins July 1 of that year
Tips for a Smooth Enrollment
Start early
Don't wait until the last week. Plans can fill up or have technical issues near deadlines.
Review annually
Plans change every year — premiums, networks, and formularies all update. What was best last year may not be best this year.
Verify your doctors
Always confirm your preferred doctors and specialists are in-network for the plan you're considering.
Check your medications
Look up your exact drug names and dosages on the plan's formulary before enrolling.
Understand your subsidies
Report income changes promptly to avoid owing money back at tax time or missing out on additional help.
Work with an agent
Licensed agents compare plans across many carriers at no cost to you and can help you avoid costly mistakes.
Ready to enroll?
Our licensed NJ agents can walk you through your options and enroll you — free of charge.