Priorityhealth

When is Open Enrollment for 2026 health plans and what are the key deadlines?

Open Enrollment for Individual & family plans - also known as the Affordable Care Act (ACA), Obamacare or the Health Insurance Marketplace ® - runs from Nov. 1, 2025 to Jan. 15, 2026 in most states.  If you enroll between Nov. 1 and Dec. 15, your coverage will start Jan. 1 If you enroll between Dec. 16 and Jan. 15, your coverage will start Feb. 1

What’s the Medicare Annual Enrollment (AEP) window?

Every year, people with Medicare can change Medicare Advantage (Part C) or Part D drug plans Oct 15–Dec 7 for the following year. Changes generally take effect Jan 1.

Is there another Medicare change window after January 1?

Yes. The Medicare Advantage Open Enrollment Period (MA-OEP) runs Jan 1–Mar 31 . If you’re in an MA plan, you can switch to a different MA plan or return to Original Medicare and join a Part D plan; new coverage begins the first day of the month after your request. 

How do I choose the right health plan (HMO vs PPO vs EPO vs HDHP/HSA)?

Think about your provider network needs , prescriptions and how much care you use. HMO : lower premiums, in-network only (referrals often required). PPO : broader access, out-of-network coverage at higher cost. EPO : HMO-like (no out-of-network except emergencies), usually no referrals.

Deductible vs copay vs coinsurance vs out-of-pocket max—what do these mean?

Deductible : what you pay before the plan starts paying (except many $0 preventive services). Copay : a flat fee per service or drug. Coinsurance : a percentage you pay after the deductible. Out-of-Pocket Maximum (MOOP) : the cap on your spending in a year for in-network covered services; the plan pays 100% after you hit it.

What are “metal tiers” (Bronze, Silver, Gold, Platinum)?

Metal tiers reflect how you and your plan share costs, not the quality of care. Bronze generally means lower monthly premiums but higher out-of-pocket costs when you receive care. Silver generally means moderate monthly premium s and moderate out-of-pocket costs when you receive care. Gold generally means higher monthly premiums but lower out-of-pocket costs when you receive care.