Open Enrollment Period
The Open Enrollment Period (OEP) is the annual window during which you can sign up for, change, or cancel a health insurance plan through the Marketplace. For 2026 coverage, Open Enrollment runs from November 1, 2025 through January 15, 2026 on HealthCare.gov (some states have different deadlines).
If you miss Open Enrollment, you generally must wait until the next annual period — unless you qualify for a Special Enrollment Period. It's essential to review your plan every year, as premiums, networks, and benefits can change.
Tip: Even if you're happy with your current plan, compare options each year. A better plan at a lower cost may be available, and your tax credit amount changes annually based on income and plan pricing.
Special Enrollment Period (SEP)
A Special Enrollment Period allows you to enroll in or change your health coverage outside of Open Enrollment if you've had a qualifying life event. You generally have 60 days from the qualifying event to enroll.
Common qualifying events include:
- Loss of job-based health coverage
- Getting married or divorced
- Having or adopting a child
- Moving to a new coverage area
- Gaining citizenship or lawful presence
- Losing Medicaid or CHIP coverage
- Changes in income affecting Medicaid eligibility
We are currently in a Special Enrollment Period. Contact a licensed broker to confirm if you qualify and to start your enrollment.
Advance Premium Tax Credits (APTC)
If your household income is between 100% and 400% of the Federal Poverty Level (FPL), you may qualify for a Premium Tax Credit — also called an Advance Premium Tax Credit (APTC). This credit reduces your monthly premium, sometimes to $0.
For 2026, the income ranges for a single individual are approximately:
- 100% FPL: ~$15,060/year
- 200% FPL: ~$30,120/year
- 400% FPL: ~$60,240/year
The American Rescue Plan (extended through 2025) also expanded eligibility so that people with incomes above 400% FPL can still receive credits if their premiums would otherwise exceed 8.5% of their income. Our advisors calculate your exact credit eligibility at no charge.
Understanding Metal Levels
Marketplace plans are categorized into four "metal" tiers — Bronze, Silver, Gold, and Platinum — based on how costs are split between you and the insurance company. These tiers have nothing to do with the quality of care.
- Platinum: You pay ~10% of costs. High monthly premiums, lowest out-of-pocket. Best for frequent health care users.
- Gold: You pay ~20% of costs. Good balance for moderate use.
- Silver: You pay ~30% of costs. Eligible for Cost Sharing Reductions (CSR) if income qualifies — often the best value for those with mid-range incomes.
- Bronze: You pay ~40% of costs. Lowest monthly premiums. Best if you're generally healthy and want protection against major events.
- Catastrophic: Very low premiums, very high deductibles. Available to people under 30 or with qualifying hardship exemptions.
IRS Form 1095-A
If you enrolled in a Marketplace plan, you will receive Form 1095-A — your Health Insurance Marketplace Statement. This is sent by the Marketplace (not your insurance company) and is required for filing your federal tax return if you received any APTC.
Form 1095-A is typically available in your HealthCare.gov account and mailed by January 31 each year. You'll use it to complete IRS Form 8962, which reconciles your tax credit with your actual income.
Missing or incorrect 1095-A? Submit a request and we'll locate your form within 1 business day.
Medicare Information
Medicare is the federal health insurance program for people 65 or older, and for some younger people with disabilities or specific conditions. It consists of several parts:
- Part A: Hospital insurance (inpatient care, skilled nursing, hospice)
- Part B: Medical insurance (outpatient services, preventive care, doctor visits)
- Part C (Medicare Advantage): Private plans that bundle Parts A and B, often with extra benefits
- Part D: Prescription drug coverage
- Medicare Supplement (Medigap): Plans that help cover gaps in Original Medicare
Our licensed advisors can help you compare Medicare Advantage and Supplement plans available in your area. We represent multiple carriers and provide unbiased guidance at no cost. Contact Medicare.gov or call 1-800-MEDICARE for information on all Medicare options.
Frequently Asked Questions
Is your service really free?
Yes. Our advisory and enrollment services are completely free to you. We are licensed insurance brokers compensated directly by insurance carriers when you enroll in a plan through us. You never pay a fee, surcharge, or markup of any kind.
Do you work with all insurance carriers?
We have access to plans from all major insurance carriers available in your area through both the federal Marketplace and private (off-exchange) markets. Our advisors are not incentivized to recommend any single carrier.
Can I keep my current doctor?
This depends on the plan's network. During your consultation, we will verify that your preferred doctors and specialists participate in the plans we recommend before enrollment. This is a standard part of our advisory process.
What if I need to change my plan after enrolling?
You may change plans during Open Enrollment each year. Changes outside Open Enrollment require a qualifying life event. Your dedicated broker will guide you through any mid-year changes and is available year-round for assistance.
What is the difference between an HMO and a PPO?
HMO (Health Maintenance Organization) plans generally require you to use in-network providers and get referrals to see specialists. They typically have lower premiums. PPO (Preferred Provider Organization) plans offer more flexibility — you can see any provider without a referral — but usually cost more. Our advisors help you weigh these tradeoffs based on your specific health needs.