Open enrollment runs November 1 - January 15. Here's your step-by-step guide to getting it right.

Important Dates

Open Enrollment Period:

  • Starts: November 1, 2025
  • Ends: January 15, 2026
  • Deadline for Jan 1 coverage: December 15

30 Days Before (October)

Preparation Checklist

  • ✓ Review last year's health expenses
  • ✓ Calculate total healthcare spending
  • ✓ Estimate next year's income (conservatively)
  • ✓ Use FreelancerHealth calculator for real monthly cost
  • ✓ Research plan options in your marketplace
  • ✓ Make shortlist of 3-5 potential plans

How to Estimate Income

Method 1: Use this year's actual (project Oct-Dec)
Method 2: Average last 2 years, adjust for growth
Method 3: Conservative projection (slightly high is safer)

⚠️ Critical: Be realistic. Too low = owe money at tax time. Calculate your accurate projection.

During Open Enrollment (Nov-Jan)

✅ Compare Silver Plans First

Why Silver? Benchmark for subsidies. If income under 250% FPL, Cost-Sharing Reductions (CSR) ONLY apply to Silver plans.

CSR Benefits: 100-150% FPL: Plan pays ~94% | 150-200% FPL: ~87% | 200-250% FPL: ~73%

✅ Check Provider Networks

Network Verification

  • ✓ Primary care doctor in-network?
  • ✓ Specialists in-network?
  • ✓ Preferred hospital in-network?
  • ✓ Prescriptions covered (check tier)?
  • ✓ Call doctor's office to confirm

✅ Calculate Total Annual Cost

Don't just compare premiums. Use our calculator to see your real monthly cost after tax impacts.

✅ Enroll by December 15

After Enrollment (Jan-Dec)

Year-Round Actions

  • ✓ Save 1095-A form when it arrives (Feb/March)
  • ✓ Set quarterly income review reminders
  • ✓ Report income changes as needed
  • ✓ Save 10% of APTC monthly as buffer
  • ✓ Schedule preventive care (free!)

Special Enrollment Periods

You can enroll OUTSIDE open enrollment if you have a qualifying life event:

Time limit: 60 days from event

The Premium vs. Deductible Trade-Off

Bronze (Low Premium, High Deductible)

Best for: Healthy people who rarely see doctors
Watch out: One accident = massive out-of-pocket

Silver (Balanced)

Best for: Most freelancers, occasional visits
Sweet spot: CSR benefits if income under 250% FPL

Gold/Platinum (High Premium, Low Deductible)

Best for: Chronic conditions, ongoing care
Trade-off: Higher monthly cost but predictable

Pro Tips

Don't Miss These

  • CSR eligibility: Income under 250% FPL? MUST get Silver
  • HSA for high earners: Over 400% FPL? Consider HDHP + HSA
  • FreelancerHealth first: Calculate real cost before enrolling
  • Preventive care: Annual physical, screenings = 100% free
  • Dental/vision separate: Not included in ACA plans

Common Mistakes to Avoid

❌ Waiting until January 15 (coverage starts Feb 1, not Jan 1)
❌ Only comparing premiums (ignoring deductibles)
❌ Overestimating income "to be safe" (pay more than needed)
❌ Not checking provider networks (stuck with wrong plan)
❌ Forgetting CSRs (miss thousands in extra value)

Your 4-Week Action Plan

Week 1 (October)

Week 2 (November)

  • Check provider networks
  • Review prescription coverage
  • Compare total annual costs

Week 3 (December 1-15)

Week 4 (January)

  • Receive insurance cards
  • Set quarterly reminders
  • Schedule preventive care

Calculate Before You Enroll

Know your real monthly cost before making a decision.

Get My Real Cost

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