Open enrollment is the annual window to enroll in or change health coverage for the coming year. Your deadline depends on where you get insurance. If you use the federal Health Insurance Marketplace, enrollment for 2027 coverage begins November 1, 2026. If you have coverage through work, ask your employer for its dates. This guide covers the deadlines, what to compare, and how to think about an HSA during enrollment.
What Is Open Enrollment?
Open enrollment is the annual period when you can enroll in, switch, or cancel health insurance and other benefits. Outside this window, you can only make changes if a qualifying life event gives you a Special Enrollment Period.
During open enrollment, you can:
Enroll in a health plan for the first time
Switch plan types, such as moving from a PPO to a high deductible health plan (HDHP)
Add or remove a spouse or dependents
Enroll in or change dental, vision, and other add-on coverage
Set how much to contribute to a health savings account (HSA) or flexible spending account (FSA)
The choices you make generally stay in place for the full plan year. That makes open enrollment your one reliable chance each year to match your coverage to your health needs and your budget.
When are the open enrollment dates for 2027?
Open enrollment dates for 2027 depend on where your coverage comes from. The table below shows each window and the date you need to enroll by for coverage starting January 1, as of September 2026.
Coverage type | 2027 open enrollment window | Enroll by this date for January 1 coverage |
|---|---|---|
Marketplace plans (HealthCare.gov states) | November 1, 2026 to January 15, 2027 | December 15, 2026 |
State-run Marketplaces | Set by each state | Set by each state |
Employer-sponsored plans | Set by each employer, usually in the fall | Set by each employer |
Medicare | October 15 to December 7, 2026 | December 7, 2026 |
Medicaid and CHIP | Open all year | Not tied to open enrollment |
For Marketplace plans, December 15, 2026 is the deadline that matters most if you need coverage on January 1. Plans you pick between December 16 and January 15 start February 1, 2027, and Marketplace coverage starts once you pay your first premium.
A federal rule would have ended the HealthCare.gov window on December 15 starting with 2027 coverage. A federal court vacated that change in June 2026, and CMS confirmed the November 1 to January 15 schedule in August 2026. State-run Marketplaces set their own calendars, so check your state's Marketplace site if you do not use HealthCare.gov.
Employers choose their own open enrollment dates, and most with a January 1 plan year hold them in the fall. Your HR team or benefits portal lists your exact deadline.
Who can enroll during open enrollment?
Anyone eligible for employer coverage or Marketplace coverage can enroll or make changes during open enrollment. That includes:
Employees offered health benefits through work
Spouses and dependents who can be added to an employer or Marketplace plan
People who buy their own coverage through HealthCare.gov or a state-run Marketplace
Medicaid and CHIP follow a different rule: you can apply and enroll any time of year. Medicare has its own open enrollment from October 15 to December 7, and people with Medicare cannot use the Marketplace to buy a health plan.
What Happens If You Miss Open Enrollment?
If you miss open enrollment, you generally have to wait until next year's window to change your coverage, unless you qualify for a Special Enrollment Period. For an employer plan, that usually means keeping your current elections for the full plan year, or going without employer coverage if you did not enroll.
Some plans renew automatically if you take no action, but premiums, provider networks, and covered drugs can change from one year to the next. Reading your renewal notice before your deadline is the simplest way to catch those changes.
What Is a Special Enrollment Period (SEP)?
A Special Enrollment Period (SEP) lets you enroll in or change health coverage outside open enrollment after a qualifying life event. You may need to show proof of the event when you apply.
Common qualifying life events include:
Losing other health coverage, such as a job-based plan
Getting married
Having a baby or adopting a child
Moving to a new ZIP code or county
Becoming a U.S. citizen
A change in income or household size that affects your eligibility for Marketplace savings (Marketplace plans only)
How long you have to enroll depends on your coverage. For Marketplace plans, you usually have 60 days before or 60 days after the event, depending on the type of event. Employer plans must give you at least 30 days. The HealthCare.gov Special Enrollment Period page lists every qualifying event.
Without a qualifying life event, your next chance to change coverage is the following open enrollment.
What Benefits Can You Choose During Open Enrollment?
Open enrollment covers your full benefits package, from your medical plan to the accounts you use to pay for care. The medical plan you choose also decides which accounts you can use.
Choosing a medical plan
Most employers and Marketplaces offer some mix of PPO, HMO, and high deductible health plans (HDHPs). The core trade-off is a lower monthly premium with a higher deductible, or a higher premium with more predictable costs when you get care. Only a plan that qualifies as an HDHP, or a Marketplace Bronze or Catastrophic plan, lets you contribute to an HSA.
Dental and vision coverage
Dental and vision plans are usually separate elections with their own premiums. Depending on the plan, they cover cleanings and eye exams, plus part of the cost of fillings, glasses, contacts, or orthodontics.
How does an HSA fit into open enrollment?
Open enrollment is when you choose whether an HSA fits your 2027 coverage, since only an HSA-compatible health plan lets you contribute. Each health spending account pairs with different plans, and the choices you make at enrollment determine which ones you can use in 2027. The table below shows what each account works with and what you decide during open enrollment.
Account | Works with | What you decide at open enrollment | Learn more |
|---|---|---|---|
HSA (Health Savings Account) | An HSA-compatible plan, with no disqualifying coverage such as a general-purpose health FSA | Whether to set up payroll contributions for 2027, and how much | |
General-purpose health FSA | Any health plan your employer offers; blocks HSA contributions | How much to elect for the 2027 plan year | |
Limited-purpose FSA | Works alongside an HSA; covers dental and vision expenses | How much to elect for the 2027 plan year | |
LSA (Lifestyle Spending Account) | Any health plan; funded by your employer | Check the amount your employer provides and what it covers |
If you choose an HSA-compatible plan, a general-purpose health FSA in the same year makes you ineligible to contribute to an HSA, including a spouse's FSA that covers you. A limited-purpose FSA does not affect HSA eligibility. IRS Publication 969 explains the rules.
Choosing an HSA-compatible plan, electing payroll HSA contributions, and opening an HSA are three separate steps. Your employer's enrollment form handles the first two, and you can open an HSA inside or outside open enrollment. If an HSA fits your 2027 coverage, you can open a Lively HSA once you are enrolled in an HSA-compatible plan.
Other workplace benefits
Some employers also offer commuter benefits, life insurance, disability insurance, and wellness programs during open enrollment. Review each one, since most are elected once a year alongside your medical plan.
How do you prepare for open enrollment?
The most useful preparation is estimating what you will spend on care next year, then comparing each plan's total yearly cost. Total cost is your premiums plus what you expect to pay in deductibles, copays, and coinsurance.
Run that comparison twice: once for a routine year and once for a year with a large medical bill. The plan with the lowest premium can cost the most in the second scenario, so seeing both totals shows how much risk each plan leaves with you.
Answering these questions before you open your enrollment form makes the comparison faster:
How often did I, or my family, use care this year, and will that change in 2027?
Could I pay this plan's deductible if a large bill came up early in the year?
Are my doctors and prescriptions covered in 2027?
Does my employer contribute to an HSA, and how much?
Do I, or does my spouse, have a general-purpose health FSA that would block HSA contributions?
If my coverage starts or ends partway through 2027, how does that change what I can contribute?
Do I expect a life change in 2027, such as marriage, a new child, or retirement?
Your answers point to the plan structure that fits: lower premiums with a higher deductible, or higher premiums with more predictable costs.
Open enrollment checklist
Use this checklist before you submit your 2027 elections. Each step catches a change that automatic renewal can leave in place without notice.
Read your renewal notice or plan summary for 2027 premiums, deductibles, and copays.
Estimate your 2027 care, including prescriptions and planned visits.
Compare each plan's total yearly cost for a routine year and a high-cost year.
Confirm your doctors, specialists, and hospitals are in-network for 2027.
Check that your prescriptions are on the plan's 2027 drug list, called a formulary.
Set your 2027 HSA or FSA contribution, and confirm a general-purpose FSA will not block your HSA.
Add or remove a spouse or dependents.
Mark your enrollment deadline, and December 15 if you use HealthCare.gov.
Save your confirmation after you submit.
Finishing these steps before your deadline gives you time to ask HR, your broker, or your insurer about anything that looks different from this year.
Key Terms to Know for Open Enrollment
These are the terms you will see most often on plan summaries and enrollment forms. Knowing them makes it easier to compare plans side by side.
Premium: The amount you pay each month to keep your coverage, whether or not you use care.
Deductible: The amount you pay for covered care before your plan starts paying its share. Plans with lower premiums usually have higher deductibles.
Copay: A fixed amount for a covered service, such as $25 for a doctor visit. Your plan decides whether copays apply before or after the deductible.
Coinsurance: Your percentage share of covered costs after you meet the deductible. For example, you pay 20% and your plan pays 80%.
Out-of-pocket maximum: The most you pay for covered, in-network care in a plan year. After you reach it, your plan pays 100% of covered, in-network costs for the rest of the year.
In-network: Providers that have a contract with your plan. Out-of-network care usually costs more, and some plans do not cover it at all.
Qualified medical expense: A cost the IRS allows you to pay tax-free with HSA or FSA funds, such as doctor visits and prescriptions. IRS Publication 502 lists them.
Qualifying life event: A change such as marriage, a birth, a move, or losing coverage that lets you enroll outside open enrollment.
With these terms, a plan summary becomes a direct comparison of what each plan costs you.
Open Enrollment for Individuals
For individuals, open enrollment is the main opportunity each year to update or switch health coverage. Even if you are satisfied with your current plan, reviewing your options is important. Premiums, provider networks, and drug formularies can all change, and if you let your plan automatically renew, you may face higher costs or lose access to your preferred doctor or medications without realizing it.
Marketplace enrollees should also confirm their eligibility for subsidies, which are based on income and household size. Updating your information each year ensures you receive the right amount of financial assistance. Subsidies can significantly reduce monthly premiums and out-of-pocket costs, making coverage more affordable.
Open enrollment is also the time to think about long-term planning. If you are healthy and rarely use care, a High Deductible Health Plan paired with a Health Savings Account (HSA) may lower costs while allowing you to save tax-free for the future.
In 2026, the One Big Beautiful Bill (OBBB) expanded HSA eligibility to certain ACA Bronze and Catastrophic plans. If you expect to consider one of these plans, reviewing your options now will help you prepare for new opportunities next year. Our OBBB HSA Guide explains what’s changing and how to plan ahead.
Open Enrollment for Employers
Employers play a central role in ensuring their teams understand and value the benefits available to them. A thoughtful open enrollment strategy not only boosts employee engagement but can also reduce administrative headaches and long-term healthcare costs. Employers should focus on clear communication, proactive planning, and highlighting the value of benefits like HSAs and FSAs.
Key strategies include:
Plan communications early (3–4 months in advance) so employees have time to ask questions and compare options.
Host webinars or in-person sessions to walk through plan details and answer questions directly.
Provide comparison tools and cost calculators that make it easier for employees to see the trade-offs between PPOs, HDHPs, and other plan types.
Promote cost-saving accounts like HSAs and FSAs to improve employees’ financial wellness. HSAs in particular offer long-term tax advantages and can reduce both employee and employer healthcare spending.
Employers also benefit directly: contributions made to employee HSAs are exempt from payroll taxes, lowering overall costs while helping employees save for future healthcare needs.
Open Enrollment for Brokers
Brokers serve as trusted advisors to employers, helping them balance cost management with employee satisfaction. Open enrollment is a critical moment to reinforce that value by providing timely insights, strategic guidance, and communication support.
Best practices for brokers include:
Review plan performance from the prior year to highlight cost trends, employee utilization, and opportunities for adjustment.
Stay updated on legislative or insurance changes, such as the OBBB expansion of HSA eligibility in 2026, so employers remain compliant and competitive.
Equip HR teams with communication templates, guides, and FAQs to simplify employee education.
Support benefits fairs (virtual or in-person) to drive awareness and provide employees with direct access to experts who can answer their questions.
By preparing early and offering hands-on support, brokers can deepen client relationships, differentiate their services, and position themselves as long-term strategic partners during open enrollment and beyond.
Making the Most of Open Enrollment
Open enrollment may seem complicated, but it doesn’t have to be. With the right questions and preparation, you can make confident choices that protect both your health and your wallet.
By approaching enrollment with a clear sense of your healthcare needs, financial priorities, and long-term goals, you can select benefits that truly fit your life. Whether that means exploring an HSA for tax savings, adjusting coverage for your family, or simply confirming your current plan still works, thoughtful preparation pays off.
With the right plan in place, you’ll have more confidence, fewer surprises, and benefits that help protect both your health and your budget in the year to come.
Disclaimer: the content presented in this article are for informational purposes only, and is not, and must not be considered tax, investment, legal, accounting or financial planning advice, nor a recommendation as to a specific course of action. Investors should consult all available information, including fund prospectuses, and consult with appropriate tax, investment, accounting, legal, and accounting professionals, as appropriate, before making any investment or utilizing any financial planning strategy.