Affordable Care Act Open Enrollment for 2025: What You Need to Know

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The Patient Protection and Affordable Care Act is a 2010 health-reform law better known as the Affordable Care Act, ACA, and, often, Obamacare.

The comprehensive ACA law has three main goals:

• Make affordable health insurance available to more people

• Expand the Medicaid program

• Support medical care delivery that reduces costs

You can apply for marketplace health insurance or renew your coverage during the open enrollment period. The national marketplace website, HealthCare.gov, and most state marketplaces began accepting applications for 2025 health coverage on November 1, 2024.

For coverage beginning January 1, 2025, you must enroll in a health insurance plan by December 18, 2024. In most states, you can sign up for a plan until January 15, 2025, but the deadlines are sometimes later or earlier.

If you enroll after December 18, 2024, your coverage may not begin until February 1, 2025, or later.

Why is it important to sign up for ACA coverage by December 18, 2024?

If you want coverage to begin on January 1, 2025, it is important to enroll in a health insurance plan by December 18, 2024. If you enroll after that date, your coverage may not begin until February 1, 2025, or later.

In most states, you must enroll by January 15, 2025, to have coverage any time in 2025. Otherwise, your only other access to health insurance through the ACA would be during a special enrollment period.

What is the deadline for ACA enrollment?

The enrollment deadline for 2025 coverage depends on where you live in the U.S. Generally, you must enroll by January 15, 2025.

Some states and Washington, D.C. have extended the 2025 open enrollment period beyond the HealthCare.gov window. Extended open enrollment deadlines for 2025 coverage are:

• California: January 31, 2025

• Massachusetts: January 23, 2025

• New Jersey: January 31, 2025

• New York: January 31, 2025

• Rhode Island: January 31, 2025

• Washington, D.C.: January 31, 2025

One state has a different open enrollment window for the 2025 coverage year:

• Idaho: October 15, 2024 to December 16, 2024

Where can you find the specific open enrollment period for your state?

Specific open enrollment periods can be found on the marketplace in your state or via HealthCare.gov. People in U.S. territories can enroll only if they qualify as residents of Washington, D.C. or one of the states.

If you live in Washington, D.C. or any of the following 19 states, you will enroll through a state marketplace:

• California

• Colorado

• Connecticut

• Georgia

• Idaho

• Kentucky

• Maine

• Maryland

• Massachusetts

• Minnesota

• Nevada

• New Jersey

• New Mexico

• New York

• Pennsylvania

• Rhode Island

• Vermont

• Virginia

• Washington

If you live in any other state, you will enroll through the HealthCare.gov national marketplace.

What happens if you miss the ACA open enrollment period?

If you need 2025 coverage for yourself or your family members, it is very important to meet the enrollment deadline where you live. If you miss the deadline, you may have to wait until the next annual open enrollment period in late 2025 that will provide health insurance coverage in 2026.

If you have a life change after the deadline to enroll for 2025 coverage, you may be able to access health insurance later in the year. This time outside of open enrollment is called a special enrollment period.

You may qualify for a special enrollment period if you have certain life events, including:

• Losing health coverage

• Moving to a new state

• Getting married

• Having a baby

• Adopting a child

There's also more opportunity to change your ACA plan during the year - multiple special enrollment periods - for people who expect to have low incomes in 2025. For this purpose, low income is defined as no more than 150% of the federal poverty level, which is $22,590 for 1 person, and $38,730 for a family of three in 2025. (Federal poverty level amounts are higher in Alaska and Hawaii.)

What do you need to prepare for ACA enrollment?

ACA enrollment requires you to complete a marketplace application. You will need to have some information ready about you, the people in your household, and your income.

The application will ask you about:

• Who you are: Basic information including your name and date of birth.

• Your household: Your spouse or partner, children in your home, and all dependents.

• Where you live: Your home and/or mailing addresses.

• Everyone applying for coverage: Social Security numbers or other information about everyone who you want to receive health insurance coverage.

• Your taxes: How you file - such as separately or jointly - and everyone you claim as a dependent.

• Your current income: Your employer and what you make from wages, tips, and other sources.

• Your 2025 estimated income: Your best guess about household income in 2025.

• Other insurance: Your current health coverage from jobs, Medicaid, and other health plans.

• Health reimbursement: If anyone in the household works for a business that offers help paying for health expenses through a health reimbursement account (HRA).

After your application is complete, you will need to pay your first premium to the insurance company for your coverage to begin.

Who is eligible for ACA open enrollment?

Many people who need health insurance will qualify for an ACA health insurance plan. You are eligible to enroll for 2025 coverage if you:

• Live in the U.S.

• Are a U.S. citizen, U.S. national, or are lawfully present in the U.S.

• Are not incarcerated

• Are not covered by Medicare

How can I save on 2025 ACA coverage?

Because of the American Rescue Plan Act of 2021 and the Inflation Reduction Act of 2022, financial assistance continues for ACA plans in 2025. The Centers for Medicare & Medicaid Services (CMS) reports that 4 out of 5 people will be able to find a plan for $10 or less per month with premium tax credits.

You can use the premium tax credit - also known as a premium subsidy - to reduce your monthly insurance payment for an ACA plan. The tax credit is based on your household information and the 2025 income estimate on your application.

In addition, some people will qualify for cost-sharing reductions. These are extra savings on out-of-pocket expenses such as deductibles, copayments, and coinsurance when you receive care.

Here's more information about the tax credit and cost-sharing reductions:

• You are likely to qualify for a premium tax credit if your household income is between 100% and 400% of the federal poverty level - and, sometimes, at more than 400%.

• Your health insurance premium, or the amount you pay every month, has a good chance of being lower or even $0 with the premium tax credit.

• You may be able to buy a platinum or gold plan, which usually have the lowest out-of-pocket costs when you receive care.

What tools are available to help you select ACA coverage for 2025?

Choosing the marketplace plan that fits your needs can be difficult because there are so many options. There are tools and other resources available to help you select the ACA plan that is right for you and your family, such as:

• ACA marketplace income level & savings tool: It shows exact plan prices and what you might save on premiums.

• KFF health insurance marketplace calculator: This tool helps you estimate your potential premiums and subsidies.

• ACA navigator: They can help you through the process in person. A navigator is a trained individual or organization available to walk you through the marketplace process, including eligibility and enrollment. These services are free. The Find Local Help tool will help you locate in-person assistance in your area.

If you still have questions, contact the Marketplace Call Center at 800-318-2596. This line is available 24 hours a day, 7 days a week - excluding holidays.

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