2026 ACA Open Enrollment: Everything You Need to Know

Open Enrollment for 2026 health coverage is here. Whether you're getting marketplace coverage for the first time or renewing your plan, this guide covers key dates, plan changes, and strategies to maximize your savings.

What's New for 2026

Enhanced Subsidies Continue

The enhanced Premium Tax Credits (PTCs) originally passed in the American Rescue Plan and extended through 2025 continue to be available for 2026 coverage. This means:

• No one pays more than 8.5% of household income for a benchmark Silver plan
• People earning above 400% FPL remain eligible for subsidies
• Many consumers qualify for $0 premium Bronze plans or very low-cost Silver plans

Updated Poverty Level Guidelines

The 2026 Federal Poverty Level (FPL) guidelines have been adjusted for inflation. For subsidy purposes in 2026:

• Individual: 100% FPL = $15,650; 400% FPL = $62,600
• Family of 4: 100% FPL = $32,150; 400% FPL = $128,600

New Standardized Plan Options

CMS has introduced more standardized plan options for 2026, making it easier to compare plans across insurers. Standardized plans have identical cost-sharing structures (deductibles, copays, coinsurance), so you can focus on comparing networks and premiums.

Step-by-Step Enrollment Guide

Step 1: Gather Your Information

Before you start, collect:

• Social Security numbers for everyone who needs coverage
• Immigration documents (if applicable)
• Employer and income information for all household members
• Policy numbers for current health insurance (if renewing)

Step 2: Estimate Your 2026 Income

Your subsidy is based on your expected 2026 income, not last year's taxes. Be as accurate as possible—underestimating means you'll owe money back; overestimating means smaller monthly subsidies.

Step 3: Compare Plans Carefully

Don't just look at the premium. Consider:

• Total cost: Premium + expected out-of-pocket (deductible, copays)
• Network: Are your doctors and preferred hospitals in-network?
• Formulary: Are your medications covered, and at what tier?
• Metal tier: Bronze (low premium, high cost-sharing) vs. Silver/Gold (higher premium, lower cost-sharing)

Step 4: Check for Cost-Sharing Reductions (CSR)

If your income is below 250% FPL (about $46,950 for an individual in 2026), you may qualify for Cost-Sharing Reductions. These only apply to Silver plans and can significantly reduce your deductible, copays, and out-of-pocket maximum.

Step 5: Complete Your Application

Visit Healthcare.gov(or your state marketplace if applicable) to complete your application. The process typically takes 30-45 minutes if you have all your information ready.

Auto-Renewal Warning

If you had marketplace coverage in 2025, your plan will auto-renew if you don't take action. However, this is often NOT the best option. Plan prices, networks, and formularies change annually. Even if your plan name stays the same, the details may have changed.

We recommend logging in and actively comparing plans each year, even if you end up choosing the same plan again.

Special Enrollment Periods

Missed Open Enrollment? You may still qualify for a Special Enrollment Period (SEP) if you experience a qualifying life event:

• Lost health coverage (job loss, aging off parent's plan, divorce)
• Moved to a new area
• Got married or had a baby
• Income dropped below certain thresholds
• Became a U.S. citizen

State-Specific Resources

We provide detailed marketplace guides for each state we cover:

• California (Covered California)
• New York (NY State of Health)
• Texas (Healthcare.gov)
• Florida (Healthcare.gov)
• View all states →

Need Help?

Free assistance is available:

• Healthcare.gov: 1-800-318-2596 (24/7 during Open Enrollment)
• Navigators: Free, unbiased enrollment assistance in your community
• Certified brokers: Licensed agents who can help compare plans (no cost to you)