Eligibility & enrollment

Who can enroll

Marketplace coverage is open to U.S. citizens and lawfully present residents who live in the country and aren’t incarcerated. You can buy a plan even if your job offers coverage — but if that employer coverage is considered affordable, you generally won’t qualify for premium tax credits, which changes the math. People already on Medicare or Medicaid usually don’t use the Marketplace. If you’re not sure where you fall, it’s worth checking, because the rules around employer offers and subsidies have real consequences for your costs.

Open Enrollment

There’s one main window each year to enroll or switch plans, called Open Enrollment. In most states it runs from November 1 to December 15 for the following year’s coverage — a shorter window than in past years, after a 2025 rule change. Some state-run exchanges set their own dates, a few starting in mid-October and others extending the deadline to as late as December 31, so it’s worth confirming with your state’s exchange. Plans you select during Open Enrollment take effect January 1.

If you do nothing, you may be automatically re-enrolled in your current plan — but relying on that is rarely a good idea. Prices, networks, and the benchmark plan that sets your subsidy all shift from year to year, and actively reviewing your options each fall is the only way to catch a better deal or avoid a quiet premium increase.

Special Enrollment Periods

Outside Open Enrollment, you can only sign up if you have a qualifying life event — and that event opens a Special Enrollment Period. The common triggers are losing other coverage (a job loss, aging off a parent’s plan at 26, or a divorce), getting married, having or adopting a child, or moving to an area where your current plan isn’t offered. You usually have 60 days from the event to choose a plan, and you may be asked to document it. For most of these, coverage starts the first day of the month after you enroll; a few, like the birth of a child, can start retroactively.

How to enroll

You enroll through the official Marketplace — HealthCare.gov in most states, or your state’s own exchange. Part of the process is estimating your household income for the coming year, because that’s what determines your premium tax credit. Estimate carefully: starting with 2026, there’s no longer a cap on repaying credits you weren’t entitled to, so underestimating your income can mean paying the difference back at tax time. When you’re ready to see the plans and prices where you live and start an application, you can compare them through PlanMatch Health.