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October 27, 2024 - The Health Insurance Marketplace^®[1] Open Enrollment Period on HealthCare.gov runs from November 1 to January 15. Consumers who select a plan by midnight December 15 (5 a.m. EST on December 16) can get full-year coverage that starts January 1, 2025. Consumers who select a plan after December 15, 2024, but before the deadline in January 2025, can have coverage that starts February 1, 2025.

Related: Affordability and Choice Anchor Biden-Harris Administration’s Launch of Window-shopping for 12th HealthCare.gov Marketplace Open Enrollment

The Centers for Medicare & Medicaid Services (CMS) continues its focus on increasing access to consumer assistance and ensuring robust outreach and education efforts to reach consumers about the opportunity to enroll in or re-enroll in Marketplace coverage. National estimates from the last Open Enrollment Period showed that most consumers qualified for $0 premiums after financial assistance or continued to see annual premium savings exceeding $800, underscoring the continued impact of expanded subsidies made available thanks to the American Rescue Plan Act of 2021 (ARP) and Inflation Reduction Act of 2022 (IRA). More consumers than ever before will be able to choose plans from among at least three insurance issuers. CMS also invested $100 million in grant funding for new and returning Navigator organizations for the 2025 Open Enrollment Period. The grants are part of a commitment of up to $500 million over five years – the longest grant period and financial commitment to date, and a critical boost for recruiting trusted local organizations to help consumers find the right health coverage option, complete their Marketplace application, and enroll in coverage. Navigator awardee organizations are available to provide comprehensive assistance through customized educational and outreach activities, especially to underserved communities.

Providing Continued Access to Lower Costs

In 2021, the ARP expanded the availability of financial assistance for coverage through the Marketplace, making financial assistance available to more consumers and at greater levels. Thanks to the IRA, these benefits are available to eligible new and returning consumers through plan year (PY) 2025. In part, as a result of the IRA, four in five HealthCare.gov customers will still be able to find health care coverage for $10 or less per month for 2025 after subsidies.

In May 2024, CMS published a final rule removing for the first time the barrier to eligibility for Deferred Action for Childhood Arrivals (DACA) recipients to enroll in health coverage through the Marketplace or a Basic Health Program. Effective November 1, 2024, DACA recipients will be considered lawfully present for purposes of eligibility and enrollment in a Marketplace plan and can be eligible for premium tax credits and cost-sharing reductions to lower their Marketplace health insurance costs. 

Improving Consumer Choice

Consumers on HealthCare.gov continue to benefit from greater choices of health insurance issuers. Ninety-seven percent of HealthCare.gov consumers will have access to at least three health insurance issuers for 2025, up from 96% last year.

CMS has implemented policies to help streamline plan selection by improving access to meaningful plan choices.

Making It Easier Than Ever to Enroll & Manage Coverage

Every year, CMS works to improve the consumer experience on HealthCare.gov. This year, CMS made two major improvements to streamline the consumer experience.

First, we redesigned the HealthCare.gov homepage to refresh the visual styling and include prominent calls to action that ensure quick access to the most needed information based on consumer feedback. Featured items help consumers find additional information they may need at different times during the year. The visual refresh provides a more consistent user experience throughout the entire enrollment journey on HealthCare.gov. These clear calls to action will help new and returning consumers better navigate Marketplace basics and apply and enroll in coverage. 

In addition, CMS launched the first updates in a series of modernizations and redesigns for the account management experience after consumers log in to enhance user experience and foster consistency across HealthCare.gov. This modernization includes a streamlined account home with improved messaging on next steps for applications and enrollment, easy access to manage account settings and preferences, an updated messages section where consumers can access Marketplace notices, and an application-focused section that simplifies access to application history. These updates also bring mobile optimization into the account management experience to align with the existing mobile application and enrollment experiences and streamline navigation and ways to make account updates for consumers who use HealthCare.gov on a mobile device. These updates are part of ongoing modernization efforts to improve the consumer experience when managing their application and enrollment information.

Continuing to Offer Support to Consumers When and Where They Need It Most

The Marketplace Call Center

The Marketplace Call Center is often the front line of assistance for consumers as they apply for coverage and compare plan options. For the last several Open Enrollment Periods, the consumer satisfaction rate remained high – averaging 90% – throughout the Open Enrollment Period. To help prepare the Marketplace Call Center representatives to handle high consumer demand, CMS will continue providing extensive training before Open Enrollment and weekly refreshers throughout the Marketplace Open Enrollment Period.

In addition to the Marketplace Call Center, local assistance will continue to be available to help consumers with enrollment through Navigators and other assisters, as well as Marketplace-registered agents and brokers.

CMS-Coordinated Outreach

Building on successes over the last several years, CMS will continue supporting an extensive outreach effort, which includes a broad-reaching national campaign with traditional broadcast advertising and targeted digital efforts. Open Enrollment outreach will include investments to reach multiple audiences that experience lower access to health care. CMS has partnered with cultural marketing experts, for example, to deliver strong campaigns to African Americans, Spanish- and English-speaking Latinos, and Asian American and Pacific Islander communities in multiple languages. These campaigns will connect people to local help and resources.

We are also planning to continue targeted outreach to uninsured individuals. This fall, CMS will partner with the Internal Revenue Service (IRS) to send letters to individuals and families who it appears are uninsured and may be eligible for low-cost health insurance coverage to encourage them to enroll in coverage. CMS and IRS partnered on a similar outreach strategy in 2017 which resulted in increased health insurance coverage and evidence that health insurance coverage can reduce mortality.

Local Assistance

Consumers will benefit from a continuing robust Navigator presence. Navigators are unbiased experts who help consumers, especially those in underserved communities, understand their benefits and rights, review plan options, and enroll in Marketplace coverage. In addition to an increased staffing capacity, Navigators are offering more non-traditional appointment hours, bringing in-person assistance to consumers through the use of mobile units, and offering virtual appointments aimed at reducing transportation barriers and making it easier for consumers to get help signing up for quality, affordable health care coverage. This will also help reduce health disparities in communities across the country. The Navigator program is also augmented by additional assisters. This means that consumers will have access to more than 5,000 assisters (including Navigators, certified application counselors, and other enrollment assisters) specifically trained to help them.

Additionally, more than 64,000 Marketplace-registered agents and brokers will be available to work with consumers to help them select and enroll in Marketplace plans. CMS anticipates additional assisters, agents, and brokers will complete training before November 1.

CMS will also continue to partner with the “Help On Demand” service for agents and brokers. This service allows consumers to request that a Marketplace-registered, state-licensed agent or broker in their area contact them directly for help applying and enrolling. Registered agents and brokers can set times when they are available and then reach out to consumers who expressed interest in assistance.

To find someone local or to be contacted by a Marketplace-registered agent or broker, consumers should visit HealthCare.gov/find-assistance/. Consumers can choose if they would like to browse and select an assister or an agent/broker in their area, or they can request that an agent/broker contact them directly to help with their application and enrollment. Consumers who choose to search through available assisters, agents, and brokers in Find Local Help can look for a specific person or organization and can filter results based on their preferences and services provided, including language capabilities.

CMS will continue to boost its outreach with the help of the Champions for Coverage program. This community initiative includes more than 1,000 local organizations that are active in providing outreach and education about the Marketplace and how consumers can enroll in coverage through HealthCare.gov, Medicaid, or the Children’s Health Insurance Program (CHIP).

Improving Awareness of Deadlines, Important Calls to Action, and Other Must-know Information

Notices

Each year, the Marketplace sends notices to consumers currently enrolled in a Marketplace plan before November 1 about the upcoming Open Enrollment Period. This notice provides consumers with key dates for Open Enrollment. It emphasizes the importance of consumers returning during this time to update their applications and actively re-enroll in a plan for 2025. The notice also provides certain consumers with customized messaging for specific situations, such as if they are at risk of losing premium tax credits. The Marketplace also sends notices to consumers who may be at risk of losing premium tax credits for failing to file and reconcile prior year premium tax credits they used to help lower the cost of their Marketplace plan. Consumers receive additional notices from their current insurance company with important information about premiums, coverage, benefit changes, and plan availability for 2025.

To see examples of Open Enrollment notices, visit: cms.gov/marketplace/in-person-assisters/applications-forms-notices/notices

Automatic Re-enrollment

Consumers who are currently enrolled in Marketplace coverage are strongly encouraged to come back and update their information, as well as to compare plans and pick a plan that best suits their needs before the December 15 deadline in order to have coverage effective January 1, 2025. 

However, as in previous years, most current consumers who do not actively select a plan by December 15 will be automatically re-enrolled into the same plan they had in 2024 or a suggested alternate plan for 2025. After December 15, the Marketplace sends a notice to consumers who were automatically re-enrolled. Consumers who prefer to select a new plan actively can return to the Marketplace to do so before the January 15 close of Open Enrollment, at which point their January coverage generally will be through the auto-re-enrolled plan, and their active selection generally will be effective February 1.

As in previous years, consumers currently enrolled in 2024 Marketplace coverage with an issuer that is not returning to the Marketplace for 2025 will be matched with a different issuer for 2025. The 2025 plan will be selected to be similar to their current 2024 plan. These consumers will receive an additional notice with information about this alternate plan. These consumers are especially encouraged to review their options and pick the best plan for 2025 that meets their needs. Consumers who are matched with an alternate issuer through automatic re-enrollment are eligible for a Special Enrollment Period and have until December 31 to make a plan selection for coverage effective January 1.

HealthCare.gov Scheduled Maintenance Windows

Every year, CMS establishes scheduled maintenance windows for HealthCare.gov. As is true for other information technology systems, these scheduled maintenance windows are how CMS updates and improves its systems to run optimally as part of the normal course of business. 

Consumer access to HealthCare.gov may be limited or restricted when this maintenance is required. Maintenance will only occur within these windows when deemed necessary to provide consumers with a better shopping experience. The purpose of scheduling these times is to minimize any consumer disruption.

Regularly scheduled maintenance will continue to be planned for the lowest-traffic time periods on HealthCare.gov, which are Sunday mornings.

For more information on the scheduled maintenance times, visit:  https://www.cms.gov/files/document/healthcaregov-scheduled-maintenance-windows.pdf

What Consumers & Advocates Should Know About State/Consumer-specific Open Enrollment Programs

State-based Marketplaces

Consumers in states operating their own Marketplace platform can also enroll in a 2025 Marketplace plan starting on November 1. For 2025, Georgia transitioned from HealthCare.gov to its own Marketplace. Consumers in these states can find information about available plans and prices, in-person or virtual help, local events, and state-specific enrollment deadlines by visiting or calling their state’s Marketplace.

An additional State-based Marketplace fact sheet includes details for each State-based Marketplace, and consumers can visit HealthCare.gov/marketplace-in-your-state to find their state’s website.

Small-business Health Options Program (SHOP)

Similar to previous years, small business employers will be able to enroll directly with an issuer or with a SHOP-registered agent or broker. HealthCare.gov allows employers to preview available SHOP plans and find an issuer or agent/broker to work with to offer SHOP coverage to their employees. Quality rating information will also be available for SHOP plans.

Additional Resources

CMS plans to release enrollment snapshots for HealthCare.gov and State-based Marketplaces throughout the Open Enrollment Period. Consistent with previous years, snapshots will be released approximately biweekly and will include national-level data that incorporates data from State-based Marketplaces.

For additional information on updates and improvements for HealthCare.gov Marketplace Open Enrollment, consult the following:

• The Plan Year 2025 Qualified Health Plan and Premiums in HealthCare.gov States – Report, Appendix Tables, and Methodology.
• The Plan Year 2025 Health Insurance Marketplace^® Public Use Files.
• Information on Quality Ratings for Plan Year 2025.
• The Plan Year 2025 Projected Health Insurance Exchange Coverage Map.
• The Plan Year 2025 State-based Marketplace Open Enrollment Fact Sheet.