7 Tips for Navigating Open Enrollment for Health Insurance
It’s open enrollment season — the time of year that health plans accept new applicants. If you’ve been diagnosed with breast cancer, it’s especially important to get coverage that lets you access the care you need and keep your out-of-pocket costs as low as possible.
Even if you’re thinking of renewing your current health plan, experts recommend checking at least once a year to see if there are other plans that can better meet your needs. Your existing plan’s benefits and costs are likely to change when it’s time for you to re-enroll. For some plans, the eligibility rules are changing too. But researching and comparing plans isn’t easy, and some health insurance companies and brokers make the task more difficult with misleading marketing practices. Follow these seven tips so you don’t get saddled with unexpectedly large bills for your medical care.
1. Pay attention to enrollment deadlines
There are some health plans that eligible people can enroll in any time of year, such as Medicaid plans. For most other types of plans, you usually need to sign up during an annual open enrollment period. Keep an eye out for the dates so you don’t miss an enrollment window. Due to recent policy changes, the enrollment dates and process for some plans are changing.
For Health Insurance Marketplace plans in most states, open enrollment this year is from Nov. 1, 2025 to Jan. 15, 2026. (Sign up must happen by December 15 for coverage to take effect January 1).
If you’re planning ahead, keep in mind that starting in the fall of 2026, the open enrollment period for Health Insurance Marketplace plans in most states will be shorter than in the past: Nov. 1 through either Dec. 15 or 31, 2026 (depending on the state).
For making changes to existing Original Medicare and Medicare Advantage coverage (joining, switching, or dropping either type of plan), open enrollment is from Oct. 15, 2025 to Dec. 7, 2025. There is also a separate open enrollment period from Jan. 1, 2026 to March 31, 2026 for people who are enrolled in a Medicare Advantage plan and who want to switch to a different Medicare Advantage plan or to Original Medicare. The date that you can initially enroll in Original Medicare or Medicare Advantage is based on when you turn 65 or qualify for other reasons (not based on an open enrollment period).
Check with your employer about open enrollment dates for these.
2. Check if automatic re-enrollment is an option for you
While it’s always a good idea to check if there are health plans that could be better for you than your current plan, you may decide to continue with your existing plan — if it’s still available and you’re still eligible. Keep an eye on whether your plan offers automatic re-enrollment so you don’t have any gap in coverage. Some plans that used to offer automatic re-enrollment, such as Marketplace plans, will be phasing that option out. Also, some plans may ask you for information to see if you qualify before you can re-enroll.
3. Calculate the total costs for a plan you’re considering
It’s easy to focus mainly on the cost of monthly premiums when you’re evaluating a plan. But be sure to take into account all of the other out-of-pocket costs, including the annual deductible and out-of-pocket maximum, co-pays, coinsurance, and the coverage for specific prescription medicines you take. It may make sense to choose a plan with a higher monthly premium but that covers more of your costs over the long term.
4. See if you’re eligible for programs that could reduce your costs
People who are eligible for government programs that reduce out-of-pocket costs for health insurance often don’t know about them and miss out on big savings.
If you’re thinking about signing up for Medicare, see if you’re eligible for any of the Medicare Savings programs and the Medicare Extra Help/Part D Low-Income Subsidy program.
In 2025, for the first time ever, people with Medicare Part D prescription drug coverage (through a traditional Medicare or a Medicare Advantage plan) will have their out-of-pocket costs for covered medications capped at $2,000.
And if you have a low income or a disability, see if you’re eligible for free or low-cost Medicaid coverage.
Up until now, many people who bought insurance through the Health Insurance Marketplace at Healthcare.gov were eligible for financial assistance through the premium tax credit or cost-sharing reductions. It’s unclear if Congress will extend the enhanced tax credits that made Marketplace plans more affordable for a lot of people.
Starting during the fall 2025 open enrollment period, more people will be eligible to sign up for “catastrophic” plans sold through the Marketplace. These plans have lower monthly premiums but a higher annual deductible compared to other Marketplace plans.
5. Watch out for Medicare Advantage plans that don’t meet your needs
If you’re 65 or older or are a younger person with disabilities, you may be eligible for Medicare. You can choose to receive your benefits through Original Medicare or a Medicare Advantage plan. Medicare Advantage plans are offered by Medicare-approved private health insurance companies and are aggressively marketed to seniors. These plans may have lower monthly premiums, and offer a few benefits that Original Medicare does not. For instance, many Medicare Advantage plans offer vision, hearing, and dental care and perks like gym memberships.
But make sure you do your homework before you enroll in one. People who enroll in Medicare Advantage plans often find they have more limited provider networks and more requirements to get prior authorizations for a medical service or to see a specialist. They also often have higher overall out-of-pocket costs than people who have Original Medicare plus a supplemental (Medigap) plan and a Medicare prescription drug plan.
In addition, reports by federal investigators in 2018 and 2022 found that Medicare Advantage plans frequently deny claims that should be covered. And a KFF analysis found that Medicare Advantage plans denied more prior authorization requests in 2022 than in other recent years.
6. Don’t choose a short-term health insurance plan
Short-term plans can be tempting: They have lower monthly premiums and are a way to get coverage for a short period of time when you’re waiting to enroll in a traditional health plan, such as when you’re between jobs. But short-term plans are not required to comply with the consumer protections of the Affordable Care Act and can deny you coverage if you have a pre-existing condition such as cancer. If a health insurer allows you to enroll in a short-term plan and you have a pre-existing condition, medical services related to that condition aren’t typically covered.
Short-term plans also tend to offer skimpy coverage overall. For example, they often have very high deductibles and may not cover preventive care or outpatient prescription drugs. Short-term plans are still available in most states, but in some states they’ve either been banned or insurers have stopped offering them.
7. Avoid Healthcare Sharing Ministries
Healthcare Sharing Ministries (HCSM) are not the same as health plans. They’re organizations in which members who share common religious or ethical beliefs make monthly payments to cover the cost of each other’s medical bills. An HCSM is not health insurance, although misleading marketing can make it seem like a lower-cost, viable alternative. If you join an HCSM, there is no guarantee that it will pay your medical costs, even if your claims meet the HCSM’s requirements for eligibility. HCSMs don’t have to comply with the consumer protections of the Affordable Care Act and in many cases don’t have to comply with state laws that normally govern health insurance. In recent years, some states have taken legal action against HCSMs or issued consumer alerts warning people about the risks of joining one. There’s also proposed legislation that would protect consumers from the deceptive practices of HCSMs.
Where to get help
To get free, unbiased professional assistance comparing health insurance options, you can:
Enter your zip code at Healthcare.gov/localhelp to find local assisters, agents, and brokers who can help you find health insurance plans. If it’s an option for you, you might want to look specifically for an assister. They don’t work on commission and are required to provide impartial and accurate information. (Keep in mind that agents and brokers typically work on commission so their advice may not be totally unbiased; however, they must be licensed and in some states they are required to act in a consumer’s best interest.)
Work with a financial navigator or social worker at your hospital or cancer center.
Contact one of the nonprofit organizations that offer free financial navigation services to people diagnosed with cancer and their caregivers, such as Triage Cancer and the Patient Advocate Foundation.
Contact your state’s SHIP (State Health Insurance Assistance Program) or The Medicare Rights Center for assistance comparing Medicare coverage options.
Explore the National Coalition for Cancer Survivorship’s online resources that help cancer survivors choose a health insurance plan.
Learn more about options for health insurance coverage.
Read our special report on the Cost of Breast Cancer Care.
— Last updated on October 1, 2025 at 11:00 PM