Protect Yourself, Your Family and Your Future During Open Enrollment

Health insurance is the gateway to access health services that can ensure healthier individuals, healthier families and healthier communities.

No one plans to get sick or hurt, but most people need medical care at some point. Comprehensive health insurance protects individuals and families from health and financial risks in a number of important ways. It provides a shield against unexpected medical bills by covering costs related to hospitalization, treating illness and accidents. It also covers preventive services, like vaccines, screenings and primary care visits, typically with little or no cost-sharing.

Open enrollment for many types of health insurance coverage will take place during the next few months.  Medicare open enrollment for 2025 began Oct. 15 and runs through Dec. 7. Open enrollment for 2025 health insurance Marketplace plans begins on Nov. 1 and runs through Jan. 15, 2025, in most states. If you need to make a change to your current health coverage or enroll for the first time, this is your opportunity.

For Americans who do not have comprehensive insurance through their employer, Medicare, Medicaid, or another existing program, or have lost their Medicaid coverage during the redetermination process, open enrollment is the time to research and enroll in a plan that offers strong consumer protections. The plans sold through the Marketplaces must cover medically necessary care, without regard for pre-existing conditions and without arbitrary limits on that coverage.

Eligible individuals and families also may be able to enroll for free or at very low cost as a result of subsidies that can reduce premiums and cost-sharing. Last month, the government released new data showing that nearly 50 million Americans, or 1 in 7 U.S. residents, have chosen coverage through the Affordable Care Act Marketplaces since January 2014.

As is the case every year, there will be some changes for 2025 in terms of which insurers offer Marketplace coverage. In most states, the list of participating Marketplace insurers is the same for 2025 as it was for 2024. But in some states, new insurers are joining the Marketplace, while other states will see insurers exiting the Marketplace or leaving the individual market altogether.

While premiums are certainly a factor while shopping for coverage, it’s important to look beyond the premium and make sure your doctors and medications are covered and that the plan’s deductible and cost-sharing amounts won’t stand in the way of being able to access care. The good news is the ACA is fortified with important consumer protections, including out-of-pocket limits that ensure coverage kicks in for costly and unanticipated treatments and essential health benefit requirements that ban insurers from refusing to cover things like behavioral health or maternal care.

Consumers also should be aware there are health insurance plans offered outside of the Marketplaces that are not subject to the same consumer protections and are likely to have significant gaps in coverage. They may cost less upfront, but it comes at the expense of much lower coverage. For example, these types of plans have been known to deny coverage for emergency care or hospitalizations. On top of that, such plans often exclude the prescription drugs that are needed to help manage a chronic condition.

The risks to patients of these inadequate health plans are exactly why hospitals and health systems have long been strong advocates for ensuring everyone is enrolled in comprehensive, affordable health coverage.

The AHA urges enrollees to research all aspects of their coverage options and carefully review the steps involved before making a final selection. For more information, visit aha.org/getcovered.

We can never know where life or health may take us. But the peace of mind that comes with knowing you and those you care about are covered can reduce stress and help you focus on your health and well-being.

Open enrollment allows consumers to pick the health plan that best fits an individual’s or household’s needs. It has been a lifeline — or a health line — for millions of people.