Missed Open Enrollment? Here’s What You Can (and Can’t) Do Now

If you missed the ACA Open Enrollment deadline, you’re not alone. Every year, people realize after the window closes that their coverage isn’t what they expected—or that they didn’t make a selection at all.

The first thing to know is this: missing Open Enrollment doesn’t mean you’re completely out of options, but it does mean the rules are more limited.

Here’s what you can still do, what you can’t, and how to move forward without making costly assumptions.

What Changes After Open Enrollment Ends

Once Open Enrollment closes, ACA plans are no longer available to everyone on demand. At that point, enrolling in or changing coverage typically requires qualifying under specific rules.

That’s where much of the confusion comes from.

After Open Enrollment:

• You cannot freely switch ACA plans

• You cannot enroll just because premiums went up

• You cannot make changes simply because you changed your mind

However, some pathways do still exist.

When You May Still Be Able to Enroll or Change Coverage

1. Qualifying for a Special Enrollment Period (SEP)

A Special Enrollment Period allows you to enroll outside of Open Enrollment if you experience certain life events, such as:

• Losing employer-sponsored coverage

• Losing eligibility for Medicaid or CHIP

• Getting married or divorced

• Having a baby or adopting a child

• Moving to a new coverage area

Each SEP has specific timing and documentation requirements, so it’s important not to assume eligibility without reviewing the details.

2. Employer-Sponsored Coverage

One common misconception is that employer health plans only start in January. In reality, group health insurance can often begin at various points throughout the year, depending on the employer.

This may apply if:

• You’re starting a new job

• Your employer is offering coverage for the first time

• A business is setting up benefits mid-year

Employer plans follow different rules than ACA plans, and enrollment timing can be more flexible.

3. Coverage Options That Are Available Year-Round

Some types of coverage are not tied to Open Enrollment and can be enrolled in throughout the year, including:

• Dental insurance

• Vision insurance

• Accident, hospital indemnity, and other supplemental policies

While these do not replace major medical coverage, they can help manage specific costs.

What ACA Alternatives Can (and Can’t) Do

If you don’t qualify for a Special Enrollment Period, you may hear about ACA alternatives that are available year-round.

These options can sometimes help fill a coverage gap until the next Open Enrollment, but it’s important to understand their limitations.

ACA alternatives:

• Are not ACA-compliant major medical plans

• May have underwriting requirements

• Often include coverage limits or exclusions

• Are not appropriate for every situation

They can be helpful in certain circumstances, but they should be reviewed carefully to ensure expectations are clear.

What You Can’t Do After Open Enrollment

It’s just as important to know what’s not possible.

After Open Enrollment ends, you generally cannot:

• Enroll in an ACA plan without a qualifying SEP

• Change plans simply due to higher premiums

• Retroactively enroll for months already passed

Understanding these boundaries helps prevent frustration and unrealistic expectations.

Why It’s Still Worth Reviewing Your Situation

Even if ACA enrollment is closed to you right now, a review can still be helpful to:

• Confirm whether you qualify for a Special Enrollment Period

• Understand what options may be available in your situation

• Plan ahead for the next Open Enrollment

• Avoid going uninsured longer than necessary

Many people assume they’re completely stuck when that’s not always the case.

Ready to Talk Through Your Options?

If you missed Open Enrollment and aren’t sure what your next step should be, a conversation can help bring clarity.

I offer one-on-one coverage reviews to:

• Discuss whether a Special Enrollment Period may apply

• Explain year-round coverage options and limitations

• Help you understand what makes sense now versus later

• Plan ahead so you’re better prepared next Open Enrollment

Every situation is different, and there’s no one-size-fits-all answer.

If you’d like help understanding your options after missing Open Enrollment, schedule time with me to review your situation and map out next steps.

Click Here To Schedule Time With Me!

ACA Renewals Explained: Why Auto-Renew Can Quietly Raise Your Costs

Auto-renewal sounds helpful. After all, if nothing has changed, why not let your health insurance renew on its own?

The problem is that with ACA plans, something almost always changes—even if your life hasn’t.

Each year, people are surprised by higher premiums, reduced tax credits, or coverage that no longer fits their needs, all because they relied on auto-renewal.

Here’s why that happens—and what you can do about it while Open Enrollment is still open.

What Auto-Renew Really Means

When you auto-renew an ACA plan, the system attempts to place you back into the same plan—or the closest available version of it—using the information it already has on file.

Auto-renew does not mean:

• Your plan is still the best option available

• Your income information is current

• Your tax credits were re-evaluated with updated details

• Your coverage still matches your medical or financial needs

It simply means no changes were made.

Why Auto-Renew Can Increase Your Costs

Even if your household looks the same on paper, several things may have changed behind the scenes.

1. Your Income Was Estimated, Not Updated

If you didn’t log in and confirm your income, the system may have reused outdated information or applied a generic estimate. Since tax credits are tied to projected income, this can directly affect your monthly premium.

2. Tax Credit Rules Changed

Recent changes to expanded ACA tax credits—particularly for higher earners—mean that some households now qualify for less assistance than in previous years.

Auto-renewal doesn’t account for how those changes impact your situation.

3. Plan Pricing Changes Every Year

Insurance companies adjust premiums annually. The plan that was competitively priced last year may now be one of the more expensive options in your area.

4. Provider Networks and Benefits Shift

Doctors, hospitals, and prescription coverage can change from year to year. Auto-renew doesn’t evaluate whether your providers or medications are still covered the same way.

Why This Often Goes Unnoticed Until January

Many people don’t realize anything changed until:

• The January premium is withdrawn

• A prescription costs more than expected

• A provider is suddenly out-of-network

By then, the frustration sets in—and people assume they’re stuck.

What You Can Do During Open Enrollment

ACA Open Enrollment is open through January 15, and that window gives you the opportunity to review and adjust your coverage—even if your plan already renewed.

Here’s what a review can help with:

1. Confirm Application Information

Making sure income and household details are accurately reflected on your application can help avoid unnecessary surprises.

2. Compare Available Plans

A side-by-side comparison often reveals options that better match your budget or medical needs.

3. Evaluate Coverage Levels

Sometimes a different metal tier (Bronze, Silver, Gold) offers a better balance of premiums and out-of-pocket costs once tax credits are applied.

4. Avoid Paying More Than Necessary

Auto-renewal keeps you enrolled—but it doesn’t protect you from overpaying.

What Happens After January 15

Once Open Enrollment closes, plan changes become much more limited.

After January 15, changes typically require:

• A Special Enrollment Period (SEP) due to a qualifying life event, or

• Waiting until the next Open Enrollment period

That’s why reviewing your plan before January 15 is so important.

Ready to Review Your Renewal?

If you auto-renewed your ACA plan—or aren’t sure whether your current coverage still makes sense—a review can provide clarity.

I offer one-on-one ACA renewal reviews to:

• Review the information used to renew your policy

• Explain how changes may be affecting your premium

• Compare available plans and pricing

• Help you decide whether staying put or switching makes more sense

With Open Enrollment ending January 15, now is the time to take a closer look.

If you’d like help reviewing your ACA plan, schedule time with me before the Open Enrollment window closes.

Click Here To Schedule Time With Me!

The End of Expanded ACA Tax Credits: What You Can Still Fix Before Open Enrollment Ends

If your health insurance premium went up this year—or you’ve been putting off reviewing your renewal—you’re not alone. Many people are feeling confused and frustrated as changes to ACA tax credits take effect.

ACA Open Enrollment is open through January 15.

That means there is still time to review your coverage and make changes for the year ahead.

Let’s walk through what’s happening, who this affects, and what you can still fix before the deadline.

How ACA Tax Credits Normally Work (The Simple Version)

When the Affordable Care Act was created, premium tax credits were designed to help people whose household income fell between 100% and 400% of the Federal Poverty Level (FPL) afford health insurance.

If your income was within that range, the government helped offset the cost of your monthly premium.

If your income was above that range, you typically paid full price for coverage.

That structure was in place for many years.

What Changed During COVID

At the beginning of COVID, the government temporarily expanded ACA tax credits to help more people maintain coverage during a time of economic uncertainty.

For a limited period, higher-income households—roughly those in the 500–600% of FPL range, and sometimes higher—also became eligible for tax credits, as long as premiums exceeded a certain percentage of their income.

This expansion meant:

• Many people qualified for financial help for the first time

• Monthly premiums were capped at more affordable levels

• Middle- and upper-middle-income families saw meaningful savings

These expanded credits were approved for a temporary, multi-year term, not as a permanent change.

What’s Expiring Now (and What’s Not)

ACA tax credits are not going away.

People whose household income falls within the original 100–400% FPL range may still qualify for subsidies.

What is expiring is the expanded eligibility for higher earners that was put in place during COVID.

As a result, some households are seeing:

• Reduced or eliminated tax credits

• Higher monthly premiums than in prior years

• Unexpected increases at renewal time

This change most commonly affects people who:

• Earn more than they did a few years ago

• Fall above the original ACA income limits

• Became accustomed to lower premiums during the expansion period

Why This Is Catching People Off Guard

Most ACA plans automatically renew if no action is taken. While that can feel convenient, it can also hide important changes.

Auto-renewal may mean:

• Income information wasn’t updated

• The applied tax credit amount changed

• Plan pricing or benefits shifted

• A different plan may now be a better fit

Many people don’t realize anything has changed until they see their January premium.

What You Can Still Fix Before January 15

Because Open Enrollment is still open, you can make changes now—even if your plan has already renewed.

1. Update Your Income Information

Tax credits are based on projected household income. Ensuring the information on your application is current is one of the most important steps you can take.

2. Compare Available Plans

The plan that worked last year may not be the most cost-effective option this year. Networks, prescription coverage, and pricing change annually.

3. Adjust Your Coverage Level

In some cases, moving between metal tiers (Bronze, Silver, Gold) can reduce overall costs based on how tax credits are applied.

4. Avoid Costly Auto-Renew Mistakes

Auto-renewal does not mean “best option.” It simply means the system kept you where you were.

What Happens After January 15

Once Open Enrollment closes, plan changes become much more limited.

After January 15, changes typically require:

• A Special Enrollment Period (SEP) due to a qualifying life event, or

• Alternative coverage options that can help bridge the gap until the next Open Enrollment

That’s why taking action before January 15 is so important.

Ready to Review Your Coverage?

If your premium increased, your tax credit changed, or you’re unsure whether your current plan still fits your needs, a review can help bring clarity.

I offer one-on-one ACA policy reviews to:

• Review how income information is entered on your application

• Explain how tax credits are being applied to your policy

• Compare available plan options and pricing

• Identify coverage gaps or more suitable alternatives

Appointments are limited as we approach the January 15 deadline.

If you’d like help reviewing your coverage, schedule time with me now while Open Enrollment is still open.

Click Here To Schedule Time With Me!