If you’re in the market for an individual or family health insurance plan for 2025, the annual Open Enrollment Period (OEP) is your time to shop. This guide answers all the key questions about dates, deadlines, plan options and how to enroll so you’ll have the right coverage when you need it.

What is the Open Enrollment Period (OEP) for health insurance?

The Open Enrollment Period (OEP) is a yearly opportunity for you to sign up for or change your individual or family health insurance plan for any reason. It occurs late fall into winter so you can select the best coverage for the upcoming calendar year.

Open Enrollment is available to consumers who don’t already have health insurance coverage from Medicare, Medicaid, an employer-sponsored plan, their parents’ plan, or from Veterans Affairs.

Employers have their own open enrollment periods, which can vary. And if you’re 65 or older, you’re eligible for your Medicare Initial Enrollment Period (IEP) which starts three months before the month of your 65th birthday and ends three months after.

When is Open Enrollment for health insurance coverage for 2025?

Open Enrollment runs from November 1 through January 15 for private health insurance plans as well as individual and family insurance plans purchased through the marketplace, on MNsure (for Minnesota residents) or healthcare.gov (for Wisconsin residents).

Your coverage dates are based on when you enroll for your insurance plan.

If you live in Wisconsin

You can enroll on or before December 15 for coverage that begins on January 1, 2025.

You can enroll between December 16 and January 15 for your coverage that begins on February 1, 2025.

There is an important distinction between the year of enrollment and the year of coverage. When you sign up for or switch your health insurance during OEP, coverage kicks in the following calendar year. So, the enrollment dates and deadlines in 2024 are setting up your coverage for 2025.

What insurance plans and benefits are available?

During OEP, you can purchase any health insurance plan through the individual marketplace (on-exchange), directly from an insurance provider (off-exchange), or with the assistance of a broker. What option you choose depends on your coverage needs and budget.

Specific benefits and coverage will vary by plan type, so be sure to review what is covered (and what isn’t) in the plan’s Summary of Benefits and Coverage (SBC) before you enroll.

Additionally, the Affordable Care Act (ACA) guarantees a set of minimum consumer protections for all individual medical policies. Thus, the ACA requires that all health insurance plans sold on the individual marketplace and most off-exchange plans provide coverage for these 10 essential health benefits:

1. Prescription drugs
2. Pediatric care
3. Preventive care
4. Emergency services
5. Hospitalization
6. Mental health
7. Maternity care
8. Outpatient services
9. Laboratory services
10. Rehabilitative services and devices

And, you can’t be denied coverage due to a preexisting condition.

How to enroll in health insurance

Whether you have already found your ideal plan or not, there are several ways to shop and enroll in health insurance. Each option provides a level of customer support to help you make the right choice.

Buying through a health insurance company

This is when you purchase a plan directly from an insurance provider, such as HealthPartners. Health insurance companies are the most knowledgeable about their plans and can break down the details of their offerings. This option is also referred to as an off-exchange purchase.

Working with a health insurance broker

A health insurance broker can show you different types of plans from a variety of insurance companies as opposed to just one single insurer. This can help you weigh your options more broadly but still get the assistance you need to pick a plan that meets your needs. Plus, brokers can usually provide ongoing support after you enroll.

Shopping through a health insurance marketplace

Marketplaces are great for shoppers who want to compare on-exchange health plan prices and benefits in a single location. Minnesota residents can shop through MNsure on their own or they can take advantage of support from an assigned navigator to help navigate enrollment. Wisconsin residents can shop through healthcare.gov.

Common documents you’ll need to sign up for health insurance

When applying for health insurance, depending on the plan and where you live, you may need documentation to verify certain things like your citizenship (proof of lawful residency status may be required).

Here are the most common documents you should have available:

1. For proof of age, you’ll need any one of these:
   1. Voter ID card
   2. Driver’s license
   3. Passport
   4. Birth certificate
2. For proof of identity, you’ll need any one of these:
   1. Voter ID card
   2. Driver’s license
   3. Passport
   4. Social Security card
3. For proof of address, you’ll need any one of these:
   1. Driver’s license
   2. Rental agreement if applicable
   3. Utility bill

What happens if you miss Open Enrollment for 2025?

If you miss the Open Enrollment deadline, you might be able to qualify for a Special Enrollment Period (SEP) if you have experienced a qualifying life event such as:

• The loss of health insurance from your employer or other minimum coverage
• Household changes such as marriage, divorce, a death in the family or having a baby
• A change in your home address, where available health plans are different than what was previously available to you

If you do qualify for a Special Enrollment Period, you’ll have 60 days to enroll in a new plan. However, if you miss that window, you’ll have to wait until the next Open Enrollment period to sign up for an individual health insurance plan for the following year.

Another option is to see if you qualify for Medicaid. Enrollment is available all year for those who qualify, depending on household income levels. If you experienced a significant income loss during the year, it’s worth it to check your eligibility for Medicaid.

Also, if you’re on Medicaid and find that you’re no longer eligible, you’ll be able to switch to a private plan at that point, as the loss of your Medicaid plan would be a qualifying event that triggers a Special Enrollment Period.

Have more questions about individual health insurance?

Our experts will help you find a health plan you’re confident in – no matter your situation.