What to Know Before Open Enrollment

Paul Gougé is a lead consultant in Planning Excellence at Northwestern Mutual.

Open enrollment often arrives when you’re already juggling work, family, and a long list of priorities. So it can be tempting to simply stick with last year’s selections and move on. But taking a closer look at your benefits during your workplace open enrollment window could help you avoid unexpected costs, close coverage gaps, and make sure your protection still fits your needs.

Your employer might be adjusting your existing health plan—which could lead to higher out-of-pocket costs or changes to your in-network providers. Or you may want to change your coverage to lower your premiums, increase your coverage, or switch to your spouse’s insurance for the coming year.

While many people focus on health insurance, your annual open enrollment window is also an opportunity to review life insurance, disability coverage, tax-advantaged savings accounts, and other important benefits. A little extra time now can help you avoid costly surprises and feel more confident about the year ahead.

When is open enrollment?

During this time, you’re able to choose your healthcare coverage and other benefits for the upcoming year. You can check with your HR department to find out more about your employer’s open enrollment schedule. Most companies hold open enrollment for a few weeks between October and December.

When is open enrollment for Medicare?

The open enrollment period for people already covered by Medicare is October 15, 2026, through December 7, 2026, for coverage that will begin on January 1, 2027. But if you have a Medicare Advantage plan, open enrollment is January 1, 2027, through March 31, 2027, allowing you to switch or drop your plan.

Which states have extended open enrollment windows?

Open enrollment end dates may vary by state for plans purchased through the health insurance marketplace.

Starting with the 2027 plan year, HealthCare.gov’s open enrollment runs November 1 through December 15, with coverage taking effect January 1. Some states with their own marketplaces may set different dates, but none can extend past December 31.

If you live in a state with its own marketplace, check your state’s official health insurance website for exact dates. If you use the federal marketplace, mark your calendar for December 15 to ensure your coverage begins January 1. The previous extended window that allowed applications through January 15—and a February 1 coverage start—no longer applies on the federal platform. Be sure to confirm your state’s specific open enrollment window, as dates can vary depending on whether your state operates its own marketplace or uses the federal platform.

What happens if you miss open enrollment?

If you miss the open enrollment deadline, you’ll probably remain on your current health plan until next year’s open enrollment period—unless you have a qualifying life event. These events trigger a special enrollment period, typically lasting 30 to 60 days.

Common qualifying life events include getting married or divorced, having a child or adopting, losing job-based health coverage, moving to a new coverage area, or aging out of a parent’s plan. If you don’t experience a qualifying life event, you’ll generally need to wait until the next open enrollment period to make changes. That’s why it’s important to mark your calendar, review your options carefully during the regular enrollment window, and not assume you can make changes later.

What happens to my health insurance if I leave my employer?

Because health insurance is usually offered as a benefit through an employer, leaving your job can impact your health insurance. Starting a new job is considered a qualifying life event, so if your employer offers coverage, you’ll have time to enroll in their plan.

If you lose your job, you’re not out of options. COBRA (short for Consolidated Omnibus Budget Reconciliation Act) allows you to stay on an employer-sponsored health insurance plan even if you stop working for the company. It can be pricey since you’ll be paying for it yourself. You can compare COBRA costs with health plans available through healthcare.gov to see what makes the most sense for you.

What are the costs of coverage?

It’s important to understand the following terms when shopping for health insurance:

• Premium: What you pay each month for coverage
• Deductible: The amount you must pay out of pocket before your insurance kicks in
• Copayment (copay): The set rate you pay each time you visit a doctor or fill a prescription
• Coinsurance: The percentage of charges you may have to pay after meeting your deductible
• Covered services: While certain preventative services must be covered by every healthcare plan, other services are at the discretion of your insurance company. Read these carefully before choosing a plan to avoid any unpleasant surprises.
• Excluded services: A list of services that your plan won’t cover (Cosmetic procedures, weight-loss programs, and long-term care often fall into this category.)
• Annual limits: Even if your health plan covers services like hospitalizations or prescriptions, they may set an annual cap on the dollar amount or on the number of times you can access the service.

Plans with higher premiums typically have lower deductibles and copays (and vice versa). You might want to track your yearly number of office visits for each member of the family and the reasons for their visits. This can help form the basis for the upcoming year and help you determine the right coverage for your financial situation.

What types of healthcare coverage are offered?

The three most common types of health insurance plans are HMO, PPO, and HDHP. Each plan type differs in premium costs, deductible levels, provider network flexibility, and whether you can contribute to a health savings account (HSA). Understanding these differences and the pros and cons of each can help you choose the right coverage.

Health maintenance organization (HMO)

This is a network of doctors or an organization that provides health insurance coverage for a fee (premium). The HMO limits its coverage to a certain set of providers who are under contract with the HMO and requires you to first receive care from your designated primary care physician.

• Pros: HMO plans are typically more affordable, with lower premiums, copays, and deductibles.
• Cons: You are limited to in-network providers, meaning you’ll be on the hook for most or all of any outside care you may receive. Some HMO plans are limited to a specific geographic area, so you’ll want to check that your coverage is convenient for where you live or work.

Preferred provider organization (PPO)

A preferred provider organization is a network of doctors, specialists, surgeons, and clinics and hospitals that offer services to their insured members at reduced rates. When you seek services outside the PPO’s group of preferred providers, your bills are larger.

• Pros: You have greater flexibility in choosing your providers.
• Cons: Your premiums will likely be higher than with an HMO plan.

High-deductible health plan (HDHP)

You’ll likely pay a lower monthly premium but have a higher annual deductible under an HDHP compared with other options. You’re also often eligible to contribute to an HSA.

• Pros: Low monthly premiums and tax benefits through an HSA.
• Cons: High deductibles mean you’ll need to pay a lump sum upfront before your coverage kicks in.

When deciding which plan is best for you and your family, think about your anticipated medical needs and balance that with the costs.

Most plans will cover standard services if you use an in-network provider, so if most of your medical expenses are for preventive care, such as health screenings or vaccines, a high-deductible plan could be an affordable option. But if you have a preexisting condition that requires more frequent attention and medication, you may want a plan with a lower deductible.

If you live in an area where there are multiple in-network providers to choose from, you might consider an HMO. While these plans often have lower premiums, they have a more geographically restricted list of providers.

Either way, when reviewing plans during open enrollment, check to see if your current medical providers will remain in-network. If not, you’ll likely need to pay additional costs or switch providers.

What does health insurance typically not cover?

Federal law requires most plans to cover essential medical care. Be sure to read the fine print for more specialized services. The following services may be excluded:

• Cosmetic surgery
• Weight-loss services
• Infertility treatments
• Acupuncture
• Long-term care

Dental services and eye exams usually aren’t covered in medical plans, so you also might consider adding supplemental dental and vision coverage.

Which health insurance plans allow you to use an HSA?

If you opt for an HDHP, you can contribute to an HSA, which allows you to set aside pretax dollars (if made by payroll deduction) to pay for qualified medical expenses. For 2027, the contribution limit per year for self-only coverage is $4,500, up from $4,400 for 2026; it’s $9,000 for family coverage, up from $8,750 in 2026. If you’re 55 and older, there’s also the option for an additional $1,000 catch-up contribution. Any unused funds roll over year after year; if you leave your employer, you can take your HSA with you. Funding an HSA can help reduce taxable income and allow you to use tax-free funds for health-related costs in retirement.

A flexible spending account (FSA) may also be an option if you’re not in an HDHP and don’t have an HSA. An FSA, which is similar to an HSA in that it uses pretax dollars, allows you to fund things not often covered in the health plan—like vision, dental, and dependent care expenses. However, FSAs differ from HSAs in that they can’t be rolled over from year to year.

What life insurance benefits should you review during open enrollment?

Many employers offer life insurance as a workplace benefit, typically providing group term life coverage equal to one or two times your annual salary. While this is a valuable starting point, it often isn’t enough to fully protect your dependents—especially if you have a mortgage, children, or other long-term financial obligations.

Open enrollment is a good time to evaluate whether your employer-provided coverage is sufficient. If you need more protection, you may be able to purchase voluntary or supplemental life insurance through your employer during open enrollment. These options let you add coverage beyond the base amount. Keep in mind that group life insurance through work is usually not portable—if you leave your job, you may lose that coverage. Supplemental life insurance purchased through work may have similar limitations, so it’s worth understanding the terms before you enroll.

What disability insurance benefits should you review during open enrollment?

Disability insurance protects your income if you become sick or injured and can’t work. Many employer-provided disability coverage plans protect only 60 percent of your income—which may not be enough to cover living expenses or allow you to save for the future if you’re unable to work. Supplemental disability insurance available during open enrollment can help close that gap. It’s also worth noting that employer disability benefits are often not portable, meaning you could lose coverage if you change jobs.

What voluntary and supplemental benefits are available during open enrollment?

Beyond health, life, and disability insurance, many employers offer voluntary and supplemental benefits during open enrollment. These optional, employee-paid benefits can fill coverage gaps that core health insurance doesn’t address. Common options include supplemental dental and vision coverage, accident insurance, critical illness insurance, hospital indemnity insurance, and identity theft protection.

Consider your family’s needs and budget and any gaps in your current coverage before deciding which voluntary benefits to elect. Even small additions—like dental coverage or accident insurance—can provide meaningful protection at a relatively low cost.

What else should you consider as you choose a health plan?

As you weigh your options during open enrollment, here are some additional steps that can help you find savings, build good health habits, and ensure your coverage still meets your family’s needs.

Check your spouse’s coverage

Compare options offered through your employer with those offered by a spouse’s employer. Plans change each year based on past claims experience, so you might be able to find savings by reviewing your plan options each year.

Take advantage of savings programs

Plans often provide a reduction in your required premium (their “best rate”) for completing certain health-related activities each year. Know what these activities are and start early to create good health habits that can help you qualify.

Ask questions

If you’ve read through your benefit options and still have questions, don’t hesitate to call the health insurance company. Even if you’re not planning to change your plan during open enrollment, you should review your coverage to ensure your current plan is still meeting your family’s needs.

This is also a good time to think beyond health insurance—consider whether your life and disability coverage is adequate and whether your benefit elections match your broader financial goals.

While you’re reviewing your health coverage during open enrollment, it’s a good idea to check in on your broader financial plan as well. Your workplace benefits—health insurance, life insurance, disability insurance, and voluntary benefits—are all pieces of a larger financial picture. Taking the time to connect your benefit elections to your overall plan can help you identify protection gaps and blind spots you might otherwise miss. If you’re already working with a financial advisor, schedule a yearly check-in. If not, this can be a great time to find a Northwestern Mutual financial advisor to create your financial plan and make sure your elections align with your broader goals.

Frequently Asked Questions

What is the meaning of “open enrollment”?

Open enrollment is the annual window when you can review, change, or enroll in employer-sponsored benefits—most commonly health insurance—for the upcoming year. Outside this period, you typically can’t make changes unless you experience a qualifying life event. It’s also the time to evaluate supplemental benefits like life and disability insurance.

What happens if you do nothing during open enrollment?

In most cases, your current health insurance and benefit elections automatically roll over for the next year. However, you may miss out on better plan options, new benefits, or cost savings. Some benefits—like flexible spending accounts—may require active re-enrollment each year, so doing nothing could mean losing those contributions entirely.

What’s the difference between annual enrollment and open enrollment?

The terms are often used interchangeably, though some organizations use “annual enrollment” for Medicare and “open enrollment” for employer-sponsored benefits and the Affordable Care Act marketplace. Both phrases refer to the yearly window when you can review and adjust your coverage.

Is open enrollment mandatory?

Open enrollment itself isn’t mandatory—you’re not required to make changes if you’re satisfied with your current coverage. But if you want to switch plans, add benefits, or adjust your elections for the upcoming year, you generally must do so during this window. Outside of open enrollment, changes typically require a qualifying life event.

Why is open enrollment only once a year?

The annual window aligns with the plan year and helps insurers manage risk pools and pricing. Limiting enrollment to a specific period prevents people from waiting until they need care to sign up, which would drive up costs for everyone. If you experience a qualifying life event, you may be eligible for a special enrollment period outside the annual window.

What date does open enrollment end?

End dates vary by employer and marketplace. For HealthCare.gov, open enrollment ends December 15 for coverage starting January 1. Employer plans typically close their window between October and December. Medicare’s open enrollment ends December 7. Always confirm your specific deadline with your HR department or marketplace to avoid missing the window.

How do you prepare for open enrollment?

Start by reviewing your current coverage and how you’ve used it. Estimate upcoming medical needs, compare plan options and costs, and consider any life changes that might affect your benefits. Evaluate supplemental benefits like life and disability insurance, and don’t hesitate to ask HR or a financial advisor questions before the deadline.