Health insurance open enrollment runs through most of November and into mid-December in most states, with ACA marketplace sign-ups open until January 15 in many places.
If you auto-renew last year's plan without looking, you may be leaving real money on the table or walking into a nasty surprise in January.
Here is what to actually check before you click "renew." Start with whether your doctors and medications are still covered.
Insurers shuffle their networks every year, and a plan that covered your cardiologist in 2024 may not in 2025.
Look up each provider by name in the plan's directory, then call the office and ask if they are still in-network.
Next, check your drug formulary tier by tier.
A prescription that cost $30 last year can jump to $200 if it moves to a specialty tier.
If a medication is not covered, ask your doctor about a generic or therapeutic alternative before you commit to a plan.
Then run the math on total cost, not just the premium.
A cheaper monthly payment often comes with a higher deductible, which means you pay thousands out of pocket before coverage kicks in.
Add up premiums, deductible, copays, and your expected care for the year.
If you take expensive medications, check the out-of-pocket maximum too.
Enhanced ACA subsidies have been extended through 2025, but the amounts change based on your projected income.
If you guessed wrong last year, you may owe money back at tax time.
Report income changes to the marketplace as they happen.
If your income or household changed and you do nothing, you might be placed in a plan you would not have picked, at a price you did not expect.
Even if you keep the same plan, log in and confirm the details.
If you have an HSA-eligible plan, note the 2025 contribution limits: $4,300 for individual coverage and $8,550 for family coverage.
Funding an HSA is one of the few ways to pay for care with pre-tax dollars, so it is worth checking whether your plan qualifies.
Medicare enrollees have a separate window, generally October 15 through December 7 for Advantage and Part D changes.
The rules differ, so do not assume your workplace timeline applies.
Employer coverage usually has its own enrollment period, often in the fall.
If you miss it, you may be locked out until next year unless you have a qualifying life event like marriage, a birth, or losing other coverage.
Finally, be skeptical of anyone who calls or emails offering to "help" you enroll for a fee.
Legitimate marketplace navigators are free.
Scammers ramp up during open enrollment, and they count on confusion.
Never pay for enrollment help, and never give out your Social Security number to an unsolicited caller.
Our take: the insurance industry profits when you stay on autopilot, because inertia keeps healthy people in high-margin plans and sick people in plans that fight claims.
Spending an hour with a calculator and a coverage directory is not glamorous, but it is one of the highest-paid hours of your year.
Final Thoughts
Treat the deadline like a bill you cannot ignore.