2026 Open Enrollment Comparison Worksheet

For employer-sponsored plans, open enrollment typically runs from late October through mid-December, with coverage starting January 1. ACA marketplace open enrollment for 2026 plans runs from November 1, 2025, through January 15, 2026, in most states. Some states with their own marketplaces (California, New York, etc.) may have extended deadlines. You can also enroll outside open enrollment if you have a qualifying life event like marriage, birth, job loss, or moving.

Focus on five key factors: (1) Total annual cost — not just the monthly premium, but premium + deductible + expected copays/coinsurance based on your typical usage. (2) Provider network — make sure your doctors, specialists, and preferred hospital are in-network. (3) Prescription coverage — check that your medications are on the plan's formulary at affordable tiers. (4) Out-of-pocket maximum — the most you'll pay in a year if you have a major health event. (5) Plan type — HMO, PPO, EPO, or HDHP, each with different flexibility and cost trade-offs.

An HDHP paired with an HSA (Health Savings Account) works best if you're generally healthy, don't take expensive medications, and want to save on monthly premiums while building a tax-advantaged health savings fund. For 2026, HDHP minimum deductibles are $1,650 (individual) and $3,300 (family). If you expect significant medical expenses — surgery, ongoing specialist visits, or expensive prescriptions — a PPO or Gold-tier plan with lower cost-sharing usually saves money overall.

Use this formula: (Monthly premium x 12) + (Expected out-of-pocket costs based on your usage pattern). For the out-of-pocket estimate, add up expected copays for doctor visits, prescriptions, and any planned procedures, then factor in your deductible if you typically meet it. Our worksheet includes a built-in calculator for this comparison across up to 4 plans simultaneously.

Only if you experience a Qualifying Life Event (QLE): marriage, divorce, birth/adoption, loss of other coverage (job loss, aging off parent's plan), or moving to a new state. A QLE triggers a Special Enrollment Period (SEP), typically 60 days, during which you can enroll or change plans. Losing Medicaid eligibility also qualifies. Simply being unhappy with your current plan does not qualify.