If I didn’t make changes to my Marketplace plan and just let it auto-renew for January, am I stuck with it for the rest of the year?
After open enrollment ends – on January 15 in most states – you can't switch to a different plan unless you experience a qualifying life event that triggers a special enrollment period.
In most states, for coverage effective in 2026, you can pick a different plan between December 16, 2025 and January 15, 2026 and it will take effect in February 2026. In that case, the auto-renewed plan will cover you in January and you'll start over with the new plan on February 1. But keep in mind that if you incur any out-of-pocket costs in January, they will not transfer to the new plan; you'll be starting over with new out-of-pocket costs when the new plan begins.
After the end of open enrollment, a special enrollment period can be used to switch to a different plan. But in most cases, the available options are limited to another plan at the same metal level as the existing plan.1
Most special enrollment periods require a specific qualifying event, but there is a year-round special enrollment opportunity for American Indians and Alaska Natives.
Can I pick a new health plan if my old one terminated and the exchange picked a new one for me?
If your health plan terminates at the end of the year, you'll qualify for a special enrollment period that starts 60 days before the end of the year, and continues for the first 60 days of the new year.1 The extension of the SEP into the new year generally applies even if you take no action before the end of the year and are automatically mapped to a new plan by the exchange or by your insurance company.
But due to the loss of coverage, you'll have until December 31 to pick a new plan with a January 1, effective date.2 This differs from the open enrollment deadline for getting a January 1 effective date, which is December 15 in most states.
So if your policy is terminating on December 31 and you're selecting a replacement plan in the latter half of December, it's important to make sure you're using your special enrollment period (triggered by the loss of coverage) as opposed to using the open enrollment period.
If you pick your new plan in January or February, it will take effect the first of the following month. If you were automatically mapped to a new plan starting January 1, it will cover you until your new plan takes effect, assuming you pay all premiums when they're due.
The special enrollment period triggered by year-end plan terminations is limited to situations in which the insurer terminates your plan, entirely exits the exchange or the full individual market in your area, or makes a major change to plan designs, such as switching everyone from PPOs to HMOs.
Changes to the benefit structure (for example, different deductibles, copays, coinsurance, etc.), provider networks, or covered drug list would not warrant a special enrollment period. Neither would premium changes, which is why it's important to pay attention to the notices your insurer and the exchange send you in the fall, so that you're not caught off guard by an unexpected premium change in January.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written hundreds of opinions and educational pieces about the Affordable Care Act for healthinsurance.org.
Footnotes
- “Title 45 § 155.420 Special enrollment periods” Code of Federal Regulations. Accessed Sep. 25, 2025 ⤶ ⤶
- “Special Enrollment Periods Reference Chart” Center on Budget and Policy Priorities, Beyond the Basics. Updated August 2025 ⤶
