Preparing for Open Enrollment 2026: Key Steps Every Consumer Should Know
Open enrollment runs Nov 1 to mid-January. Key deadlines, cost trends, and how to compare Marketplace vs. private PPO — so you don't overpay.Open Enrollment • Get Ready
Preparing for Open Enrollment: Dates, Deadlines & Smart Moves
Why costs keep climbing
- Medical inflation — hospital, physician, and facility prices keep outpacing wages
- Prescription trend — specialty drugs (including GLP-1s) are widening spend
- Higher utilization — delayed care is catching up and pushing claims higher
- Plan-design shifts — deductibles, copays, and contributions get adjusted
What to compare during Open Enrollment
Marketplace (Government)
- Premium tax credits available if your income qualifies
- HMO/EPO networks common; referrals often required
- County-based networks — choices vary by ZIP
- Available during Open Enrollment or a qualifying life event
Private PPO (Licensed Access)
- Broad PPO access, referrals typically not required
- Medically underwritten — can be lower-cost for healthy households
- Often better for travel, provider choice, and specialist access
- Available year-round (subject to eligibility)
Key enrollment timing
State-based exchanges may run different dates — ask us to confirm your state's exact deadlines, or check the current-year guide linked above.
How RKA helps — no pressure, just answers
- Side-by-side comparisons — Marketplace vs. private PPO, matched to your doctors and prescriptions
- Network & Rx checks — we confirm providers and drug tiers up front to prevent surprises
- Year-round support — we stay with you for renewals, plan changes, and claims questions
Want a side-by-side Marketplace vs. private PPO analysis?
We'll verify networks and medications, compare plans in your ZIP, and show clear costs — no pressure, just answers.
Get Free Quotes Book a CallQuick FAQs
Is the employer plan always best?
Not always. If spousal or child premiums are high, moving them to a Marketplace or private PPO plan can cut total household cost while keeping access. We model both paths.
Can you verify our doctors and hospitals first?
Yes — we confirm providers and prescriptions up front so you avoid out-of-network surprises or drug-tier shocks later.
Can we switch mid-year?
Generally only with a qualifying life event. Otherwise Open Enrollment is your main window — though a private PPO may offer year-round access if you're eligible.
Educational use only; benefits and eligibility vary by employer, carrier, and state. Always review official plan documents. Private plans are medically underwritten — not all applicants qualify. RKA Insurance Advisors is an independent, licensed health insurance brokerage (NPN 19540130). We do not offer Medicare. Call (561) 806-9913.
