ACA Open Enrollment: Find the Right Health Plan for You and Your Family in 2025

With the Affordable Care Act (ACA) Open Enrollment period having begun November 1, now is the time to sign up for quality, affordable health coverage for yourself and your family for 2025.

Legacy Community Health believes that healthcare is a right, and that’s why we are committed to guiding you through the ACA enrollment process. We’ll both help you understand how enrollment can benefit you and assist you in selecting the plan that best fits your needs.

What is the Affordable Care Act?

The Affordable Care Act is a federal health care law enacted in March 2010 to make health insurance affordable and accessible for millions of Americans and lawfully present immigrants. Under the ACA, people who lack employer-based health insurance, are self-employed, gig workers, freelancers, or work part-time, or who may have been uninsured due to preexisting conditions, can secure affordable health plans through their state’s Health Insurance Marketplace.

The Texas Health Insurance Marketplace offers a platform for individuals and families to compare health plans and find coverage options that best fit their needs and budget.

Key Dates for ACA Open Enrollment

Here are the important dates to mark on your calendar.

• November 1: Open Enrollment begins. This is the first day you can apply, renew, or make changes to your plan for 2025. Remember that even if you were enrolled in a marketplace insurance plan for this year, you must re-enroll to get coverage next year.
• December 15: This is the last day you can enroll in or make changes for coverage to start on January 1. Since it’s important not to have a lapse in coverage, it’s best if you enroll by this date.
• January 15: This is the very last day of Open Enrollment. If you don’t enroll by January 15, you can’t get coverage for 2025. (The only exception to this is for those who fall under the Special Enrollment Period due to a qualifying change of circumstances.)
• February 1: This is the day health insurance coverage begins for those who enrolled between December 16 and January 15.
• Special Enrollment Periods: These periods allow certain individuals to sign up for coverage after Open Enrollment if they experience a qualifying life event like marriage, birth, or a significant income change.

Enroll with Legacy Community Health’s Help or On Your Own

You can start the enrollment or re-enrollment process in one of two ways, either with Legacy Community Health’s assistance or on your own.

If you would like our help, schedule an appointment with one of our Certified Application Counselors (CACs) by calling (832) 548-5223. Each CAC is specially trained and can guide you step-by-step through the enrollment process, ensuring you don’t miss any critical details.
If you prefer to enroll on your own, you can visit Healthcare.gov to start the application process yourself.

Whichever option you choose, we have prepared a checklist that lists all of the required information and documents you will need to complete the enrollment. You can access the Open Enrollment Checklist here and read it online or download and print it out. Collect the information mentioned in the checklist ahead of time so that the enrollment process is seamless and easy.

Subsidies Are Available For Those Who Need Them

Many ACA plans offer financial subsidies that significantly reduce people’s monthly premiums and out-of-pocket costs. Subsidies are often available for lower-income individuals and families, helping them to afford comprehensive health care coverage through the ACA.

Legacy’s CACs can help determine if you qualify for financial assistance. To check your eligibility, either call Legacy at (832) 548-5223 to set up an appointment with one of our CACs, or contact the Marketplace Call Center directly at (1-800) 318-2596, which is available 24 hours a day, 7 days a week, except for holidays.

Choosing the Right Plan

Regardless of which plan you choose, all of the ACA Marketplace plans are required to cover ten essential health benefits. Such benefits include free preventive health services like medical screenings and vaccines, prescription medications, pediatric care, emergency services, hospitalization, and mental health services. Each plan also covers pre-existing conditions, meaning someone can receive the care they need regardless of their health history.

The Four Marketplace Categories

Marketplace plans are divided into four categories, namely Bronze, Silver, Gold, and Platinum. The difference between these plan categories is how costs are shared between the insurance provider and you, the covered person, which affect the premiums, deductibles, and out-of-pocket maximum that have to be paid.

Monthly premiums are the amount you have to pay to maintain insurance coverage. Deductibles are the amount you need to pay for a medical visit or treatment before your insurance payments kicks in. Copayments and coinsurance are the small payments you make for services each time you receive care. Meanwhile, an out-of-pocket maximum is the maximum amount you have to pay in any given year, after which your insurance covers 100% of services and treatments under your plan.

Marketplace Plan Types and Networks

There are four main health insurance plan and network types. Exclusive Provider Organizations (EPO) cover services only if you use in-network doctors, with the exception of emergencies. Health Maintenance Organizations (HMO) cover care from in-network providers only. Point of Service (POS) plans cover both in- and also out-of-network care, but require referrals for out-of-network providers. Finally, Preferred Provider Organizations (PPO) cover in-network care and also allow patients to access out-of-network providers, although at a higher cost.

Choose the plan that’s right for you based on your specific health needs and care frequency, as well as your budget. Legacy Community Health’s CACs can help you with this.

Why Health Insurance Matters

Health insurance is important not just for when you feel sick. It’s also an important security net in case you or a family member experience an unexpected accident, illness, or suffer from a chronic condition. Lack of health insurance can place you and your family into deep medical debt if an unexpected health problem occurs and lead to personal bankruptcy.

To avoid that, it’s important to sign up for affordable health coverage NOW, during the ACA Open Enrollment period. The Affordable Care Act gives you access to preventive care, emergency support, and ongoing treatment for long-term health needs. With coverage, you can focus on wellness and avoid the high costs of emergency care you would have to pay without insurance.

Legacy Community Health Can Help You With the Enrollment Process

Legacy Community Health is here to guide you through the entire ACA enrollment process. We want to ensure every member of our community has access to affordable, comprehensive health care. Call (832) 548-5223 to connect with a Certified Application Counselor. Let us guide you through the enrollment process so you can get the coverage you need and deserve.

Take charge of your health by enrolling right now during the ACA Open Enrollment period to ensure you have the best health coverage to protect yourself and your family. With Legacy Community Health by your side, finding the right plan and navigating the enrollment process is easy.