Open Enrollment: Your 2026 Guide to Health Benefits

The start of fall also means the annual benefits enrollment season is upon us. Each year, this offers an opportunity to evaluate your options to find the right health plan choice for you and your family.

This guide from Blue Shield of California gives practical advice on what to consider when it comes to your health insurance.

Important dates for enrollment

• Covered California: Open Enrollment is November 1, 2025, through January 31, 2026. Californians can also enroll at any time when experiencing a qualifying life event, such as losing a job, turning 26, experiencing impacts from wildfires and more.
• Medicare: Annual Enrollment Period is October 15, 2025, through December 7, 2025. Those who are new to Medicare can enroll as soon as they become eligible.
• Employer plans: Varies by employer, generally between September and December.

Choosing the right plan: key considerations

Whether you’re selecting a plan through your employer, Covered California or Medicare, start by thinking about the following:

• Your personal health needs should guide your decision-making. Consider the types of care you may need to access — whether it’s specialist visits, prescriptions, preventive screenings, mental health support, lab work, virtual care, or access to urgent and emergency services. Keep in mind that most plans are required to offer things like preventive care at no additional cost. Make sure you review all the benefits and resources available to you through your health plan.
• Budget matters, too. Think about the total out of pocket costs — not just in monthly premiums. Consider your typical usage of the health system as you factor in the cost of deductibles, copay and out-of-pocket maximums. Understanding the full cost of care can help you avoid future surprises.
• Consider your provider network. Confirm that your doctors and care teams are covered by your plan, and weigh whether you’ll need flexibility to see providers outside that network.
• Don’t forget plan type. The structure of your health plan affects how you access care, what you pay and how flexible your options are. Preferred Provider Organizations (PPOs) offer broad access — including out-of-network care — but usually come with higher premiums. Health Maintenance Organizations (HMOs) are more budget-friendly but require you to stay within a network and get referrals. High-Deductible Health Plans (HDHPs) may suit those who want lower premiums and can manage higher out-of-pocket costs, especially when paired with a Health Savings Account (HSA).
• Beyond medical care. Dental and vision care is strongly connected to your overall health, so don’t overlook the details when selecting these plans. You may find it helpful to select a vision/dental plan from the same insurer that’s offering your medical benefits, so that your health plan can help provide you with the full picture of your health.

Insights from Blue Shield of California experts

We asked several Blue Shield leaders to share thoughts on the importance of open enrollment and tips for members:

Ellen Sexton, Executive Vice President, Chief Growth Officer

“As one of the most important health decisions you’ll make all year, open enrollment deserves your full and undivided attention. Make sure to start researching early, compare plans and ask questions — we’re here to help you through this important process.”

Tim Lieb, Senior Vice President, Commercial Markets

“Open enrollment is a critical time to make sure your health coverage aligns with your needs. If you’re covered through your employer, don’t hesitate to reach out to us directly for help navigating your options. If your employer is hosting a benefits fair, that’s also a great opportunity to get your questions answered to help you make informed decisions that support both your health and financial well-being.”

Patrice Bergman, Vice President, Individual and Family Plans

“Choosing a health insurance plan can feel daunting, especially if you’re navigating other life changes. When reviewing your options, be sure to consider what will be covered at each plan level, and what your premium will be when factoring in subsidies and other assistance that may apply to you. Whether you’re enrolling through Covered California or buying a plan directly through Blue Shield, we’re available to educate and support our members every step of the way.”

Alex Uhm, Vice President, Medicare

“Your health needs are unique, and your Medicare plan should reflect that. Each year, your needs may change, so the annual enrollment period is a critical time to assess your current health and lifestyle, review your options, and ask questions to make sure your plan is a good fit for you — and make any necessary changes.”

Theresa Boudreau, Vice President, Specialty

“Dental exams and cleanings are not just about maintaining a bright, pretty smile and vision exams offer a unique opportunity for preventive measures, as well. Both can help detect and prevent serious health conditions. Open enrollment is your moment to think holistically about your health, and that means being informed, proactive and intentional about the coverage you select.”

Learn more about the medical, dental and vision plans Blue Shield of California offers.

From BlueShieldCA.com