Three Top Tips Financial Advisors Need to Know During Marketplace Open Enrollment
The Open Enrollment period for the Federal ACA Marketplace this year (2025) starts on November 1st and runs until January 15th, so now is the time for financial advisors and their clients to take action. It’s important to note, however, that some states have their own Marketplaces and might have different timelines, so make sure to check if your state has its own Marketplace.
During Open Enrollment for the ACA Marketplace, your clients can:
- Switch from an alternative health plan (like short-term health plans and health sharing ministries) to an ACA Marketplace plan.
- Switch from one ACA Marketplace plan to another.
- Enroll in the ACA Marketplace if they’re uninsured.
- Join an ACA Marketplace plan for the first time.
- Actively renew their current ACA Marketplace plan.
But, simply enrolling is not enough to optimize clients’ healthcare costs and coverage. The plans available to your clients vary in price and benefits, and there can be hundreds of plan options to choose from. Plus, taking clients’ specific budgets, needs, and preferences into consideration will effectively narrow their search down and optimize their coverage. So, let’s dive into the three top tips you, the financial advisor, need to know for a successful ACA Marketplace Open Enrollment.
Timing is everything.
January 15th might sound like it’s far away, but it’ll be here before we know it. Not to mention that once the holiday season is in full swing, you and your clients will be busier and more preoccupied than at other points in the year. It’s also worth noting that even though ACA Marketplace Open Enrollment is open until January 15th, if your clients want their 2026 coverage to start on January 1st, they need to enroll by December 15th. An easy rule of thumb to remember is to make sure your clients get their health coverage taken care of during November.
And it’s not just the actual act of enrolling that’s on a time crunch.
For you to successfully help clients enroll in the ACA Marketplace, you also need to get a head start on having a healthcare planning conversation with clients. Lucky for you, a great way to bring clients in for a meeting is to let them know that the ACA Marketplace Open Enrollment is happening, so now is a good time to meet to go over their healthcare needs, preferences, and budget.
Look at all the costs, not just monthly premiums.
We offer this advice a lot, but something this important bears repeating. Copayments, deductibles, drug costs, and out-of-pocket maximums are all important factors to consider when optimizing clients’ healthcare costs.
The ACA Marketplace also has two cost-saving opportunities that need to be considered: Advanced Premium Tax Credits and medical tax deductions.
Advanced Premium Tax Credits (PTCs) are a type of subsidy that reduces the premium amount for individual or family health plans purchased through the ACA Marketplace. For your clients to be eligible, they must have an annual household income between 100% and 400% below the Federal Poverty Level (FPL), be enrolled in an ACA Marketplace plan, have U.S. citizenship or legal residency, file federal income tax returns, and must not qualify for other programs such as Medicaid and Medicare. Additionally, your client can not be eligible for an employee plan that offers minimum essential coverage. Below is a helpful chart you can use to determine your clients’ household subsidy.
Even if your client doesn’t meet the requirements to receive an Advanced Premium Tax Credit, there are other ways to reduce their overall annual healthcare costs.
How? Tax deductions.
If your clients itemize on their tax return, the IRS allows a medical tax deduction for qualified medical expenses when they exceed 7.5% of adjusted gross income (AGI), which is income minus any adjustments. The 7.5% threshold has varied over the years but was made permanent by the Consolidated Appropriations Act. Although taking this deduction requires tracking and itemizing allowable medical expenses, it may provide enough tax savings to make tracking worthwhile.
Review clients’ healthcare needs from the last year.
Taking the time to review how frequently clients used the healthcare system can make a big difference in the healthcare planning process. Review their medication costs, how frequently your client utilized the healthcare system and the out-of-pocket costs associated with those visits, and their monthly premiums.
If your client suspects their needs will remain the same, review their current plan to see if any coverage will change. For example, a medication that was covered last year under their current plan might not be covered at the same cost next year under the same plan. Another example is that their medication could still be covered, but the pharmacy they typically get the medication from won’t be considered “preferred, in-network” next year under their current plan. Contracts change every year, so never assume that just because a plan covered something last year, it’ll be covered next year under the same plan. The same goes for providers and hospitals. Just because your clients’ providers were in-network with their plan last year doesn’t mean that they’ll always be in-network.
Moving Forward
After reading these tips, you might be asking yourself how on earth you’ll have the time to meet with all your ACA Marketplace-eligible clients before January 15th. Or maybe you like the idea of helping your clients optimize their healthcare coverage, but you don’t like the idea of talking to them about their healthcare needs. In either case, it can feel overwhelming to do all this on your own. But the good news is that you don’t have to, because Move Health is here to help.
Our healthcare planning software and team of licensed agents take the heavy lifting of healthcare planning off of you, the advisor. We also simplify the process for your clients, making an often confusing and daunting experience much easier.
Schedule a call with our team to learn how partnering with Move Health supports clients’ financial goals, offers peace of mind for one of the most stressful areas of life (healthcare), and makes you the ultimate comprehensive financial advisor.
