Is Your Insurance Changing at Open Enrollment? How to Talk It Through With Your Therapist So Care Is Not Interrupted

Reviewed by: Matthew Sexton, LCSW

Yes, if your insurance may change at open enrollment, talk it through with your therapist before choosing a plan, so a network change shows up before a new Medicare plan starts January 1. This applies to clients picking 2027 coverage through Medicare (October 15 to December 7), the HealthCare.gov Marketplace (from November 1) or an employer plan, because a new plan can leave a therapist out of network; the step is to ask the therapist and the plan, before enrolling, whether that therapist is in the plan’s network. The official pages at Medicare.gov and HealthCare.gov, checked October 4, 2026, give the enrollment dates and tell people to ask their doctors if they are in network with the plan. They do not show whether a given therapist will be in a given plan’s network. Bring the plan names to the next session.

Key takeaways

• Medicare Open Enrollment runs October 15 to December 7, per Medicare.gov.
• Marketplace Open Enrollment for 2027 starts November 1, per HealthCare.gov.
• Medicare tells people to ask their doctors whether they are in network with the plan.
• In a Medicare HMO, care outside the network may cost the full price.

Why Does Open Enrollment Matter for Therapy?

A plan change can change who is in network. HealthCare.gov defines a network as the providers a plan “has contracted with to provide health care services,” and a therapist who contracts with one plan may not contract with the next.

Skipping the question has a cost. In a Medicare HMO, people generally must get care from providers in the plan’s network, and Medicare.gov warns that care outside the network may mean paying the full cost. Most Medicare HMOs also require a referral to see a specialist.

The question is sharper this fall. Medical Daily reports that the two largest Medicare Advantage insurers are steering members toward plans with tighter doctor networks, and that members who let a plan roll over without checking could start the new year in a network that no longer includes their doctors.

When Are the 2027 Enrollment Windows?

Each kind of plan has its own window. Medicare’s Open Enrollment Period runs October 15 to December 7, and a new Medicare plan starts January 1 if the plan gets the request by December 7, per Medicare.gov.

On HealthCare.gov, Open Enrollment starts November 1, December 15 is the last day to choose a plan that starts January 1, and enrollment ends January 15, per the Marketplace dates page. Healthinsurance.org notes the November start applies in most states, so people on a state-run exchange should check that exchange.

Employer plans are not covered by the Medicare or Marketplace dates above; the employer’s own plan materials give that window.

What Should a Client Ask the Therapist Before Picking a Plan?

The client should ask plain questions, early. Medicare.gov’s advice is to ask doctors whether they are in network with the plan, and the same habit fits any plan type. Useful questions:

• Which plans and networks does the practice contract with now?
• Is the practice in the network of the plan being considered, under that exact plan name?
• What changes for the client when new coverage starts, and what paperwork does the practice need?
• If the plan is an HMO, will a referral be needed to keep seeing the therapist?
• If the therapist is out of network, what are the options, including paying the therapist directly?

A therapist’s answer is a starting point. The plan’s own directory and member services are the next place to ask.

What Should the Therapist Do With That Conversation?

The therapist’s job here is information, not plan advice. A useful response names the plans the practice contracts with, says plainly when the answer is unknown, and points the client to the plan’s directory and to Medicare.gov or HealthCare.gov for the rules.

It is not a sales talk. It is a continuity talk. Raising it before enrollment closes gives the client time to compare plans while the therapist is still one phone call away. MWS has written about how network rules affect behavioral health access for clinicians who want the policy side.

What if the New Plan Does Not Include the Therapist?

The client still has choices, and the therapist can help sort them. Some clients keep the therapist and pay out of network or directly. Some choose a different plan. Others need a clinician in the new network or within a new budget.

For that last group, Couch Commons is a directory where clients can find and contact clinicians directly. It is not an insurance tool and does not check networks; the plan confirms network status. MWS explains what Couch Commons is in more detail.

Takeaway

Open enrollment is not only a money decision. It is a care decision. A short conversation with the therapist before choosing a plan, followed by a check of the plan’s directory, is a chance to spot a network change before it affects sessions.

Frequently asked questions

Should a client tell the therapist about an insurance change before open enrollment ends?

Yes. Medicare.gov tells people choosing a plan to ask their doctors whether they are in network with the plan, and the therapist is one of those clinicians. Raising it before enrolling leaves time to compare plans.

Can a therapist say whether a 2027 plan will pay for sessions?

No one can promise that in advance. The therapist can say which plans the practice contracts with; the plan’s own directory and member services are the next place to ask.

What if an employer plan, not Medicare or the Marketplace, is changing?

The Medicare and Marketplace dates do not apply; the employer’s own plan materials give the window. The questions for the therapist are the same.

What happens if a client misses the Marketplace deadline?

HealthCare.gov says that after Open Enrollment ends, people can enroll in or change plans only if they qualify for a Special Enrollment Period, such as losing job-based coverage.

This article is general information for clinicians, not legal, billing or clinical advice.

Sources

All checked October 4, 2026.

• Medicare.gov, Joining a plan: https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/joining-a-plan
• Medicare.gov, Health Maintenance Organizations (HMOs): https://www.medicare.gov/health-drug-plans/health-plans/your-coverage-options/HMO
• HealthCare.gov, When can you get health insurance?: https://www.healthcare.gov/quick-guide/dates-and-deadlines/
• HealthCare.gov, Network (glossary): https://www.healthcare.gov/glossary/network/
• HealthCare.gov, Special Enrollment Period: https://www.healthcare.gov/coverage-outside-open-enrollment/special-enrollment-period/
• Healthinsurance.org, Health insurance premium increases for 2027: https://www.healthinsurance.org/blog/health-insurance-premium-increases-for-2027-proposed-rates-by-state-and-what-consumers-should-know/
• Medical Daily, UnitedHealthcare and Aetna Shift 2027 Medicare Advantage Toward HMOs: https://www.medicaldaily.com/medicare-advantage-2027-hmo-shift-check-doctors-479480

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