It’s that time of year again: In most states, the Affordable Care Act‘s annual open enrollment season for health plans begins Nov. 1 and lasts through Jan. 15.

Current enrollees who do not update their information or select an alternative will be automatically reenrolled in their current plan or, if that plan is no longer available, into a plan with similar coverage.

Last year marked a record enrollment of about 21 million people. This time around, consumers will find a few things have changed.

Don’t fall for advertising scams

While some health plans offer small-dollar gift cards or other incentives to encourage participation in wellness efforts, they would not offer cash cards worth thousands of dollars a month to help with groceries, gas or rent. Even so, social media and online sites are rife with such promises.

Such ads are among the avenues allegedly used by unscrupulous brokers who enroll or switch plans without the express permission of consumers, according to a lawsuit filed in Florida.

Also, be cautious about the websites you use to search for coverage.

Type “Obamacare” or “cheap health insurance” into a search engine and often what pops up first are sponsored private sector websites unaffiliated with the official state or federal government marketplaces for ACA coverage.

While they may try to look official, they are not. Many such sites offer various options, including non-ACA coverage with limited benefits, a “secret shopper” study found in 2023. Such non-ACA coverage would not qualify for federal subsidies to help consumers pay premiums.

The fine print on some websites says that consumers who provide personal information automatically consent to be contacted by sales agents via phone calls, emails, text messages or automated systems with prerecorded messages.

When exploring plans, always start with the official federal marketplace’s website, healthcare.gov.

Even if you don’t live in one of the 29 states served by the federal marketplace, its website provides the link to your official enrollment site when you select your state, or the District of Columbia, from a drop-down list. The federal and state marketplaces also have call centers and other ways to get enrollment assistance. The “find local help” link on healthcare.gov, for example, gives consumers a choice of finding assisters or sales agents near them.

Is it real insurance?

Another concern: Regulators are seeing an increase in complaints from consumers about offers of health coverage requiring consumers to join a limited liability corporation, or otherwise attest they are working for a specific company. Indeed, at least two states — Maryland and Maine — have issued warnings, saying that instead of comprehensive ACA coverage, these are often non-ACA products, amounting to a hodgepodge of discount cards, for example, or limited-indemnity plans. This type of plan pays a flat-dollar amount — say, $50 for a doctor visit or $1,000 for a hospital stay — and is meant to buttress more comprehensive coverage, not replace it.

“Unlike major medical plans, some of these self-funded plans only cover preventive services such as a yearly check-up or annual health screening,” the warning from the Maine Bureau of Insurance says.

Premiums might be higher — and other new things

Some insurers will lower premium rates for 2025, but many others are increasing them.

Although final numbers are still being crunched, experts estimate a median increase of 7% for premiums, according to an analysis by KFF, a health information nonprofit that includes KFF Health News. Most people who buy ACA coverage are eligible for a subsidy to help with the premiums, which is likely to offset much of the increase, although the higher cost means the government will be paying out more for those subsidies.

Rising health costs — including for hospital care and the new class of weight loss drugs — are contributing to the increase.

Some other changes this open season: 

• People often referred to as “Dreamers” because they qualified for the Deferred Action for Childhood Arrivals — a federal program offering some protection to those brought to the country as children without proper immigration documentation — can now enroll in ACA coverage and are eligible for subsidies.
• Short-term plans, which are technically not ACA coverage and not subject to its benefit rules and preexisting benefit protections, can be issued for, at most, only four months of coverage, based on a Biden administration action that took effect with plans starting Sept. 1. It walks back a Trump administration rule that loosened requirements to allow insurers to offer coverage that ranged up to 364 days, and allowed insurers the option of renewing the policies for up to two additional years. Existing plans and those issued before Sept. 1 don’t fall under the new rules. But consumers who relied on the longer periods need to check their plans’ details and consider enrolling in an ACA plan instead to avoid a situation in which their short-term plan expires early or midyear, potentially leaving them unable to get coverage elsewhere for the remainder of the year.

The sign-up process might take longer, too

Federal regulators this year wrestled with a growing number of complaints — 200,000 in the first six months alone — from consumers who were being enrolled into or switched from ACA plans without their express permission by agents seeking to gain commissions.

To thwart such efforts, they put new rules in place.

What does that mean for most consumers? If you are working with a new agent — one who wasn’t already listed on your ACA plan — you will likely need to get on a three-way call with the federal marketplace to confirm that you are, indeed, authorizing that agent to make changes to your policy for the coming year. Plan on this taking additional time. No one knows how busy the call lines will get during open enrollment.

You don’t need to use a broker to enroll. But sorting through the dozens of options on the marketplace is challenging, so most people do seek assistance. Consumers need to weigh not only the monthly premium cost, but also variations in deductibles and copayments for such things as doctor visits, hospitalization, and drugs. 

Shop around

Experts say another consideration when choosing a plan is to check whether its network includes the doctors and hospitals you typically see, as well as whether its formulary covers your prescription medications, and how much it charges for them.

To help with making comparisons, rules kicked in two years ago requiring insurers to include some “standardized plans” as options, which must all have the same deductibles, and costs for such things as doctor visits, emergency room care, and other consumer cost sharing.

Even so, many people have dozens of options available, which can be daunting.

But one piece of advice remains constant: Whether you are enrolling for the first time or have an existing plan, it’s always worth it to shop around. Even if you don’t change plans, you can make sure the one you have is still your best option.

In most states, consumers must enroll by Dec. 15 to get coverage that begins Jan. 1. Heads up in Idaho, where open enrollment starts earlier — Oct. 15 — but also ends sooner, closing on Dec. 15. In California, New Jersey, New York, Rhode Island and the District of Columbia, residents can enroll through Jan. 31.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling and journalism.

At least six people were killed and seven injured in an Israeli airstrike on an apartment building in Beirut overnight, Lebanon’s Health Ministry said, as governments around the world scrambled to evacuate their citizens from the country.

The airstrike hit near the residential Bashoura district.

Residents reported a sulfur-like smell following the attack, and Lebanon’s state-run National News Agency accused Israel of using internationally banned phosphorous bombs. Human rights groups have in the past accused Israel of using white phosphorus incendiary shells on towns and villages in conflict-hit southern Lebanon.

Israel was pursuing a ground incursion into Lebanon against Hezbollah while conducting strikes in Gaza that killed dozens, including children. The Israeli military said eight soldiers have died in the conflict in southern Lebanon.

On Wednesday, the United Nations Security Council held an emergency meeting Wednesday to address the spiraling conflict in Middle East.

Iran’s ambassador to the U.N. said his country launched nearly 200 missiles at Israel on Tuesday as a deterrent to further Israeli violence, while his Israeli counterpart called the barrage an “unprecedented act of aggression.”

Israeli Prime Minister Benjamin Netanyahu vowed late Tuesday to retaliate, and an Iranian commander threatened wider strikes on infrastructure if Israel did so. U.S. President Biden said Wednesday that he would not support an Israeli attack targeting Iran’s nuclear program.

Israel and Hezbollah have traded fire across the Lebanon border almost daily since the day after Hamas’ cross-border attack on Oct. 7, 2023, which killed 1,200 Israelis and took 250 others hostage. Israel declared war on the militant group in the Gaza Strip in response. More than 41,000 Palestinians have been killed in the territory, and just over half the dead have been women and children, according to local health officials.

Japan on Thursday dispatched two Self Defense Force planes to prepare for a possible airlift of Japanese citizens from Lebanon. And the Australian Foreign Minister Penny Wong said on Thursday her government had booked 500 seats on commercial aircraft for Australian citizens, permanent residents and their families to leave Lebanon on Saturday.   

A joint federal intelligence bulletin obtained by CBS News warns of potential violent extremism and hate crimes committed in response to the one-year mark of the Oct. 7 attack on Israel by the militant group Hamas and the resulting conflict in Gaza.

The bulletin, authored by FBI, Department of Homeland Security and National Counterterrorism Center, was first disseminated by federal law enforcement to local law enforcement partners late Wednesday. 

The agencies found that the one-year mark of the attack “as well as any further significant escalations” in the Israel-Hamas war “may be a motivating factor for violent extremists and hate crime perpetrators to engage in violence or threaten public safety,” the bulletin read.

The bulletin provided several recent examples of such threats, including the Sept. 6 arrest of a Pakistani national by Canadian authorities who was accused of planning a mass shooting at a Jewish center in New York City.

The bulletin also comes as tensions have continued to ramp up in the Middle East. Following an Israeli airstrike on Beirut last week which killed longtime Hezbollah chief Hassan Nasrallah, Iran on Tuesday responded with a missile salvo on Israel, launching nearly 200 ballistic missiles, most of which were intercepted by Israel’s missile defense systems. Hamas and Hezbollah are both proxies of Iran. 

Israel also began limited ground operations in southern Lebanon this week.  

Following Iran’s missile attack, a senior DHS official told CBS News during a briefing Wednesday, “I don’t know that we’ve got a crystal clear assessment on that at this point. We are literally in the earliest days of trying to understand what exactly Iranian intentions might be. We do, though, assess that Iran has a global capacity and a global capability, that it can draw, that it can target U.S. interests around the world – that it certainly has the reach and capacity to do, to carry out, to engage with individuals here inside the United States in ways that present potential threat to the United States, here in the homeland.”

The official added that this is an area of “near daily engagement” between DHS, FBI and other law enforcement partners.

Iran has been involved in “a variety of other efforts in the aftermath of Oct. 7,” the official noted, including “putting out fabricated material to try to increase people’s anger about the post-Oct. 7 situation.” 

The bulletin cautioned that “the expansion of the conflict further into the region could serve as motivation for violence against Jewish, Israeli, or American targets in retaliation for civilian deaths, and we cannot preclude the possibility that threat actors in the United States will react with violence to the death” of Nasrallah.

Intelligence analysts revealed in the bulletin that the Oct. 7 attack and Israel-Hamas war “have been cited as sociopolitical grievances influencing some individuals mobilization to violence in the United States,” adding that “hate crimes surged shortly following the attacks and have decreased over the past several months to levels consistent with reporting prior to the conflict, a trend that mirrors hate crimes following previous international conflicts or events.”

In the immediate months after Oct. 7, reports of antisemitic incidents surged in the U.S. The Anti-Defamation League said it recorded 2,031 antisemitic incidents nationwide between Oct. 7 and Dec. 7 of 2023, a 337% increase compared with the same period in 2022.

“Over the past year, we have observed violent extremist activity and hate crimes in the United States linked to the conflict,” the bulletin read. “Jewish, Muslim, or Arab institutions, including synagogues, mosques, and community centers, and large public gatherings, such as memorials, vigils, or other demonstrations, present attractive targets for violent attacks or for hoax threats by a variety of threat actors, including homegrown violent extremists, domestic violent extremists, and hate crime perpetrators who may view the anniversary as an opportunity to conduct an attack or other high-profile, illegal activity.”

The bulletin also warns that foreign terrorist organizations have created media that compares the Oct. 7 and 9/11 attacks and encourages “lone attackers to use simple tactics like firearms, knives, Molotov cocktails, and vehicle ramming against Western targets in retaliation for deaths in Gaza. Individuals inspired by this online messaging could act alone to commit an attack with little to no warning.”