Open Enrollment 2027: Your Health Insurance Checklist

Key Dates for Open Enrollment 2027

What Changed for 2027

Enhanced subsidies remain in place. The Inflation Reduction Act extended enhanced premium tax credits through 2025, and subsequent legislation has continued them into the 2027 plan year. This means more people — including those with moderate and higher incomes — qualify for meaningful premium reductions than in prior years.

The benchmark plan calculation may shift your subsidy. Each year, the government recalculates the second-lowest-cost Silver plan (the benchmark) in your area. Even if your income did not change, your subsidy amount may be different because the benchmark plan changed. Always re-check your eligibility rather than assuming last year's subsidy still applies.

Carrier and plan availability changes annually. Insurers enter and exit markets, change their networks, and restructure their plan tiers every year. A plan you were happy with in 2026 may have different premiums, a different network, or different drug formulary in 2027. Never auto-renew without reviewing your options.

Medicaid redeterminations are ongoing. If your income is near the Medicaid threshold, verify your eligibility status before Open Enrollment. Some households that lost Medicaid coverage during the redetermination process may now qualify for marketplace subsidies they did not previously need.

How to Compare Plans: The Four Numbers That Matter

Premium — what you pay every month regardless of whether you use care. A lower premium is not always better; it usually means a higher deductible or narrower network. Look at the full picture, not just the monthly cost.

Deductible — what you pay out of pocket before insurance starts covering most services. A $6,000 deductible plan with a $200 monthly premium may cost more than a $1,500 deductible plan at $350 per month if you use your insurance regularly.

Out-of-pocket maximum — the most you will ever pay in a plan year. Once you hit this number, insurance covers 100% of covered services. For 2027, the federal out-of-pocket maximum for marketplace plans is $9,450 for an individual and $18,900 for a family. Some plans set lower limits.

Network — which doctors, hospitals, and specialists are covered. HMO plans require referrals and restrict you to in-network providers. PPO plans offer more flexibility but typically cost more. Before you enroll, confirm your primary care doctor, any specialists you see regularly, and your preferred hospital are in-network.

Do You Qualify for a Subsidy?

Premium tax credits (subsidies) are available to households earning between 100% and 400% of the Federal Poverty Level — and under the enhanced subsidy rules, households above 400% FPL may also qualify if their benchmark plan premium would exceed 8.5% of their household income.

For 2027, the income thresholds are approximately: $15,060 for a single person (100% FPL), $20,440 for a two-person household, $25,820 for three people, and $31,200 for a family of four. These figures are updated annually — use the current year's FPL table when calculating your eligibility.

Cost-sharing reductions (CSRs) are an additional benefit available to households earning between 100% and 250% FPL. CSRs lower your deductible, copays, and out-of-pocket maximum — but only if you enroll in a Silver-tier plan. If you qualify for CSRs, a Silver plan will almost always give you more value than a Bronze plan even if the Bronze premium looks lower.

To claim your subsidy, you must enroll through the federal marketplace (healthcare.gov) or your state's exchange. You cannot receive premium tax credits through an off-marketplace plan. An independent insurance advisor can help you calculate your estimated subsidy before you enroll.

What to Do If You Miss Open Enrollment

If you miss the January 15 deadline without a qualifying life event, you have a few options — none of them ideal, but all worth knowing.

Short-term health plans are available outside of Open Enrollment and can provide temporary coverage while you wait for the next enrollment window. However, they are not ACA-compliant, which means they can exclude pre-existing conditions, cap benefits, and deny claims for services they deem non-essential. They are a bridge, not a solution.

Medicaid and CHIP have no enrollment window. If your income qualifies, you can apply any time of year. Medicaid eligibility is based on current monthly income, not annual income, so a job loss or income reduction may make you newly eligible even mid-year.

Special Enrollment Periods (SEPs) are triggered by qualifying life events: losing job-based coverage, getting married or divorced, having or adopting a child, moving to a new coverage area, gaining citizenship, or leaving incarceration. You typically have 60 days from the event to enroll. Document the event — you will need to provide proof when you apply.