Open enrollment for 2027 coverage opens November 1, 2026 and closes January 15, 2027, with December 15 as the practical deadline if you want coverage in force on January 1. Those weeks decide the plan you will live with for all of 2027, and this year the decision carries more weight than usual: for the second year in a row, Marketplace insurers have filed double-digit price increases, and several of the rules that shaped last year’s comparison have changed. Here is a plain-English guide to comparing your 2027 options before the window closes.
What is behind the 2027 numbers
Insurers have proposed a median increase of 15% for 2027, according to a KFF analysis of filings from 276 insurers across the country published on August 3, 2026. That follows 2026, when the median proposed increase was 18% and the median finalized increase was 20% — two consecutive years of double-digit requests after several years of near-flat pricing.
Two forces are doing the work. The first is ordinary: the rising cost of health services, general inflation, and workforce shortages in care delivery. The second is specific to this market: the enhanced premium tax credits — the federal help that stretched affordability from 2021 through 2025 — expired at the end of 2025. Healthier enrollees were the first to drop coverage when their help shrank, which left a sicker, more expensive pool behind. In the filings that break the numbers apart, insurers attribute roughly four percentage points of their 2027 requests to that effect alone, and they expect it to continue.
What does that look like on a real bill? KFF’s example: a 40-year-old in Indianapolis earning $65,000 a year paid $316 a month in 2025 with the enhanced credit in place. In 2026, after the credit expired and prices rose, the same person paid $477. If the 2027 filings are approved as filed, that payment reaches $546 — a 41% increase in two years.
Two important qualifiers keep that from being the whole story:
- Subsidies move with the benchmark. Premium tax credits are set against the second-lowest-cost silver plan in your area, so when that plan’s price rises, the credit rises with it. 87% of Marketplace enrollees were receiving a subsidy at the start of 2026, and many of them are partially insulated from the headline increase. If you do not receive a credit — including everyone who buys coverage outside the Marketplace — the full increase lands on you.
- Your number is not the average number. For context behind the averages: KFF found the average Marketplace consumer’s monthly premium payment after tax credits rose 58% in 2026, from $113 to $178, and the average deductible rose 37% to $3,786 — the highest average in its records. The average benchmark silver plan carried a gross premium of roughly $625 a month in 2026, while the average lowest-cost bronze option ran about $456. If you want the fuller picture, our post on what changed in 2026 Marketplace premiums and deductibles walks through it, and what happened to the enhanced ACA subsidies explains the policy shift itself.
There is one more number worth holding onto as you shop. Plan selections fell to 23.1 million for 2026, down from a record 24.3 million the year before, and the mix shifted sharply: according to CMS, bronze plan enrollment rose by 10 percentage points while silver fell by nearly 14 points compared with 2025. A lot of people bought down on premium without comparing the deductible and the worst-case year first. That is the mistake this checklist exists to prevent.
Three things that changed for 2027
Standardized plans are no longer required. Under the 2027 Payment Notice final rule CMS issued in May 2026, insurers are no longer required to offer the standardized plan options that made plans line up side by side. Expect fewer apples-to-apples comparisons, which means the line-by-line reading below matters more this year than last.
The out-of-pocket maximum is higher. For 2027 the cap on your worst-case year is $12,000 for an individual and $24,000 for a family, up from $10,600 and $21,200 in 2026. Some bronze plans are allowed to carry even higher individual limits. This single number decides what a bad year actually costs you, so read it before you fall for a low premium.
Subsidy eligibility is narrower. Starting with 2027 coverage, premium tax credits and cost-sharing reductions are limited to U.S. citizens and nationals and a defined set of immigration statuses. If you are not a U.S. citizen, confirm your eligibility before you count on a credit — you can still buy a plan, but the math changes. Verification of income and household details is also stricter for 2027, so expect to re-confirm your information during enrollment rather than carrying last year’s answer forward.
Also worth checking: insurers enter and leave the Marketplace from year to year. The plan you have today may not exist in the form you are used to, so confirm it is still offered before you assume renewal is the default.
The comparison checklist
1. Compare three numbers, not one
The premium is one line of a three-line bill:
- Premium — what you pay every month, whether or not you use care.
- Deductible — what you pay before the plan starts sharing costs. (For a deeper walkthrough of how deductibles actually behave, see understanding your health insurance deductible.)
- Out-of-pocket maximum — your worst-case year, and higher for 2027 than it was for 2026.
A bronze plan with the lowest premium can be the cheaper choice in a year you barely see a doctor — and the more expensive one in a year you need real care. Neither answer shows up in the premium column.
2. Re-check your subsidy — do not assume it
The formula, the eligibility rules, and your own income and household can all move the number between one year and the next. Households above 400% of the federal poverty level generally receive no premium tax credit, while many households below that line still qualify for meaningful help — and the income thresholds are updated with each plan year. Check the 2027 income levels published with the plan year rather than reusing last year’s figures, and run your own situation instead of assuming last year’s answer still applies.
3. Check the network, not just the price
A plan is only as good as the doctors and hospitals it actually includes. Before you renew or switch, confirm that your primary care physician, any specialists you see, and your preferred hospital are in the plan’s provider network — and re-check even if you are staying in the same plan, because networks can change year to year. If you are weighing plan types at all, the HMO vs. PPO decision guide is a useful side-by-side.
4. Check the drug formulary
If you take prescription medications, the formulary deserves its own line in your comparison. Look up each of your medications on the plan’s drug list and note the tier, the copay or coinsurance, and any prior authorization or step therapy requirements. Two plans with identical premiums can differ by hundreds of dollars a month on the prescriptions you actually fill.
5. Look at silver plans if your income qualifies
Cost-sharing reductions — separate from the premium tax credit — can dramatically lower deductibles and copays on silver plans for people below certain income levels. In 2026, KFF’s figures showed the average benchmark silver deductible dropping to roughly $80 for enrollees under 150% of the federal poverty level, and to about $790 between 150% and 200%. Bronze plans do not qualify for cost-sharing reductions at all. Whether that discount applies to you under the current formula is worth checking, not assuming.
6. Read the renewal notice line by line
Your renewal notice is not just a bill. It typically shows what your new premium will be if you stay, and any changes to your plan’s benefits, network, or drug coverage. If the number looks higher than expected — with a second year of double-digit requests behind it, it may well be — that is the signal to compare, not to panic, and not to auto-renew without looking.
7. Put the dates on your calendar
For most people, open enrollment for 2027 coverage runs November 1, 2026 through January 15, 2027, with December 15 as the deadline for coverage starting January 1. Enroll between December 16 and January 15 and coverage generally starts the first of the following month. State-run Marketplaces keep somewhat different windows, so check your own schedule rather than assuming the federal dates. Outside of a qualifying life event, you generally cannot switch plans mid-year — the plan you choose at enrollment is the one you live with for twelve months.
If you are self-employed
This enrollment period lands differently when there is no employer plan behind you. There is no group contract to absorb the increase and no HR department to re-shuffle the design — your plan is your plan, which makes the total-cost comparison above more consequential for you than for almost anyone else. If a Marketplace plan no longer fits your budget, it is worth asking what else is available before you simply accept the renewal price.
It is also a good moment to remember what health insurance does not do. It covers medical bills; it does not cover the months of work you might miss, and it does not leave your family anything if something happens to you. Disability income coverage and life insurance are the natural companions to a self-employed health plan for exactly that reason — they cover the income the health plan was never designed to cover. Options, pricing, and eligibility vary by individual circumstances and are subject to underwriting.
Want a second set of eyes on the comparison?
If comparing five spreadsheets of plan details is not your idea of a good evening, you do not have to do it alone. A licensed agent can walk through the three numbers with you — premium, deductible, and worst-case year — side by side, check your providers and prescriptions against each plan, and help you see which option fits how you actually use care. Explore your health insurance options or give us a call. There is no cost to talk, and no pressure to buy.
This article is general information, not a guarantee of pricing, eligibility, or plan availability — those depend on your location, income, and circumstances. For official plan information and enrollment, you can always visit HealthCare.gov.
For more information, visit us at trekis.net or call 888-960-0442.