When is open enrollment for 2027 coverage?

On HealthCare.gov it runs November 1, 2026 to January 15, 2027. Pick a plan by December 15 for January 1 coverage. State exchanges set their own end dates, from December 15 in Idaho to January 31 in several states. Medicare has its own window, October 15 to December 7.

Did the bigger tax credits come back?

No. They expired at the end of 2025. The House passed a three-year extension on January 8, 2026, but it didn't become law, and the 400 percent of poverty cutoff is back. We found nothing enacted through October 14, 2026.

What is the most I could pay out of pocket in a year?

For covered in-network care, up to $12,000 for one person and $24,000 for a family in 2027. That's up from $10,600 and $21,200 in 2026. Premiums and out-of-network care don't count toward the limit.

Why did my premium jump, and what is the cliff?

Federal help shrank in 2026. Average premiums paid after credits rose 58 percent, from $113 to $178 a month. For 2027 coverage there is no federal premium credit above $63,840 of income for one person or $132,000 for a family of four.

How do I avoid scams and unwanted plan changes?

Type HealthCare.gov or your state exchange directly, because scammers pay for top spots in results and copy government names. After any agent contact, check your account or call 1-800-318-2596. Report fraud at ReportFraud.ftc.gov.

Is a short-term plan a cheaper substitute?

It isn't an ACA plan. Short-term plans are generally exempt from the individual-market rules, and in August 2025 the federal government said it wouldn't prioritize enforcing the four-month limit. The FTC alleged in 2025 that sellers misrepresented preexisting-condition coverage and benefit caps. Read the exclusions before you pay.

Finance & Insurance

Before You Buy Health Insurance for 2027: The Bigger Tax Credits Are Gone. The Deductible Is Where It Hurts.

The bigger federal tax credits expired after 2025, and what people paid each month after credits rose 58 percent on average. Here's what a bad year can cost on a 2027 plan, the income line that ends federal help, and the sales tricks to dodge.

Published July 19, 2026 Updated October 20, 2026 22 min read High Risk

Disclosure: This guide may contain affiliate links. Learn more.

Quick Verdict

Buy at HealthCare.gov or your state exchange by December 15 for January 1 coverage if you have no affordable employer plan and your income is under 400 percent of the poverty level. Check your doctors, your drugs and your worst-case year before you click enroll. Walk away from anyone who calls you first, calls a plan a government give-back or asks for your Social Security number by text.

No-email calculator

What could this health plan cost you in a year

See your best case, your cost for the care you expect and your worst case once you add twelve premiums to what you pay at the doctor.

Monthly premium after any tax credit (dollars) Default: KFF's average premium paid after tax credits in 2026, across all enrollees. Replace it with the price on your plan. Deductible (dollars) Default: KFF's average Marketplace deductible for 2026. Your share of costs after the deductible (percent) Placeholder from a silver plan paying about 70 percent on average. Use the coinsurance on the plan's Summary of Benefits and Coverage. Out-of-pocket maximum (dollars) Default: the 2027 federal ceiling for one person. Many plans set it lower. Covered in-network care you expect, at plan-allowed prices (dollars a year) Placeholder, not an average. We found no sourced typical figure for one person.

Best case (you use no care) Calculating...

If you use the care you entered Calculating...

Worst case (you hit the maximum) Calculating...

This is a planning estimate, not insurance advice. Real plans use copays and their own rules, so check the Summary of Benefits and Coverage. In-network preventive care is generally free even before the deductible. The maximum leaves out premiums, out-of-network care, services the plan doesn't cover and charges above the allowed amount.

Your Premium Isn't Last Year's Premium

The bigger federal tax credits expired at the end of 2025.

Congress didn't agree to extend them. The House passed a three-year extension (H.R. 1834) 230 to 196 on January 8, 2026. It didn't clear the Senate.

KFF's October 6, 2026 fact sheet still blames that expiration for higher payments and lower sign-ups.

Here's what it did to the average enrollee:

Measure	2025	2026
Premium paid after tax credits, per month	$113	$178
Average Marketplace deductible	$2,759	$3,786
Share of people choosing bronze	30%	40%
Share of people choosing silver	57%	43%

That's 58 percent more per month, about $780 more a year. Our arithmetic. The deductible rose 37 percent, the steepest jump since the markets opened, KFF says.

You may have seen a 114 percent figure. That was KFF's projection for people with credits who kept the same plan. The 58 percent is what people paid on average. Many stories merged the two.

People did the sensible thing. They moved to cheaper plans with bigger deductibles.

A bill that isn't law can't lower your January premium.

We found nothing enacted through October 14, 2026 that brings the bigger credits back. Don't wait for Congress. Enroll inside the window.

What Plans Cost Before Credits, and What 2027 May Add

Before any credit, these are the national average prices for a 40-year-old, from KFF:

Plan	2025	2026
Lowest-cost bronze	$381	$456
Lowest-cost silver	$486	$611
Benchmark (second-lowest-cost silver)	$497	$625
Lowest-cost gold	$507	$615

The benchmark matters most. Your federal credit is built on it.

For 2027, KFF reports a median proposed increase of 15 percent across 276 insurers. A year earlier the median was 18 percent proposed and 20 percent finalized.

Final 2027 rates weren't published when we checked. As an illustration only, 15 percent on $625 is $718.75 a month. That's not a forecast.

HealthCare.gov says 2027 income levels and savings show up starting November 1. Prices for your ZIP code arrive then.

The Income Line That Ends Federal Help

For 2027 coverage, there's no federal premium credit above 400 percent of the poverty level.

That's $63,840 for one person and $132,000 for a family of four. Our arithmetic: four times the 2026 guidelines of $15,960 and $33,000.

Below the line, the IRS sets how much of your income you're expected to pay toward the benchmark silver plan. This is the 2027 table from Rev. Proc. 2026-26, released July 21, 2026:

Income as a share of the poverty level	Share of income you're asked to pay
Under 133%	2.15%
133% to under 150%	3.23% to 4.30%
150% to under 200%	4.30% to 6.78%
200% to under 250%	6.78% to 8.66%
250% to under 300%	8.66% to 10.22%
300% to 400%	10.22%
Over 400%	No federal premium credit

Two examples for a single person. Our arithmetic.

At 250 percent ($39,900), you're asked for 8.66 percent. That's $3,455 a year, about $288 a month.

At 400 percent ($63,840), you're asked for 10.22 percent. That's $6,524 a year, about $544 a month.

Now add a benchmark. We used 2026's national average of $625 a month ($7,500 a year) as a stand-in.

The first person would get about $4,045 in credit. The second would get about $976. One dollar over the line, nothing.

The line doesn't bend. Know where you sit before you pick a plan.

Your real credit also depends on your age, your ZIP code, your household and your plan. The Marketplace calculates it.

Two more facts:

Healthinsurance.org explains that HSA and pre-tax retirement contributions lower the income used for the credit
If your employer's employee-only plan costs more than 10.22 percent of household income in 2027, or fails the minimum value test, you may qualify for the credit instead

KFF found sign-ups from the 400 to 500 percent group fell 44 percent.

Your Worst Year: What the Maximum Covers and Skips

The out-of-pocket maximum is the most you pay in a year for covered, in-network care. After that the plan pays 100 percent of that care.

Limit	2026	2027
Out-of-pocket maximum, one person	$10,600	$12,000
Out-of-pocket maximum, family	$21,200	$24,000

That's 13.2 percent higher for 2027. Our arithmetic.

What the maximum leaves out, according to HealthCare.gov:

Your premiums
Out-of-network care
Services the plan doesn't cover
Charges above the plan's allowed amount

Not every dollar waits for the deductible. In-network preventive care is generally covered at no cost before you meet it. HealthCare.gov says $0 isn't guaranteed in every case.

The metal tiers describe what a plan pays on average. They don't describe what you'll pay. Bronze pays about 60 percent, silver 70, gold 80 and platinum 90. Silver with extra savings pays 73 to 96 percent.

Here's the gap in 2026. The standard silver plan averaged a $5,304 deductible. A silver plan with cost-sharing reductions, for a person at 150 percent of the poverty level, averaged $80. That's KFF's number.

Use the calculator above to see your own best case, expected case and worst case.

Bronze, Silver or Gold: Run the Numbers at Your Income

Cost-sharing reductions only come with silver plans.

Silver premiums run high because insurers add the unfunded cost of those reductions to silver prices. Healthinsurance.org says that can make bronze or gold cost less than silver after credits in many places. Check actual prices at your income.

A few facts that changed:

Every Marketplace bronze and catastrophic plan counts as HSA-eligible since January 1, 2026, per IRS Notice 2026-5 (we read it through summaries)
The 2027 HSA limit is $4,500 for one person and $9,000 for a family
A 2027 high-deductible plan needs a deductible of at least $1,750 (one person) or $3,500 (family)
Its out-of-pocket maximum can't top $8,700 or $17,400
Catastrophic plans are for people under 30 or with a hardship exemption, and a court stayed the September 2025 expansion on July 16, 2026

A bronze plan fits when you have cash for the deductible. The 2026 average is $3,786. The 2027 ceiling is $12,000 for one person.

If you can't cover those in a bad year, the cheap premium isn't cheap.

Other Ways to Get Covered

The Marketplace isn't the only door.

Employer coverage. It counts as affordable in 2027 if the employee-only premium is at most 10.22 percent of household income and the plan meets minimum value. Otherwise Marketplace credits may apply.

COBRA. You may be required to pay the entire premium, up to 102 percent of the plan's cost, the Department of Labor says. We couldn't confirm the election window, so check your notice.

Medicaid and CHIP. You can apply any time. Healthinsurance.org puts expansion-state eligibility at up to 138 percent of the poverty level. People eligible for Medicaid or CHIP can't get premium credits.

Off-exchange plans. Same insurer, same plan, no credit. Healthinsurance.org says this only makes sense above 400 percent, and only after you compare the exchange price.

Medicare. It's a separate market with its own window, covered in the dates section below. For what Original Medicare does and doesn't pay for hearing aids, see the hearing aids guide.

For car, home and life coverage, see the insurance guide.

Check the Doctors, Drugs and Insurer Before You Click

Federal law (42 U.S.C. 300gg-115) says plans must verify and update provider directories at least every 90 days and remove providers they can't verify.

If you rely on wrong in-network information, the plan can't charge you more than in-network cost sharing.

Still, ask the office and the insurer. Write down the date, the name and a reference number.

A formulary is the list of covered drugs, per HealthCare.gov. Ask for the tier. Ask whether the drug needs prior authorization or step therapy. "Similar drugs are covered" isn't an answer.

This is a document check, not medical advice.

Then check your insurer. KFF's October 7, 2026 tracker lists 11 insurers announcing 2027 exits and 6 entering. Cigna leaves all 11 of its states. KFF counts over 350,000 on-exchange enrollees there in the first quarter of 2026.

Healthinsurance.org earlier counted at least a dozen exits. Counts differ by date and definition.

If your plan ends, auto-renewal picks a replacement for you. Healthinsurance.org's advice is to pick your own.

Auto-renewal is a default. It isn't a recommendation.

Dates That Decide Your January

Event	Date
HealthCare.gov open enrollment	November 1, 2026 to January 15, 2027
Enroll by this date for January 1 coverage	December 15, 2026
Enroll by this date for February 1 coverage	January 15, 2027
Special enrollment	January 16 to October 31, with a qualifying event
Medicaid and CHIP	Any time
Medicare open enrollment	October 15 to December 7
Medicare Advantage open enrollment	January 1 to March 31, for people already in a plan

Why isn't the window shorter? HHS's 2025 rule would have ended HealthCare.gov enrollment on December 15. A federal judge in Maryland vacated that change on June 12, 2026 in City of Columbus v. Kennedy.

HHS appealed in July. Oral argument is set for late October. The schedule could change for fall 2027.

State exchanges set their own dates. Healthinsurance.org's list was updated August 10, 2026. It runs from December 15 in Idaho to January 31 in California, D.C., New Jersey, New York and Rhode Island.

Some dates changed in July and August. Confirm yours.

Turning 65? Marketplace credits stop once you're eligible for premium-free Part A. Your initial Medicare window lasts 7 months, starting 3 months before the month you turn 65.

That's a date check, not Medicare advice.

Income Mistakes and Missed Payments Cost More Now

Starting with tax year 2026, the cap on repaying excess advance premium tax credits is gone. You repay the full excess.

The Journal of Accountancy reports that Treasury and the IRS estimate about 3.7 million returns in 2028 will include repayment. That comes from proposed regulations in October 2026.

HealthCare.gov says your savings are based on your income estimate for the year you want coverage, not last year.

Never let anyone else set your income estimate.

Then the first bill. With advance credits you get a 3-month grace period if you already paid at least one full month. If you never pay what you owe, coverage can end back to the first month you missed.

Non-payment doesn't open a special enrollment period. And if coverage ends before mid-December, you won't be auto-re-enrolled for next year.

It shows in the counts. KFF has paid-up enrollment falling from a 2025 high of 22.1 million to 19.2 million in February 2026, about 13 percent. Sign-ups fell only about 5 percent. KFF ties the drop to the jump in premium payments.

When a Health Insurance Sale Goes Wrong: The Cases

These are public cases. Most are allegations or settlements without a trial. Most licensed agents aren't part of any of them.

Assurance IQ and MediaAlpha, August 7, 2025. The FTC announced $145 million in settlements, $100 million from Assurance IQ and $45 million from MediaAlpha. The FTC described both as refunds to consumers.

The FTC alleged Assurance IQ telemarketers sold short-term and limited-benefit plans bundled with telemedicine and discount plans. It alleged they claimed the plans covered preexisting conditions and had no benefit caps. It alleged consumers were charged without informed consent.

The FTC alleged MediaAlpha sold about 119 million consumer leads in 2024. It alleged the company ran sites such as ObamacarePlans.com and GovernmentHealthInsurance.com and promoted a nonexistent government "Health Insurance Give Back Program" using actors and celebrities.

The orders were proposed stipulated orders. The FTC case page still said "Pending," and we found no docket entry showing court approval.

Unauthorized switches. A CMS update dated October 17, 2024 counted 183,553 complaints of unauthorized enrollment and 90,863 of unauthorized plan switches from January through August 2024. CMS suspended 850 agents and brokers from June to October 2024. We found no 2025 or 2026 update.

Lloyd and Strong. A federal jury in West Palm Beach convicted both on November 17, 2025 of conspiracy and wire fraud. Strong was also convicted of money laundering. DOJ says they sought over $233 million in fraudulent subsidies and at least $180 million was paid.

DOJ says applications used falsified income and mismatched addresses and Social Security numbers. Some enrollees lost Medicaid or other coverage. DOJ's April 7, 2026 release says Lloyd was sentenced to 20 years.

AP of South Florida and AssuredPartners, April 7, 2026. DOJ says APSF agreed to plead guilty to one count of major fraud over $141.5 million in subsidies, with $27.6 million in restitution. AssuredPartners paid $107 million to settle civil claims. Those civil claims are allegations with no finding of liability, and the plea needed court acceptance. DOJ described people losing Medicaid or local assistance coverage and facing plans that didn't cover their medical needs.

Why it matters to you: with no repayment cap, an income someone else typed into your application can become your bill.

Short-term plans. They're generally exempt from ACA individual-market rules. A 2024 rule capped new plans at four months. On August 7, 2025 the Departments of Labor, HHS and Treasury said they intend new rulemaking.

They also said they don't intend to prioritize enforcement of the 2024 definition until then. We found no final rule.

Paid ads that look official. The FTC's September 28, 2026 alert says scammers sometimes pay to appear at the top of results and use web addresses that resemble government sites. Type the official name. Look for "Ad" or "Sponsored" and a .gov ending. Report fraud at ReportFraud.ftc.gov.

For how quote forms sell your details, see the insurance guide.

Your Rights After You Enroll

We found no federal free-look window for individual health plans on HealthCare.gov. After the deadlines, changes need a special enrollment period. We also found no sourced state free-look rules.

Appeals. If a claim is denied or coverage is canceled, you can ask for an internal appeal and then an external review by an independent third party. Urgent cases get faster handling. HealthCare.gov doesn't list deadlines, so check your plan's letter.

Surprise bills. The No Surprises Act took effect January 1, 2022. It protects you from out-of-network bills for emergency care, certain non-emergency care at in-network facilities and air ambulance.

CMS's consumer page doesn't mention ground ambulance. Complaints go to 1-800-985-3059.

If you're uninsured or self-pay, you can request a good faith estimate. You can dispute a bill at least $400 above it.

Unwanted enrollment. If an agent enrolled you without your consent, call the Marketplace Call Center at 1-800-318-2596 (TTY 1-855-889-4325).

Medical debt. KFF's 2022 survey found 41 percent of adults had health care debt. The CFPB's January 2025 rule to remove medical bills from credit reports was vacated on July 11, 2025.

Twelve Checks Before You Click Enroll

Twelve lines. Each comes with the answer that should worry you.

Am I on the real site? HealthCare.gov or your state exchange, ending in .gov. Bad answer: an "Ad" result, a .com lookalike or a "give back" program.
My 2027 income estimate. Bad answer: copying last year's income or letting a stranger set it.
Where I sit against 400 percent. $63,840 for one person and $132,000 for a family of four. Bad answer: finding out in April that you were a dollar over.
Do I qualify for silver savings? Check on HealthCare.gov. Bad answer: choosing bronze without pricing a silver plan with extra savings.
The worst year, not just the premium. Twelve premiums plus the maximum. Bad answer: a tiny premium next to a $12,000 maximum and no cash.
Is my doctor in the network today? Ask the office and the insurer, and write it down. Bad answer: we take most plans.
Is my drug on the formulary? Get the tier, prior authorization and step therapy in writing. Bad answer: similar drugs are covered.
How does the network work? Ask about out-of-network coverage and referrals. Bad answer: assuming PPO or EPO means the same thing everywhere.
Is my insurer staying? Read the renewal or discontinuation notice. Bad answer: accepting the auto-renewal pick without comparing.
Does the plan fit an HSA? Use the 2027 numbers above. Bad answer: planning contributions on a plan that doesn't qualify.
How do I pay the first bill? Know the grace period. Bad answer: assuming a missed payment is harmless.
After any agent call, did anything change? Log in or call 1-800-318-2596. Bad answer: an enrollment you don't recognize, a Social Security number asked for by text or a "government give-back."

The Summary of Benefits and Coverage is HealthCare.gov's "easy-to-read summary" for comparing plans. Ask for it before you enroll.

Who Should Buy Now, Wait, or Walk Away

Six rules. Each one comes from the numbers and cases above.

Buy at the exchange now if you have no affordable employer plan and your income is under 400 percent

Credits are tied to the benchmark plan. The HealthCare.gov window runs November 1 to January 15. Enroll by December 15 for January 1.
Don't wait for Congress to restore bigger credits

Through October 14, 2026 they hadn't returned. A rule that isn't law can't lower your January bill.
Wait to click enroll until you've checked your doctor, your drugs and your worst-case year

That's checks 5 to 7 above. December 15 still gets you January 1.
Walk away from a seller who calls you first, calls the plan a government give-back, asks for your Social Security number by text or won't name the plan

The FTC's 2025 cases and its September 2026 alert describe those moves.
Walk away from a short-term plan as a replacement for a real plan unless you've read the exclusions

The FTC alleged sellers misrepresented preexisting-condition coverage and benefit caps.
Think twice about bronze unless you can cover the deductible and the maximum

The 2026 average deductible is $3,786. The 2027 maximum is $12,000 for one person. A silver plan with extra savings may beat bronze if your income qualifies. At 65 or close, check Medicare's window instead.

How We Checked It

We read HealthCare.gov, CMS, the IRS and the Department of Health and Human Services. We read the FTC, the Department of Justice, the Department of Labor and Medicare.gov. We checked them on October 20, 2026. KFF, Healthinsurance.org, the Journal of Accountancy and ASTHO are secondary sources.

Healthinsurance.org says it may receive compensation, including from an affiliated licensed insurance agency. We used it for dates and for facts it cites to CMS, KFF and the IRS, and checked key numbers against primary pages where we could.

Nothing here is medical, legal, tax or insurance advice.

The pages we used:

What we couldn't confirm:

Final 2027 premiums, which weren't published when we checked
Whether a court approved the FTC's Assurance IQ and MediaAlpha orders
The income limit for silver cost-sharing reductions, which HealthCare.gov puts on a separate page we didn't use
Whether the family plan rule that caps each person at the self-only limit applies to your plan
CMS unauthorized-enrollment counts for 2025 or 2026
Average prices for short-term plans and health care sharing ministries
State free-look rules, appeal deadlines and the COBRA election window
A typical yearly care cost for one person
Whether a short-term plan rule has been proposed

This guide is part of our series on what people research before they buy.

Frequently Asked Questions

When is open enrollment for 2027 coverage?: On HealthCare.gov it runs November 1, 2026 to January 15, 2027. Pick a plan by December 15 for January 1 coverage. State exchanges set their own end dates, from December 15 in Idaho to January 31 in several states. Medicare has its own window, October 15 to December 7.
Did the bigger tax credits come back?: No. They expired at the end of 2025. The House passed a three-year extension on January 8, 2026, but it didn't become law, and the 400 percent of poverty cutoff is back. We found nothing enacted through October 14, 2026.
What is the most I could pay out of pocket in a year?: For covered in-network care, up to $12,000 for one person and $24,000 for a family in 2027. That's up from $10,600 and $21,200 in 2026. Premiums and out-of-network care don't count toward the limit.
Why did my premium jump, and what is the cliff?: Federal help shrank in 2026. Average premiums paid after credits rose 58 percent, from $113 to $178 a month. For 2027 coverage there is no federal premium credit above $63,840 of income for one person or $132,000 for a family of four.
How do I avoid scams and unwanted plan changes?: Type HealthCare.gov or your state exchange directly, because scammers pay for top spots in results and copy government names. After any agent contact, check your account or call 1-800-318-2596. Report fraud at ReportFraud.ftc.gov.
Is a short-term plan a cheaper substitute?: It isn't an ACA plan. Short-term plans are generally exempt from the individual-market rules, and in August 2025 the federal government said it wouldn't prioritize enforcing the four-month limit. The FTC alleged in 2025 that sellers misrepresented preexisting-condition coverage and benefit caps. Read the exclusions before you pay.