Marketplace Open Enrollment Starts November 1: Your Guide to Shopping 2027 Health Plans
Shopping for health insurance can feel more complicated when premiums, plan choices and eligibility rules are changing at the same time. For 2027, individuals and families should expect to compare plans carefully, not simply renew last year’s coverage and assume the price, doctors or benefits are unchanged.
The Marketplace open enrollment period runs November 1, 2026, through January 15, 2027, in most states. If you want coverage to begin January 1, plan to enroll or make changes by December 15. Here’s a plain-English guide to the dates, key changes and plan details to check before you choose.
Key dates for 2027 coverage
According to HealthCare.gov’s dates and deadlines:
November 1, 2026: Open enrollment begins. You can apply, renew or change Marketplace plans.
December 15, 2026: Generally, the last day to enroll or change plans for coverage beginning January 1.
January 1, 2027: Coverage can begin for people who enroll by December 15 and pay their first premium.
January 15, 2027: Open enrollment ends in most states.
February 1, 2027: Coverage can begin for people who enroll or change plans between December 16 and January 15, once the first premium is paid.
State-based Marketplaces may have different details, so check your state exchange’s deadline. After open enrollment ends, you generally need to qualify for a Special Enrollment Period, often because of a life change such as losing other coverage, moving, getting married or having a baby. Medicaid and CHIP applications are accepted year-round for people who qualify.
What’s changing for 2027?
Premiums may rise, but your increase depends on your situation
Insurers have proposed a median premium increase of about 15% across the individual market, according to KFF’s analysis of 2027 premium proposals. That is a proposed rate change across insurers, not a prediction that every customer’s bill will rise by 15%. Your final premium depends on your location, age, plan, household and eligibility for financial assistance.
The enhanced premium tax credits available from 2021 through 2025 were not extended. That can mean higher costs for some people, particularly those who no longer qualify for the same level of assistance. At the same time, eligible consumers’ tax credits are tied to the cost of a benchmark Silver plan, so the impact is not identical for everyone. Enter your updated information and compare the actual prices available to you before deciding.
Some insurers are leaving markets
Insurer participation is changing in some states and counties. KFF’s tracker of 2027 Marketplace participation reports both carrier exits and new entries. That can affect which plans are available where you live, and whether your current doctors or hospitals are in network.
Even if your current insurer still offers coverage, check the new plan’s provider directory, prescription list and cost-sharing. A familiar company name doesn’t guarantee the plan is unchanged.
Some noncitizens may no longer qualify for federal financial assistance
Starting with 2027 coverage, eligibility for Marketplace premium tax credits and cost-sharing reductions is limited to U.S. citizens, U.S. nationals and specified categories of eligible noncitizens. Other lawfully present noncitizens may still be able to enroll in a Marketplace plan, but generally won’t qualify for those federal forms of assistance under the new rules.
Because eligibility depends on immigration category and individual circumstances, don’t assume you qualify, or don’t qualify, without checking. The Centers for Medicare & Medicaid Services’ guidance explains the categories and verification process.
Be ready for identity and document checks
The federal Marketplace may need to verify identity or information provided on an application. Applicants seeking financial assistance may need to provide information from immigration documents so their eligibility can be checked. If information can’t be confirmed electronically, you may be asked to submit documents by a deadline.
Broker-assisted applications also require consumer authorization, and some situations may require identity proofing before an agent or broker can proceed. Keep requested documents accessible, review notices promptly and respond by the stated deadline. For more detail, see CMS’s identity-proofing and broker-authorization FAQs.
Maximum out-of-pocket costs and HSA limits are higher
For 2027 Marketplace plans, the maximum in-network out-of-pocket limit is $12,000 for self-only coverage and $24,000 for family coverage. This is a ceiling for covered in-network care, not a cap on premiums, noncovered services or all out-of-network expenses. Review the plan’s terms to understand what counts toward the limit.
The 2027 HSA contribution limits are $4,500 for self-only coverage and $9,000 for family coverage. These are contribution limits, not the deductible. You must have an HSA-qualified high-deductible health plan to contribute, so confirm a plan’s HSA status before factoring the account into your budget.
How to compare plans beyond the monthly premium
A low premium can be appealing, but it doesn’t tell you what a year of care might cost. Compare these details for each plan you’re considering:
Total cost exposure: Review the deductible, copays, coinsurance and out-of-pocket maximum. Consider both a typical year and a year with unexpected medical needs.
Doctors and hospitals: Confirm that your primary care provider, specialists and preferred hospitals are in network for the specific 2027 plan. Provider directories can change.
Prescription coverage: Search the plan’s drug formulary for every medication you take. Check its tier, restrictions and estimated cost.
Plan structure: Understand whether the plan is an HMO, PPO, EPO or another type. Rules for referrals and out-of-network care vary.
Financial assistance: Update your household size, income estimate and other application details. Don’t rely on last year’s estimate or assume an existing credit will stay the same.
Household needs: If you’re choosing coverage for several people, compare each person’s doctors, medications and expected care, not just the household premium.
If you qualify for cost-sharing reductions, compare eligible Silver plans closely: these reductions apply to out-of-pocket costs, not just the monthly premium. For more help weighing plan details, see our guide to 20 questions to ask before choosing individual health coverage.
Make a short checklist before you enroll
Gather the information you’ll need to estimate eligibility and compare coverage:
Your household members and expected 2027 income
Social Security numbers or other requested application details
Current coverage information
Names of preferred doctors, hospitals and prescriptions
Any documents the Marketplace asks you to provide
Then compare available plans, verify network and drug information directly with the insurer, and review your final application before submitting it. Pay the first premium by the insurer’s deadline to activate coverage.
When one-on-one help can be useful
Individual health insurance help can make the process easier if you’re comparing several plans, estimating household income, checking provider networks, responding to a verification request or navigating a change in subsidy eligibility. A licensed insurance professional can help explain trade-offs and guide you through the steps, while the Marketplace or insurer makes official eligibility and coverage determinations.
At DATC Consulting Group, we help individuals and families make informed insurance decisions based on their needs and budget. If you’d like support reviewing your options, contact DATC Consulting Group or book a consultation.
Mark the dates, update your information and compare your 2027 options before renewing. A careful review now can help you choose coverage that fits your health needs and your financial plans for the year ahead.
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