2027 Open Enrollment Tips: How to Avoid Overpaying This Year

Why this year's open enrollment matters more than usual

Enhanced premium tax credits, which had temporarily made Marketplace coverage more affordable for a broader range of incomes, expired at the end of 2025. That expiration drove a roughly 58% average increase in what Marketplace enrollees actually paid out-of-pocket in 2026, even after subsidies. For 2027, insurers are now proposing a second consecutive year of double-digit rate increases, with a median proposed increase around 14% and some insurers requesting more than 20%.

The practical impact varies significantly depending on your income. Most enrollees, including the 87% who still qualified for some subsidy in 2026, are at least partially cushioned, since subsidy amounts generally rise as premiums rise. But if your household income is at or above 400% of the federal poverty level, you likely lost your subsidy entirely when the enhanced credits expired, meaning you're now facing the full brunt of these increases with no cushion at all.

It's also worth knowing that at least one major national carrier, Cigna, has announced it will not offer Marketplace plans in any state for 2027, following another major carrier's exit the year before. If your current plan is with an insurer scaling back or exiting your state's Marketplace, you may not have the option to simply keep your existing coverage even if you wanted to.

Enrollment numbers themselves reflect how disruptive last year's subsidy expiration already was: effectuated Marketplace enrollment fell by several million people between early 2026 and the same point the year before, as many healthier, lower-cost enrollees dropped coverage once their out-of-pocket cost jumped. That shift in who remains enrolled is part of why insurers are citing a less favorable risk pool as one driver behind this year's proposed rate increases, on top of general rising healthcare costs.

Tip 1: Never let your plan auto-renew without comparing it first

Auto-renewal exists for convenience, not for your financial benefit. Given this year's rate environment, a plan that was competitively priced last year may no longer be the best option in your area for 2027, even before accounting for your own household's potential income or family changes. Logging into the Marketplace and actively comparing your current plan against newly priced alternatives, rather than assuming it will simply renew at a similar cost, is the single most impactful thing you can do this enrollment period.

Tip 2: Re-run your subsidy eligibility, don't assume last year's number still applies

Because subsidy amounts are tied to your projected household income for the coming year, not a fixed dollar figure, it's worth re-entering your current income estimate rather than assuming your subsidy stayed the same as last year. A change in income, household size, or even just the underlying premium increases themselves can shift your subsidy amount meaningfully in either direction. If you've never qualified for a subsidy before due to your income, it's still worth checking again, since certain thresholds and calculations are adjusted annually.

Tip 3: Confirm your doctors and hospitals are actually in-network

Insurers adjust their provider networks regularly, and a network that included your preferred doctor last year isn't guaranteed to include them this year, especially if you're considering switching plans to manage a premium increase. Before enrolling, search each plan's current provider directory directly rather than relying on a general description like "broad network," and consider calling your specific doctor's office to confirm they're still accepting that exact plan for 2027.

Tip 4: Check your prescription formulary, not just the plan's reputation

A plan's overall reputation tells you very little about whether it covers your specific medications at an affordable cost tier. Formularies change annually, and a drug that was a low-cost generic tier last year can shift to a higher-cost specialty tier under a different plan, or even under the same plan's updated formulary. If you take regular prescriptions, this is worth checking before you enroll, not after your first pharmacy visit of the new plan year.

Tip 5: Compare your total expected annual cost, not just the monthly premium

With premiums rising broadly this year, it can be tempting to simply chase the lowest monthly number. But a lower premium plan typically pairs with a higher deductible and higher cost-sharing once you actually need care. Adding your expected annual premium to a realistic estimate of your deductible, copay, and coinsurance costs based on your actual healthcare usage gives a far more accurate picture than the premium alone.

Tip 6: Watch your out-of-pocket maximum specifically

Your out-of-pocket maximum is the real ceiling on your financial risk in a bad year, the point past which your plan covers 100% of covered costs. With overall costs rising across the Marketplace this year, comparing the out-of-pocket maximum specifically between your options, not just the premium or deductible individually, is worth the extra few minutes, especially if you have any reason to expect a major medical event in the coming year.

Tip 7: If you're near the 400% FPL subsidy cliff, run the numbers carefully

If your household income is close to 400% of the federal poverty level, it's worth running your specific numbers precisely rather than assuming. A small change in projected income, a part-time hour reduction, a retirement account contribution, or a dependent change, can meaningfully affect whether you qualify for a subsidy at all given how the enhanced credits have expired. This is exactly the kind of calculation where a licensed broker's help tends to be most valuable, since the math isn't always intuitive.

Tip 8: Know your exact deadline, and don't wait until the last week

In most states, 2027 Marketplace open enrollment runs from November 1, 2026 through January 15, 2027. Enrolling by December 15 generally means coverage starts January 1; enrolling after that but before the January 15 deadline generally means coverage starts February 1. A few states that run their own exchanges set slightly different deadlines, so confirming your specific state's dates directly is worth doing rather than assuming the federal dates apply everywhere.

Tip 9: Consider getting a licensed broker's help, since it costs nothing extra

Comparing dozens of available plans against your specific income, prescriptions, and preferred providers is genuinely time-consuming to do thoroughly on your own, especially in a year when carrier lineups, formularies, and subsidy math have all shifted at once. A licensed broker can run this comparison for you across multiple carriers, and since brokers are compensated by the insurance carriers rather than by charging clients directly, this costs you nothing beyond what you'd pay enrolling yourself. If your situation has changed, say you're newly self-employed, comparing individual coverage or a short-term bridge plan alongside Marketplace options is also worth a broker's input.

A quick checklist before 2027 open enrollment ends

• Compare your current plan against newly priced alternatives rather than letting it auto-renew.
• Re-enter your current projected household income to get an updated subsidy estimate, rather than assuming last year's figure still applies.
• Confirm your specific doctors and hospitals are in-network under any plan you're considering, especially if you're switching.
• Check your specific prescriptions against each plan's current formulary and cost tier.
• Compare your total expected annual cost, premium plus realistic out-of-pocket spending, not just the monthly premium number.
• Mark your state's specific enrollment deadline, and aim to enroll well before the final date to avoid a last-minute rush.

For the authoritative, non-commercial sources on this topic, HealthCare.gov publishes the official 2027 open enrollment dates and plan comparison tools directly, and the Kaiser Family Foundation (KFF) publishes independent, non-partisan research on ACA Marketplace premium trends and subsidy impacts nationally.

Frequently asked questions about 2027 open enrollment

Have a question that isn't answered below? Our full health insurance FAQ page covers more, and our blog has deeper guides on specific coverage topics.