🎯 In 30 seconds: Compare plans on what a year really costs you (premiums plus what you pay for care), not the premium alone. If your job offers coverage, that is usually where you start. If not, the Marketplace runs November 1, 2026 to January 15, 2027 for 2027 coverage. The extra subsidies of 2021 to 2025 have expired, and anyone who underestimates income now repays all the extra subsidy at tax time.
Where your coverage can come from
| Source | Who uses it | Key point |
|---|---|---|
| Employer plan | Most working-age adults | Employer usually pays a big share of the premium; you choose once a year or within 30 days of a life event |
| ACA Marketplace | Self-employed, early retirees, small-business staff, gap years | Premium tax credits based on income; open enrollment once a year |
| Medicaid and CHIP | Lower incomes, children, pregnancy, disability (rules differ by state) | Apply any time |
| COBRA | People leaving a job at a company with 20 or more employees | Same plan, but you pay up to 102% of the full cost |
| Medicare | 65 and older, and some people with disabilities | See the Medicare page |
The Marketplace for 2027: what changed
- Dates: HealthCare.gov open enrollment runs November 1, 2026 to January 15, 2027. Enroll by December 15 for coverage starting January 1. States that run their own exchange can set different dates.
- Who gets a premium tax credit: HealthCare.gov states that household income between 100% and 400% of the federal poverty level qualifies. The enhanced credits that removed the 400% ceiling and lowered required payments expired at the end of 2025, and Congress had not renewed them as of October 2026.
- Where the ceiling sits: for 2027 coverage the 2026 poverty guidelines apply, so 400% works out to about $63,840 for one person, $86,560 for two and $132,000 for a family of four (higher in Alaska and Hawaii). Check the figures on HealthCare.gov once 2027 numbers post.
- No more repayment cap: for tax years from 2026, the 2025 budget law removed the limit on paying back excess advance credits. If your actual income comes in higher than your estimate, you repay the full difference.
- Job offer rule: if an employer offers you coverage that counts as affordable (for 2026 plan years, self-only premium under 9.96% of household income) and meets minimum value, you generally cannot get a credit for a Marketplace plan.
Metal levels in one line each
On average, a Bronze plan pays about 60% of covered costs, Silver about 70%, Gold about 80% and Platinum about 90%. Lower-income enrollees who pick a Silver plan can get cost-sharing reductions that cut deductibles and copays; other metals do not get them. Catastrophic plans are open to people under 30 and some with hardship exemptions.
HDHP plus HSA vs a traditional plan: the math
Alex is choosing between two employer plans for self-only coverage. Assume 20% coinsurance after the deductible in both.
| PPO | HDHP with HSA | |
|---|---|---|
| Alex’s yearly premium | $1,800 | $720 |
| Deductible / out-of-pocket max | $1,000 / $4,000 | $2,000 / $5,000 |
| Employer HSA deposit | none | $750 |
| Light year ($500 of care) | $2,300 | $470 |
| Medium year ($3,000 of care) | $3,200 | $2,170 |
| Worst year (hit the max) | $5,800 | $4,970 |
Here the HDHP wins in every scenario, because the premium gap plus the employer deposit beats the higher deductible. Alex’s own HSA contributions also skip income tax and, through payroll, Social Security and Medicare tax. Change the premiums or drop the employer deposit and the answer can flip, so run your plan’s real numbers. The HDHP only works if you have the cash to meet the deductible and do not skip care you need because of it. For 2027 the HSA limit is $4,500 self-only and $9,000 family, and an HSA-eligible plan needs a deductible of at least $1,750 or $3,500. The investing side is on the HSA page.
COBRA or the Marketplace after a job ends
- COBRA keeps your exact plan, doctors and progress toward this year’s deductible, usually for up to 18 months, at up to 102% of the full premium.
- You have 60 days to elect COBRA and 45 days after electing to pay. Losing job coverage also opens a 60-day window to pick a Marketplace plan.
- COBRA often makes sense if you have met most of this year’s deductible, are mid-treatment, or a Marketplace plan would mean new doctors.
- A Marketplace plan often costs less if your income for the year will be low enough for a credit.
- If you drop COBRA early on purpose outside open enrollment, you generally wait for the next open enrollment to switch. COBRA running out does open a window.
Open enrollment checklist
- List your doctors, hospitals and prescriptions; check each plan’s network and drug list.
- Estimate a light, medium and bad year for each plan, as in the table above.
- Check the out-of-pocket maximum; it is the worst case you must be able to cover.
- For the Marketplace, estimate income carefully and update it during the year.
- Use free help: local assisters and navigators are listed on HealthCare.gov.
- What is the deadline to enroll on HealthCare.gov for coverage starting January 1, 2027? Answer: December 15, 2026.
- What happens if your income ends up above 400% of the poverty level after you received advance credits? Answer: From 2026 on, you repay the full advance credit at tax time.
- Which metal level is required for cost-sharing reductions? Answer: Silver.
- How long do you have to elect COBRA? Answer: 60 days.