Changes Ahead for Health Insurance in 2027
As millions of Americans prepare to select their health insurance plans for 2027, it’s essential to note that costs are likely to shift, regardless of whether your coverage is from an employer, the ACA Marketplace, or Medicare.
“Your premiums will change. Your out-of-pocket costs can change. Drug coverage can change,” mentioned health policy analyst Louise Norris.
Rising Costs
Employer-sponsored plans, the most common source of health coverage in the U.S. for people under 65, are expected to become more expensive. The annual National Survey of Employer-Sponsored Health Plans projects an average increase of over 8% in health benefit costs for 2027.
Furthermore, 12 insurers are exiting the ACA marketplace by the end of 2026, and those that remain are proposing an average premium increase of 15%. So far, 29 states and Washington, D.C. have confirmed these increases. Despite these changes, Norris notes that 87% of ACA enrollees received some form of subsidy, which significantly reduces the average final premium they pay.
Medicare Part D plans may also see an increase in drug costs. The deductible is set to rise from $615 to $700, along with the out-of-pocket limit, which will increase from $2,100 to $2,400 in 2027.
Shop Around, Even If You’re Happy
Even if you think you’re satisfied with your current plan, Norris advises that it’s wise to shop around. “Almost certainly, it will change in some way, and you won’t know if there might be a better option unless you actively compare your options,” she explained.
This applies to all types of coverage. Whether your employer offers multiple plans, you purchase insurance from the Marketplace, or you’re considering changes to your Medicare coverage, the open enrollment period is your chance to make adjustments.
It’s a good idea to start by conducting some research. For insights on employer-sponsored and ACA Marketplace plans, you can look for resources online, as well as detailed information regarding Medicare changes.
Evaluate Your Healthcare Usage
Before renewing or selecting a new plan, take a moment to reflect on how you’ve utilized your insurance this past year:
- How frequently did you visit a doctor?
- What prescriptions were necessary?
- How much did you spend out of pocket?
The responses to these questions are important because different plans offer varying coverage for doctors and medications. “Some plans may cover certain doctors but not others; the same goes for medications,” Norris noted. “Even if a particular drug is covered, you should know what your out-of-pocket expenses will be.”
Also, consider any anticipated medical expenses for the upcoming year, like a planned surgery.
Look at Overall Costs, Not Just Premiums
Once you’ve assessed your likely needs, compare the total expenses of each plan—not just the premiums. This includes the deductible, copayments, coinsurance, and out-of-pocket maximums.
- Monthly premium (x 12): This is what you pay monthly for coverage.
- Deductible: This is the amount you’re responsible for before the plan pays anything for covered services, aside from free preventive care.
- Copayments and coinsurance: What you pay for each visit, like $20 for a doctor’s appointment or 30% of a hospital bill.
- Out-of-pocket maximum: This is the highest amount you’ll pay in a year for covered services; after that, the plan pays 100%.
Your expected usage can ultimately sway which plan is most beneficial. Additionally, examine how each plan approaches doctor visits; one may have a flat copayment while another might count visits towards your deductible, potentially leading to higher costs depending on the negotiated rates.
Lastly, check the provider networks, facilities, and drug coverage of each plan. Different plans have different rules concerning what is covered, and even a covered prescription can vary significantly in cost across plans.
A note of advice for those moving from an employer-sponsored plan to the ACA Marketplace: “Don’t assume that drug coverage or the provider network will remain consistent, even if the same insurance company is involved,” Norris cautioned. “People should recognize that provider networks and coverage policies can differ.”
Consider a Health Savings Account
If a high-deductible plan is suitable for you, a health savings account (HSA) can help manage your out-of-pocket medical expenses. For 2027, the HSA contribution limits are increasing to $4,500 for individuals and $9,000 for families.
Norris emphasized that having an HSA can provide peace of mind: “If you can consistently fund an HSA, it offers reassurance knowing that if unexpected medical needs arise, you have funds available.”
Important Dates to Remember
- Oct. 15–Dec. 7, 2026: Medicare open enrollment
- Nov. 1, 2026: Marketplace open enrollment begins in most states (typically, HealthCare.gov opens window shopping in the last week of October)
- Dec. 15, 2026: Deadline for Marketplace coverage beginning Jan. 1
- Jan. 15, 2027: Marketplace open enrollment ends in most states
- Employer-sponsored plan enrollment dates are determined by the employer, generally occurring between September and November.
