How to Choose a Health Insurance Plan for 2027

Choosing a health plan is the one financial decision many people make every year with the least information. Plans arrive as a list of premiums and acronyms, deadlines are short, and the price of a mistake can be thousands of dollars. This guide gives a repeatable seven-step method that works for an employer plan, a Marketplace plan on HealthCare.gov or a state exchange, and a plan for a family or for one person.

Step 1: List what you actually use

Before you look at any plan, write down who needs coverage, which doctors and hospitals they see, which prescriptions they take (with the dose), and the care you expect next year: a planned surgery, a pregnancy, physical therapy, mental health visits, a child’s orthodontics. Pull last year’s Explanation of Benefits statements from your insurer’s portal, because they show real totals. This list is the answer key against which every plan is checked.

Step 2: Check the network and the drug list first

A plan with the lowest price is worthless if your doctor is out of network or your medicine is not on its formulary. Use the insurer’s own provider directory, then call the doctor’s office and ask whether they take that specific plan (not just that insurance company), because insurers sell many different networks under one brand. Look up each drug in the plan’s formulary and note its tier, as the tier determines your copay or coinsurance. For HMO and EPO plans, out-of-network care is generally not covered except in an emergency, so this step matters most for them. See our guide to plan types for what each means.

Step 3: Understand metal tiers (and what they do not mean)

Marketplace plans are grouped into four metal tiers. The tiers describe how costs are shared on average, not the quality of care: bronze plans pay about 60% of costs for a typical population, silver about 70%, gold about 80% and platinum about 90%. Bronze has the lowest premium and the highest deductible; platinum has the highest premium and lowest cost when you use care. Employer plans often use the same labels or their own names. The label hides a lot of variation, which is why the numbers in the next step matter. Silver has a special feature if your income is below about 250% of the poverty line: cost-sharing reductions that cut your deductible and out-of-pocket maximum. Our CSR guide shows when a silver plan beats a gold or bronze one.

Step 4: Compare total yearly cost, not premium

For each plan you are considering, find its Summary of Benefits and Coverage (SBC), a standard four-page form that every plan must provide. Take four numbers: the monthly premium, the deductible, the coinsurance or copays, and the out-of-pocket maximum. Then calculate your cost in three kinds of year: one with almost no care, one with typical care and one with a major event. The plan comparison calculator does this for three plans at once. For 2027, ACA plans cannot have an out-of-pocket maximum above $12,000 for one person or $24,000 for a family for in-network essential benefits, so use that as the realistic worst case on a plan that does not list its own limit.

Step 5: Add subsidies and employer money

If you buy on the Marketplace, your premium tax credit makes the benchmark silver plan cost a fixed share of your income, and you can apply the same credit to any plan. Run the numbers in the subsidy calculator. If you are choosing between a lower-premium bronze plan and a silver plan, subtract the credit before you compare. With an employer, check whether it adds money to an HSA, offers wellness incentives, or charges a surcharge for a covered spouse who has other coverage. Employer money is part of the price.

Step 6: Consider the HSA

A high-deductible health plan (HDHP) that qualifies for a health savings account lets you save pre-tax for medical costs, with limits of $4,500 for self-only and $9,000 for family coverage in 2027. If you can afford the deductible out of savings, the tax savings and the ability to carry the money forward make an HSA-eligible plan attractive for many healthy households. If you could not pay a $3,500 deductible without borrowing, a plan with a lower deductible may be the safer choice even if it costs more. The HSA calculator shows what you could save.

Step 7: Check the fine print on the things that bite

• Referral and prior authorization rules for specialists, imaging and drugs.
• Separate deductibles for prescriptions or for out-of-network care.
• Coverage when you travel or live part of the year in another state; many HMOs only cover emergencies outside their area.
• Whether copays count toward the deductible. Many do not.
• Family plans: aggregate or embedded deductible. Ask which it is.

A short decision guide

You rarely use care and have savings: a lower-premium HSA-eligible HDHP is often the best value. You have regular prescriptions, a chronic condition or a planned procedure: compare the plans with a lower deductible and fixed copays, because you will almost certainly use the benefits. You have a low income and a Marketplace subsidy: check a CSR silver plan before anything else. You are pregnant or expect a baby: expect to hit the out-of-pocket maximum, so compare total cost at the maximum, and check hospital and pediatrician networks. You are close to 65: read our Medicare checklist so you do not miss your enrollment period.

Keep a record

Save screenshots or PDFs of the plan details, the confirmation page and the date you enrolled. If there is a dispute about what was promised, those records matter. Put the first premium due date in your calendar: for Marketplace plans, coverage does not begin until the first premium is received.

Mistakes people make most often

The first is choosing on premium alone. The second is auto-renewing without reading the renewal notice, which may show a changed network or a smaller subsidy. The third is assuming that a doctor who accepted last year’s plan accepts this year’s version of it. The fourth is forgetting the family: a plan can look fine for you, while a child’s specialist or a spouse’s medication is not covered. A fifth, especially among people who are young and healthy, is selecting the lowest-cost plan without checking the out-of-pocket maximum, which is the real measure of how bad a bad year can be. Take twenty minutes to write down the worst-case figure for each plan and ask whether you could pay it. If the answer is no for the cheapest plan, it is probably not the cheapest plan for you.