15 Legitimate Ways to Lower Your Health Insurance Costs for 2027

Health insurance is expensive, but there is more room to lower the total bill than most people think. Some savings come from picking a different plan, some from tax rules, and some from how you use the plan once you have it. None of the ideas below involves hiding income or gaming the system; they are ordinary, lawful choices. The list is organized from the largest, most common savings to the smallest.

Choosing the plan

1. Compare total cost, not premium. Add the premium, your expected out-of-pocket costs, and any employer contributions. A plan with a $50-a-month lower premium can cost far more in a year with a hospital stay. Use the comparison calculator.
2. Claim every dollar of the premium tax credit. Even households above the old limits can qualify under the original rules if income is below 400% of the poverty line. Run the subsidy calculator. If you take less than the full credit in advance, you can claim the rest on your tax return.
3. Check a cost-sharing reduction silver plan if your income is up to 250% of poverty. These plans have much lower deductibles at the same premium as other silver plans. See the CSR guide.
4. Consider bronze with an HSA. If you are healthy and have savings, a bronze plan can cost much less per month, and a subsidy can sometimes make it very cheap or even free. Since 2026, federal law treats Marketplace bronze and catastrophic plans as HSA-eligible, so you can pair a bronze plan with an HSA.
5. Look at a narrower network. HMO and EPO plans and narrow networks often cost less. If your doctors are included, this is an easy saving.
6. Shop in a different insurer or county for the same coverage, because prices differ by insurer even for the same metal level. You cannot choose a different county than you live in, but you can look at every insurer that serves it.

Using tax rules

7. Lower your MAGI with pre-tax contributions. Contributing to a traditional 401(k), an HSA or a deductible IRA lowers your income, and so can increase your credit. The subsidy cliff guide explains the 400% line.
8. Contribute to an HSA. A 24% federal bracket household that puts in $9,000 saves about $2,160 in federal income tax, and payroll contributions through an employer also avoid the 7.65% payroll tax. See the HSA calculator.
9. Use an FSA for predictable costs. Contact lenses, orthodontics and regular prescriptions are good candidates. Elect only what you are sure to use, with the FSA calculator.
10. If you are self-employed, deduct your premiums. The self-employed health insurance deduction lowers adjusted gross income. See the self-employed guide.

Using the plan well

11. Stay in network and confirm it every time. Ask whether the specific provider, the facility and any assistant surgeon or anesthesiologist are in your network before a planned procedure. Federal law now limits surprise bills in many cases, but not all. See the No Surprises Act guide.
12. Use free preventive care. Screenings, vaccines and annual visits are covered in network without cost sharing on most plans. Catching problems early lowers cost.
13. Ask about generics and mail-order. A generic drug can cost a tiny fraction of the brand price, and a 90-day mail supply often has a lower copay. Compare the plan price with cash discount programs, because for some low-cost generics, the cash price is lower than your copay (though it will not count toward your deductible).
14. Time care around the deductible. If you are close to meeting your deductible or out-of-pocket maximum late in the year, it may be cheaper to schedule elective care before December 31. If you have just started a year with a high deductible, you may postpone non-urgent care to a point when it is cheaper. Do not delay urgent care.
15. Review every bill. Compare the hospital bill to the insurer’s Explanation of Benefits. Errors, duplicate charges and out-of-network coding are common. You can ask for an itemized bill and appeal a denial; many appeals succeed. Many hospitals also have financial assistance programs, and nonprofit hospitals are required to have one.

What does not work

Be wary of anything that promises coverage for a fraction of the normal cost. Short-term plans, health care sharing ministries and fixed-indemnity plans are generally not ACA coverage: they may exclude pre-existing conditions, cap benefits or deny claims, and they do not qualify for premium tax credits. They can leave you with big bills after a serious illness. Also be careful with unsolicited calls or ads that appear to be from the government but are lead generators; use HealthCare.gov or your state exchange directly.

A quick example

Consider a couple, 45 and 47, with $84,000 of income in a state with benchmark premiums of $1,600 a month for the couple. In the 2027 table, their income is about 388% of the poverty line for a household of two, near the cutoff of $86,560. At that level they are expected to pay 10.22% of income, or about $8,585 a year, for the benchmark plan, so their credit is $19,200 − $8,585 = $10,615. If their income were $90,000, they would lose the entire $10,615 credit. If they can put $6,000 into a traditional 401(k) and an HSA, they stay under the line and keep a credit worth many times the tax they are saving. That is the sort of check worth making each fall.

Where to start

Make a list: your income estimate, your doctors, your drugs and your plan options. Then work from the top of this list down. The savings from plan choice and subsidy are usually the largest, and the others are worth stacking on top.

Plan a yearly routine

The most reliable way to keep health insurance costs under control is to repeat a short routine every fall. First, update your income estimate and run the subsidy calculator. Second, compare your current plan to at least two others. Third, review last year’s claims and ask whether you used the benefits you paid for. Fourth, decide how much to put into an HSA or FSA. Fifth, check for any life event coming up that would change your household. In January, check that the plan card works and the first bills match the plan. In the middle of the year, update the Marketplace if your income or household changed. This takes an hour or two a year and prevents most of the large mistakes.