Open Enrollment Checklist for 2027
Open enrollment is a short window, and most of what goes wrong happens because people leave it too late or skip a step. Use this checklist whether you get coverage through a job, through HealthCare.gov or a state exchange, or through Medicare. Print it, save it and work through it a few weeks before your deadline.
1. Know your dates
The dates depend on the type of coverage. Employer open enrollment is set by each employer, often in October or November. For Marketplace plans in states that use HealthCare.gov, open enrollment for 2027 coverage runs November 1 to December 15, 2026 (to start coverage on January 1, enroll by December 15). State-based exchanges set their own dates, and many run until December 31 or into January. Medicare’s Annual Enrollment Period runs October 15 to December 7. Our dates calculator counts the days left for each.
2. Gather your information
- Social Security numbers and birthdates for everyone who needs coverage.
- Your best estimate of 2027 household income: pay stubs, a prior-year tax return, self-employment estimates and any other income such as unemployment or investment income.
- Employer coverage information for anyone offered a job-based plan, including the premium for self-only coverage.
- Your current policy number, insurance cards, and the immigration documents if you or a family member are not US citizens.
- A list of doctors, hospitals and prescriptions.
3. Review how last year went
Look at the total you paid last year: premiums plus out-of-pocket costs. Did you hit the deductible? Were there denied claims? Did you avoid care because of the cost? That should inform whether to choose a higher or lower deductible. For ideas, see our guide on choosing a plan.
4. Check what changes for 2027
Plans change every year: premiums, networks, drug formularies and deductibles. If you do nothing, your plan may renew automatically, but it is not necessarily at the same price or covering the same doctors. Read the renewal notice. Also note the policy changes for 2027:
- The enhanced premium tax credits are gone, so the 400% of poverty line limit applies. See the subsidy cliff guide.
- The maximum out-of-pocket limit rises to $12,000 (self-only) and $24,000 (family).
- HSA limits rise to $4,500 and $9,000.
- Under the premium tax credit rules, you must repay any excess advance credit in full.
5. Update your Marketplace application
If you have Marketplace coverage, log in, update your household and income, and review the plans. An outdated application is the most common reason for a surprise tax bill. Re-enroll in the same plan or pick a new one before the deadline. If your plan is discontinued, you will be mapped to another plan and should check it. If you have a subsidy, remember that the benchmark plan and your credit will change.
6. Compare at least three plans
Find the ones that include your doctors and drugs, then compare total cost using the plan comparison calculator. If you are eligible for a CSR silver plan, check it against bronze and gold. Look at the out-of-pocket maximum as the cap on your risk.
7. Decide on your tax-advantaged accounts
With an HSA-eligible plan, decide how much to contribute. For a health FSA, choose an amount you will surely use. Do not forget the dependent care FSA. Our comparison guide explains the differences. Employer elections generally lock in on the day open enrollment ends.
8. Consider dental, vision and supplemental coverage
Dental and vision are sold separately and are not part of most medical plans. Check whether it is worth paying a premium, compared with the benefit and annual maximum. Be careful with supplemental “indemnity” plans, which pay a fixed amount and do not replace health insurance.
9. Review beneficiaries and life changes
If you have had a marriage, a baby or a move this year, update your coverage. Some of these events open a Special Enrollment Period, but only for a limited time. See our special enrollment guide.
10. Confirm, pay and save proof
After you select a plan, make sure you reach the confirmation page, and save it. For Marketplace plans, pay your first premium by the insurer’s due date, or your coverage will not start. In January, check that you have your new ID cards and that your doctors are still listed. Keep the year-end forms: Form 1095-A for Marketplace plans, which you need to file your taxes.
If you miss the deadline
Outside open enrollment, you generally cannot buy Marketplace coverage unless you have a qualifying life event. Some state exchanges allow longer periods. Medicare has a separate Medicare Advantage Open Enrollment Period from January 1 to March 31 for people already in a Medicare Advantage plan. So the best protection is to start early and finish at least a week before the final day, since websites tend to be slow when many people are trying to enroll.
Special situations to double-check
If you are turning 26, you will lose coverage on a parent’s plan, usually at the end of the month or year you turn 26, and you will have a special enrollment period to pick a new plan. If you are pregnant, confirm that the hospital and your obstetrician are in the plan’s network, and estimate costs at the out-of-pocket maximum. If you share custody of children, find out who is responsible for coverage under your agreement and how the household is counted for subsidies. If you recently moved, update your address, as plans and prices vary by county. If a family member is nearing Medicare age, look at the Medicare checklist. And if you have a chronic condition, ask whether your specialist and your treatment are covered and if prior authorization is needed, before you commit.
Finally, set a calendar reminder for the day before your deadline as a final check that your selection went through and that the first payment has been made. Many problems with coverage turn out to be unpaid first premiums, and a few minutes spent confirming the payment is cheaper than a gap in coverage.