Top 5 Things to Check Before Choosing Health Insurance for 2027

Choosing health insurance is an important financial decision. The right plan can help manage medical expenses, provide access to doctors and hospitals, and cover essential healthcare services.

As 2027 approaches, individuals and families in the United States should compare more than just monthly premiums. Deductibles, provider networks, prescription coverage and out-of-pocket expenses can all affect how much they pay throughout the year.

Here are five important things to check before choosing a health insurance plan for 2027.

1. Compare Monthly Premiums and Total Out-of-Pocket Costs

The monthly premium is the amount you pay to keep your health insurance active. However, it is not the only expense to consider.

You should also compare:

• Deductible: The amount you generally pay for covered services before the plan begins paying its share.
• Copayments: Fixed amounts you pay for certain medical services, such as doctor visits.
• Coinsurance: The percentage of covered costs you pay after meeting the deductible.
• Out-of-pocket maximum: The maximum amount you pay for covered, in-network essential health benefits during the plan year, subject to plan rules.

For example, one plan may have a monthly premium of $250 and a $6,000 deductible, while another may cost $350 per month with a $2,500 deductible.

The cheaper monthly premium does not necessarily mean the plan will cost less overall.

Compare estimated annual costs based on how frequently you expect to use healthcare services.

2. Check the Doctor and Hospital Network

A health insurance plan may not cover every doctor, specialist or hospital at the same cost.

Before enrolling, check whether your preferred healthcare providers participate in the plan's network.

Common network types include:

• HMO: Generally limits routine coverage to network providers, except for emergencies, and may require referrals for specialists.
• PPO: Usually provides more flexibility to visit out-of-network providers, but at a higher cost.
• EPO: Generally covers non-emergency care only through its network.
• POS: Combines certain HMO and PPO features and may require referrals for specialist care.

If you regularly visit a particular hospital or specialist, verify that they are included in the exact 2027 plan you are considering.

A provider's participation in one insurance company's network does not guarantee participation in all its plans.

3. Review Prescription Drug Coverage

Prescription medication costs can make a significant difference to your annual healthcare budget.

Every health plan has a list of covered medications called a formulary. Different plans may cover different drugs or charge different amounts for the same prescription.

Check these details:

• Whether your current medications are covered.
• Whether generic and brand-name versions have different costs.
• Whether specialty medications require additional authorization.
• Whether prescriptions have separate deductibles.
• Which pharmacies are included in the preferred network.

For example, a medication may be covered under one plan but placed in a higher cost-sharing category under another.

Review the 2027 formulary rather than relying on your current plan's prescription list.

4. Compare Covered Benefits and Additional Services

Marketplace health insurance plans must cover ten categories of essential health benefits, although specific coverage details and cost-sharing can vary.

These categories include:

1. Ambulatory patient services.
2. Emergency services.
3. Hospitalization.
4. Pregnancy, maternity and newborn care.
5. Mental health and substance use disorder services.
6. Prescription drugs.
7. Rehabilitative and habilitative services and devices.
8. Laboratory services.
9. Preventive and wellness services and chronic disease management.
10. Pediatric services, including oral and vision care.

Some plans may also offer additional benefits, such as adult dental, vision or wellness programs.

Check the Summary of Benefits and Coverage (SBC) to understand what is included, what you pay and which services have limitations.

5. Check Eligibility, Financial Assistance and Enrollment Deadlines

Before choosing a plan, check whether you qualify for financial assistance through the Health Insurance Marketplace.

Depending on household income, family size and other eligibility rules, you may qualify for:

• Premium tax credits: Financial assistance that can reduce monthly insurance premiums.
• Cost-sharing reductions: Additional savings on deductibles, copayments and coinsurance for eligible people who enroll in a qualifying Silver Marketplace plan.
• Medicaid or CHIP: Public health coverage for people who meet the relevant state and federal eligibility requirements.

Also, compare the four main Marketplace metal categories:

These categories describe how costs are shared, not the quality of medical care.

Important 2027 Enrollment Dates

For people using HealthCare.gov, the 2027 Open Enrollment Period runs from November 1, 2026, through January 15, 2027.

• December 15, 2026: Generally the deadline to enroll for coverage starting January 1, 2027.
• January 15, 2027: Final day of the federal Marketplace Open Enrollment Period.

Some state-run Marketplaces have different deadlines. Outside open enrollment, you generally need to qualify for a Special Enrollment Period to change or obtain Marketplace coverage. Medicaid and CHIP applications are accepted year-round.

Final Thoughts

Before choosing health insurance for 2027, compare monthly premiums, total out-of-pocket costs, provider networks, prescription drug coverage and covered benefits. Also check whether you qualify for financial assistance and make sure you understand the enrollment deadlines.

The lowest-premium plan may not be the most economical choice if it has a high deductible or does not include your preferred doctors and medications. Reviewing the full plan details can help you select coverage that fits your healthcare needs and budget.

Note: Plan availability, premiums, eligibility, coverage limits and financial assistance vary by state and individual circumstances. Review the official plan documents before enrolling.