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Health insurance

Health Insurance Open Enrollment in 2026 — How to Choose a Plan (and What Changed on Subsidies)

Open enrollment is open right now, for 2027 coverage — not 2026 — and it closes on January 15, 2027. The rules changed more this year than in any year since the Marketplace began. The biggest change: the enhanced premium tax credits that ran from 2021 through 2025 expired on December 31, 2025, and Congress has not restored them. Credits are back to the Affordable Care Act structure — only for households between 100% and 400% of the federal poverty level, with a hard cliff above 400%. Figures checked November 12, 2026.Photo: Open enrollment for 2027 coverage is open now — but the subsidy rules are different this year. (Photo: Pexels) What You Will LearnThe two deadlines that decide when coverage starts Your income as a share of the poverty level What you will pay toward a Silver plan Which metal tier fits, and why Silver matters How to compare total cost, not just the premiumStep 1: Mark the two deadlines What to do: Put December 15, 2026 and January 15, 2027 in your calendar — they do different jobs. How: On HealthCare.gov, open enrollment for 2027 coverage runs November 1, 2026 to January 15, 2027. Enroll by December 15, 2026 for coverage from January 1, 2027, once you pay the first premium. Enroll December 16 to January 15 and coverage starts February 1, 2027 — you lose a month. After January 15 you generally cannot enroll or change plans unless you qualify for a Special Enrollment Period. State-run exchanges set their own dates. Example: Pick a plan on December 14 and you are covered from January 1; pick it on December 16 and coverage starts February 1 — January is uninsured. Common mistake: Treating January 15 as the only deadline and losing a month of coverage.Illustrative diagram - The six steps to choosing a 2027 health plan. NOT a real HealthCare.gov screenshot. Step 2: Find your income as a share of the poverty level What to do: Work out where your 2027 income sits against the federal poverty level (FPL) before you shop — it decides whether you get any help. How: For 2027 coverage the Marketplace uses the 2026 HHS guidelines: $15,960 for one person and $33,000 for a family of four in the 48 contiguous states and D.C., plus $5,680 for each extra person (Alaska and Hawaii are higher). Credits are available only between 100% and 400% of FPL: the cliff is $63,840 for one person, $132,000 for a family of four. One dollar above the line and the whole credit is $0. Below 100% you generally get no credit either — check Medicaid. Use expected 2027 income, not last year's tax return. Example: A single person expecting $40,000 in 2027 is at about 251% of poverty — inside the range. Common mistake: Shopping before checking your FPL band.Illustrative diagram - The 2027 open enrollment calendar: two deadlines, two start dates. NOT a real HealthCare.gov screenshot.Photo: Your income against the poverty level decides whether you get any help at all — check it before you shop. (Photo: Pexels)Illustrative diagram - The subsidy range for 2027: 100% to 400% of the poverty level, then a hard cliff. NOT a real IRS screenshot. Step 3: Work out what you will actually pay What to do: Estimate your expected contribution toward the benchmark Silver plan. How: The credit is the benchmark premium minus your expected share of income. For 2027 that share runs from 2.15% of income at the bottom to 10.22% at the top (IRS Rev. Proc. 2026-26). Do not use last year's figure: for the 2026 plan year the top rate was 9.96% (Rev. Proc. 2025-25). The rate rises with income — about 4.30% at 150% of poverty, 6.78% at 200%, 8.66% at 250% — and is flat at 10.22% from 300% to 400%. Job-based cover has its own test: for 2027 your employer's self-only premium counts as affordable if it costs you no more than 10.22% of household income (9.96% for the 2026 plan year). Example: A single person at $31,920 — exactly 200% of poverty — pays about 6.78% of income, about $2,164 a year, about $180 a month, toward the benchmark plan; the credit covers the rest. Common mistake: Using the 9.96% figure for 2027 coverage — that was the 2026 plan-year rate.Illustrative diagram - What you are expected to pay in 2027: 2.15% to 10.22% of income. NOT a real IRS screenshot. Step 4: Pick the metal tier — and check Silver first if you earn under 250% of poverty What to do: Choose the tier by how much care you expect to use, not by the lowest premium alone. How: Plans come in four metal tiers showing roughly what share of covered costs each pays: Bronze about 60%, Silver about 70%, Gold about 80% and Platinum about 90% (HealthCare.gov). If your income is 100–250% of the poverty level, look at Silver first: cost-sharing reductions — lower deductibles, copays and out-of-pocket maximums — are available only on Silver plans. At 100–150% of poverty a Silver plan pays about 94% of covered costs, at 150–200% about 87%, and at 200–250% about 73% — better than Gold cover for a Silver premium. Bronze and catastrophic plans can now pair with a health savings account in 2027 (reported) — see HSA vs FSA in 2026: which one saves you more. Example: At 180% of poverty, Bronze looks cheaper each month — but Silver pays 87% of covered costs against Bronze's 60%, so one hospital visit can erase a year of premium savings. Common mistake: Picking Bronze for the low premium while qualifying for Silver cost-sharing reductions.Photo: Compare tiers on the Marketplace, not on premium alone — Silver can beat Bronze if your income is under 250% of poverty. (Photo: Pexels)Illustrative diagram - Silver with cost-sharing reductions can pay more than Gold. NOT a real HealthCare.gov screenshot. Step 5: Compare the total cost, not just the premium What to do: Add up the full year — premium, deductible, copays and out-of-pocket maximum — for each plan on your shortlist. How: Benchmark Silver premiums are up 13% on average for 2027 (KFF, reported), so last year's premium is no guide. CMS says more than 75% of HealthCare.gov shoppers will still have access to a plan at $50 a month or less after credits — but people above the subsidy cliff pay full price. Beyond the premium, check the deductible, the out-of-pocket maximum ($12,000 for an individual in 2027, reported), and whether your doctors and prescriptions are in-network. If a bill still lands, see how to negotiate medical bills in 2026. Example: Plan A: $280 a month, $6,000 deductible. Plan B: $340 a month, $1,500 deductible. With $4,000 of care, Plan A costs $3,360 + $4,000 = $7,360. Plan B costs $4,080 + $1,500 = $5,580 before copays. The higher premium is cheaper overall. Common mistake: Choosing the cheapest premium and discovering the deductible at the first hospital visit. Step 6: Enroll before the deadline — and know what happens if you miss it What to do: Apply on HealthCare.gov (or your state exchange) and pay the first premium. How: Have ready: Social Security numbers, your employer's details, and your best estimate of 2027 household income — guess too low and you may repay some credit at tax time. The year-round window for households under 150% of poverty is gone for 2027 — low income alone no longer opens enrollment during the year. Outside open enrollment you can generally enroll only with a qualifying life event — job loss, marriage, a baby, a move — through a Special Enrollment Period, usually 60 days from the event. Medicaid and CHIP take applications all year. One thing is not settled: the House passed a three-year extension (H.R. 1834, 230–196) on January 8, 2026, but the Senate has not acted and it is not law — enroll under the current rules; if Congress restores the credits later, the Marketplace will recalculate them. Example: You lose your job on March 1 — that qualifying event usually gives you about 60 days to enroll. Common mistake: Waiting for Congress to restore the credits before enrolling — the deadline will not wait.Illustrative diagram - Six mistakes that cost shoppers money. NOT a real HealthCare.gov screenshot. Checklist☐ December 15, 2026 in the calendar (January 1 coverage); January 15, 2027 as the last day. ☐ 2027 income checked against the poverty level and the 400% cliff. ☐ Expected contribution worked out (2.15%–10.22% of income for 2027). ☐ Silver compared first if I earn under 250% of poverty. ☐ Doctors and prescriptions checked in-network. ☐ Total yearly cost compared, not just the premium. ☐ First premium paid — coverage does not start until it is.FAQ When is open enrollment for 2027 health insurance? November 1, 2026 to January 15, 2027 on HealthCare.gov. Enroll by December 15, 2026 for January 1, 2027 coverage; December 16 to January 15 means coverage from February 1, 2027. What changed on subsidies for 2027? The enhanced credits expired December 31, 2025. Credits follow the original Affordable Care Act rules: income between 100% and 400% of the poverty level only, with a hard cliff above 400%. The top expected contribution is 10.22% of income for 2027, up from 9.96% for 2026. What income qualifies for a premium tax credit in 2027? From 100% to 400% of the 2026 federal poverty guidelines: $15,960 to $63,840 for one person, $33,000 to $132,000 for a family of four. What happens if my income is $1 over the 400% cliff? The whole credit disappears — $0. At $63,840 a single person still gets a credit; at $63,841 there is none. Can I enroll after January 15, 2027? Only with a qualifying life event (job loss, marriage, baby, move), through a Special Enrollment Period, usually within 60 days of the event. Medicaid and CHIP accept applications all year. SourcesHealthCare.gov, When can you get health insurance? (opened live November 12, 2026): https://www.healthcare.gov/quick-guide/dates-and-deadlines/ U.S. Internal Revenue Service, Rev. Proc. 2026-26 — 2027 Applicable Percentage Table and Required Contribution Percentage (opened live November 12, 2026): https://www.irs.gov/pub/irs-drop/rp-26-26.pdf Centers for Medicare & Medicaid Services, Plan Year 2027 Marketplace Plans and Prices Fact Sheet (opened live November 12, 2026): https://www.cms.gov/newsroom/fact-sheets/plan-year-2027-marketplace-plans-prices-fact-sheet-0All figures checked November 12, 2026, against HealthCare.gov, the IRS and CMS. Poverty figures are the HHS 2026 guidelines (reported); the premium change is from KFF's October 30, 2026 analysis (reported). Disclaimer: For education only, not insurance, tax or medical advice. Confirm your own figures on HealthCare.gov before you enroll.

HSA vs FSA in 2026 - Which One Saves You More, and When to Pick Each

Open enrollment is the one time of year when this choice is real. Pick the wrong account and you either leave tax savings on the table or watch your own money expire on December 31. An HSA (Health Savings Account) and an FSA (Flexible Spending Arrangement) both pay for medical care with pre-tax dollars. That is where the similarity ends. An HSA belongs to you, rolls over forever, and can even be invested. An FSA mostly belongs to your employer, and most of what you do not spend disappears. The 2026 limits below were checked against IRS Publication 969 and Revenue Procedure 2025-32 on November 9, 2026. The real decision is three questions: can you have an HSA, will you spend the money in time, and does it follow you when you change jobs?Photo: An HSA and an FSA both pay for medical care with pre-tax dollars - but the rules after that are very different. (Photo: Pexels) What You Will LearnThe HDHP test that decides whether an HSA is open to you The 2026 limits for the HSA and both kinds of FSA Rollover vs use-it-or-lose-it, and the cost of getting it wrong The pairing rules: when an FSA blocks your HSA A worked example: the tax saving on a family HSA How to enroll, and the deadlines that matterStep 1: Check whether you can even have an HSA What to do: Find out whether your health plan is a high deductible health plan (HDHP). No HDHP, no HSA. How: For 2026, an HDHP needs a minimum annual deductible of $1,700 for self-only coverage or $3,400 for family, and out-of-pocket costs - not premiums - capped at $8,500 or $17,000. You also cannot be enrolled in Medicare or be claimed as a dependent. New for 2026, bronze and catastrophic plans bought as individual coverage through an Exchange count as HDHPs even if they miss those numbers (IRS Notice 2026-5), and a direct primary care arrangement up to $150 a month for one person, or $300 for more than one, no longer blocks HSA eligibility. Example: Priya buys a bronze plan on her state's Exchange. Its deductible is below $1,700, so under the old rules it would not be an HDHP. Under the 2026 change it counts. Common mistake: Assuming any high-deductible plan qualifies. A $1,500 deductible fails the 2026 test - unless it is a bronze or catastrophic Exchange plan.Illustrative diagram - The six steps to choosing between an HSA and an FSA in 2026. NOT a real IRS screenshot. Step 2: Compare the 2026 limits What to do: Write down the three limits that apply to you before you elect an amount. How: For 2026, you can contribute up to $4,400 to an HSA with self-only coverage, or $8,750 with family coverage - plus $1,000 if you are 55 or older by year-end. A health FSA caps at $3,400 per employee. A dependent care FSA caps at $7,500 per household, or $3,750 if married filing separately - up from $5,000, the first increase since 1986. The HSA family limit is shared between spouses; the health FSA limit is per employee. Example: A couple who both work can elect $3,400 each in health FSAs, for $6,800 between them. On one family HDHP, their HSA limit is $8,750 - and it rolls over. Common mistake: Comparing only the headline limits. What matters more is what happens to unspent money - Step 3.Illustrative diagram - The 2026 limits for the HSA, the health FSA and the dependent care FSA. NOT a real IRS screenshot.Photo: The limits decide how much you can shelter - the rollover rules decide how much you keep. (Photo: Pexels) Step 3: Weigh rollover against use-it-or-lose-it What to do: Ask one question about each account: what happens to the money I do not spend this year? How: HSA money rolls over in full, year after year, with no deadline. It stays yours when you change jobs, and you can invest it. A health FSA is generally use-it-or-lose-it: your plan may let up to $680 carry over, or give you a grace period of up to 2.5 months - one or the other, never both, and anything above the carryover is forfeited. A dependent care FSA has no carryover. When you leave a job, the health FSA usually ends with it; the HSA goes with you. Example: You put $3,400 in each account and spend $2,000. The HSA keeps $1,400 for next year. The FSA keeps $680 and forfeits $720. Same contribution, same spending, $720 apart. Common mistake: Electing the full $3,400 into an FSA, then scrambling in December to spend it. Elect only what you can predict.Illustrative diagram - Same contribution, same spending: the HSA keeps $1,400, the FSA loses $720. NOT a real IRS screenshot. Step 4: Learn the pairing rules What to do: Check whether the accounts you already have block each other - the rule that surprises people most. How: A general-purpose health FSA blocks HSA contributions in any month it covers you. Three arrangements can sit next to an HSA: a limited-purpose FSA for dental and vision only, a post-deductible FSA, and a dependent care FSA for childcare. If your spouse's general-purpose health FSA covers you, that blocks your HSA too. Example: Dan has an HDHP and an HSA, and his wife's health FSA covers him. If she elects the general-purpose version, Dan cannot contribute to his HSA. If she elects the limited-purpose version, his HSA stays open. Common mistake: Enrolling in both, then learning at tax time that the HSA contributions were not allowed.Illustrative diagram - The 2026 HDHP test, and the new bronze and catastrophic plan rule. NOT a real IRS screenshot.Photo: A dependent care FSA pays for childcare so you can work - and it can run alongside an HSA. (Photo: Pexels) Step 5: Run the numbers on your own situation What to do: Work out the tax saving for your household, then match the account to your spending pattern. How: Both save tax the same way in year one: money goes in pre-tax, so you skip federal income tax and, through payroll, payroll tax too. A family contributing the full $8,750 to an HSA saves $1,925 at a 22% rate, plus $669 of payroll tax - $2,594 a year. The same $3,400 through a health FSA saves the same kind of tax in year one, but only the HSA balance is still there next year. Steady, predictable costs fit an FSA; low or uncertain costs, or a wish to build a medical cushion, fit an HSA. Example: Maya, 34, rarely sees a doctor and has a family HDHP. She puts $8,750 in the HSA, spends $900, and keeps $7,850. Tom, 41, will spend $3,000 on dental work and $7,000 on daycare, so he elects a $3,400 health FSA and a $7,000 dependent care FSA. Common mistake: Picking the HSA and leaving the money in cash, or picking the FSA for costs you only hope to have. Match the account to costs you can predict.Illustrative diagram - The worked example: a family HSA saves $2,594 a year in tax. NOT a real IRS screenshot. Step 6: Enroll and set it up right What to do: Elect during open enrollment, then manage the account through the year. How: Your FSA election is locked for the year; you can only change it after a qualifying life event such as a marriage, a birth or a job change. HSA contributions can be raised or lowered during the year. Contribute through payroll when you can, to save the payroll tax as well as income tax. HSA contributions for 2026 can be made until the tax filing deadline, April 15, 2027. Keep receipts for every HSA withdrawal. If a health shock hits, your emergency fund is the backstop - see our guide to building one on a $40,000 salary. Example: Ana elects a $2,400 health FSA in November for prescriptions she already takes. In March she raises her HSA contribution after a raise - allowed mid-year. Common mistake: Treating the FSA election like the HSA. Once open enrollment closes, the FSA amount is fixed.Illustrative diagram - Six mistakes that cost people HSA and FSA money. NOT a real IRS screenshot. ChecklistMy plan is an HDHP: deductible at least $1,700 or $3,400, out-of-pocket capped at $8,500 or $17,000. I know my 2026 limits: HSA $4,400 or $8,750, health FSA $3,400, dependent care FSA $7,500. I know whether my plan offers a carryover (up to $680) or a grace period. No general-purpose health FSA covers me or my spouse before I fund an HSA. I matched the account to costs I can predict and will keep receipts for HSA withdrawals.FAQ Can I have an HSA and an FSA at the same time?With a limited-purpose FSA (dental and vision only), a post-deductible FSA, or a dependent care FSA. Not with a general-purpose health FSA in any month it covers you. Which saves more, an HSA or an FSA?In year one, the same dollar for dollar. Over time the HSA wins: unspent money rolls over in full, while the FSA forfeits anything above the $680 carryover. What is the HSA contribution limit for 2026?$4,400 for self-only coverage and $8,750 for family, plus $1,000 if you are 55 or older by year-end. The health FSA limit is $3,400 per employee. What happens to my FSA if I leave my job?A health FSA usually ends when you leave the job, and unspent money is generally lost. An HSA is portable - it stays with you. Did HSA rules change for 2026?Yes. Bronze and catastrophic Exchange plans now count as HDHPs, and a direct primary care arrangement up to $150 a month ($300 for more than one) no longer blocks HSA eligibility (IRS Notice 2026-5). SourcesIRS Publication 969, "Health Savings Accounts and Other Tax-Favored Health Plans": https://www.irs.gov/publications/p969 IRS Revenue Procedure 2025-32, 2026 health FSA limit ($3,400) and maximum carryover ($680): https://www.irs.gov/pub/irs-drop/rp-25-32.pdf DollarLedger USA, "How to Build an Emergency Fund on a $40,000 Salary": </blog/how-to-build-emergency-fund-on-40000>All figures checked November 9, 2026, against IRS Publication 969, Revenue Procedure 2025-32, Publication 15-B (2026) and Notice 2026-5. Disclaimer: For education only, not tax or benefits advice. Confirm your HDHP status and FSA options with your benefits administrator before enrolling.