Health insurance got more expensive for many households in 2026, and 2027 is heading the same way. The enhanced federal subsidies that held Marketplace premiums down expired at the end of 2025, insurers have proposed higher rates for next year, and some carriers are leaving the individual market entirely. If you are working out how to lower health insurance costs, start here: the renewal price in your mailbox is rarely the lowest price available to you. Most of the savings come from a few decisions you make at enrollment, plus a few habits once you are covered.
Shop every plan instead of auto-renewing
Automatic renewal is convenient, and it is also how many people end up overpaying. Insurers reprice their plans every year, plan lineups change, and the benchmark plan your subsidy is measured against can shift, so the same credit may buy a different plan than it did last year. Comparing every plan in your county, across carriers and metal tiers, is the most reliable way to find a lower price for the coverage you need.
Timing matters. For states using HealthCare.gov, open enrollment for 2027 coverage runs November 1, 2026 through January 15, 2027, and December 15 is the deadline to pick a plan that starts January 1. A federal judge vacated a rule that would have ended the window in December; the government has appealed, and the appeals court hears argument on October 30, 2026. Those are the dates in effect today, but confirm them before you rely on them. Our open enrollment 2027 guide covers the dispute, and state-run Marketplaces set their own calendars.
Price the whole year, not just the premium
The lowest premium is not always the lowest cost. A fair comparison adds twelve months of premiums to what you would realistically pay for care: the deductible, copays and coinsurance, up to the plan's out-of-pocket maximum. Our explainer on the deductible versus the out-of-pocket maximum shows how those pieces stack.
- If you rarely see a doctor, a lower-premium plan with a higher deductible may cost less over the year.
- If you fill regular prescriptions or see specialists often, a plan with richer benefits can come out ahead despite the higher premium.
- For the worst case, add a year of premiums to the out-of-pocket maximum. That is the most the plan lets you spend on covered, in-network care.
- Check that your doctors, hospital and medications are covered before you switch, so a cheaper premium does not turn into out-of-network bills.
Keep your income estimate accurate: the subsidy cliff is back
Marketplace premium tax credits are based on your estimated household income for the coverage year. From 2021 through 2025, temporary enhancements made the credits larger and removed the upper income limit. Those enhancements expired at the end of 2025, and as of this update Congress has not restored them. The limit is back at roughly four times the federal poverty level: a household under it may qualify for help, and a household over it generally qualifies for none.
That makes an accurate estimate unusually important if your income sits near the line. Update your application when your income changes during the year, and use our subsidy estimator for a quick read on where you land. How income is counted for this purpose has its own rules, so confirm your figure with a tax professional or licensed agent.
Two related points. If your income is on the lower end, silver plans bought through the Marketplace can come with cost-sharing reductions that lower your deductible and copays, a discount available only on silver plans. And if your subsidy was cut off because a past year's tax return was not filed and reconciled, that is a separate problem with its own fix, covered in our guide to losing a subsidy over unfiled taxes.
If your plan is ending for 2027, pick the replacement yourself
Carriers decide their individual-market footprint one year at a time, and some are pulling back for 2027. The largest confirmed example is Cigna, which announced in April 2026 that it is leaving the individual ACA market, affecting members in 11 states. If you get a notice that your plan is discontinued, the Marketplace may match you to a similar plan from another insurer, but that match is chosen for resemblance, not for your doctors, your prescriptions or the best price.
Treat the notice as a reason to shop, since the best-value plan in your area may have changed along with the carriers. If your current plan ends December 31, choose by December 15 so the new one starts without a gap. Our guide to a health plan discontinued for 2027 walks through the steps.
Check other coverage you may be able to get
The Marketplace is not the only door, and the lower-cost option can sit somewhere else:
- An employer plan through your own job or a spouse's. Compare the cost of covering everyone, not just the employee share. An offer of affordable employer coverage can also make you ineligible for a Marketplace subsidy, which is one more reason to compare both.
- COBRA, if you recently left a job. It keeps the same plan, but you typically pay the full premium, including the share your employer used to cover. Our look at whether COBRA is worth it covers when it beats a Marketplace plan.
- A catastrophic plan. Federal law makes these available to people under 30 and to people who qualify for a hardship or affordability exemption. Premiums tend to be lower because benefits generally start only after a very high deductible, though the plan must still cover at least three primary care visits.
Spend less once you are covered
If you choose an HSA-eligible plan, a Health Savings Account lets you set money aside for medical costs with tax advantages; contribution limits are adjusted annually, so confirm them with a tax professional. If a leaner plan leaves you worried about a hospital stay, supplemental coverage such as hospital indemnity insurance pays a fixed cash benefit for covered admissions. It is an add-on to a health plan, never a replacement.
Beyond the premium, a few habits cut what you pay during the year:
- Stay in network, and confirm a provider's network status before a scheduled visit or procedure.
- Ask your doctor whether a generic or a lower-tier drug on your plan's list would work for you.
- Use your preventive benefits. ACA-compliant plans cover many preventive services with no cost sharing when you see an in-network provider.
- For non-emergency problems, check whether your plan covers telehealth or urgent care at a lower cost than the emergency room. In an emergency, go to the ER.
- Read each explanation of benefits and question any charge that does not match the care you received.
Get a second set of eyes
Weighing plans, networks, drug lists, subsidy estimates and 2027 carrier changes at once is a lot to hold. A licensed agent can compare the plans available in your county, explain the trade-offs and point out options you might miss, at no cost to you. Get a personalized quote before open enrollment opens, and confirm the exact figures for your situation, since subsidy thresholds, plan prices and deadlines change every year.