If you get health insurance through the Affordable Care Act Marketplace, there's an important change to know before you shop for 2027 coverage: the federal Marketplace open enrollment period is getting shorter.

For 2027 coverage, open enrollment on the federal Marketplace runs from November 1 through December 15, 2026. If you want your new coverage to start January 1, 2027, you generally need to enroll or change plans by December 15 and pay your first premium.

That's different from recent years, when the federal Marketplace enrollment period extended into January.

There are other changes worth knowing, too, including changes to Marketplace financial assistance and some enrollment rules. If you use healthcare regularly, it's also worth looking beyond the monthly premium and checking what your plan says about telehealth, urgent care, prescriptions, deductibles, and out-of-network care.

TL;DR: Key Takeaways

  • Open enrollment for 2027 starts November 1, 2026.
  • The federal Marketplace deadline is December 15, 2026 for coverage beginning January 1, 2027.
  • The federal Marketplace will no longer use the November 1 through January 15 open enrollment period for 2027 coverage.
  • State-based Marketplaces can set their own dates, but their annual enrollment periods must end by December 31.
  • The enhanced Marketplace premium tax credits that were temporarily expanded during the COVID-19 pandemic ended after 2025, which can affect what some people pay.
  • When comparing plans, check more than the premium. Look at deductibles, copays, prescriptions, provider networks, telehealth coverage, and your maximum out-of-pocket costs.
  • Special Enrollment Periods may still allow you to get or change Marketplace coverage outside open enrollment if you qualify.

Want help figuring out what your symptoms may mean before deciding where to get care? Try August AI's free symptom assessment to help think through your symptoms and whether you may need medical attention. If you have severe symptoms or think you may be having a medical emergency, don't use online triage.

Call 911 or go to the nearest ER immediately. AI triage isn't a diagnosis and doesn't replace an evaluation by a clinician. For questions about Marketplace enrollment, plan options, or eligibility for financial assistance, work with a licensed insurance agent or contact HealthCare.gov directly.

When is open enrollment for 2027?

For people using the federally facilitated Marketplace, open enrollment for 2027 coverage runs from November 1 through December 15, 2026.

If you enroll by December 15 and pay your first premium, your coverage can begin January 1, 2027.

The shorter window is one of the biggest open enrollment 2027 changes.

CMS finalized a rule changing the annual open enrollment period beginning with the 2027 plan year. For exchanges using the federal Marketplace platform, the period will run from November 1 through December 15. State-based exchanges have more flexibility, but their enrollment periods must start no later than November 1, end no later than December 31, and last no more than nine calendar weeks.

So if you normally wait until January to compare plans, that strategy won't work for federal Marketplace coverage in 2027.

Why did the open enrollment period change?

CMS says the shorter enrollment period is intended to reduce confusion around enrollment dates, encourage continuous coverage, and reduce the possibility of people waiting until they need healthcare before enrolling.

For consumers, the practical effect is simpler: there's less time to compare plans and make a decision.

You don't necessarily need to choose a plan on November 1. But getting an early look at available plans can give you time to compare premiums, deductibles, doctors, medications, and other costs before the December deadline.

What changed with Marketplace financial assistance?

Another important change is the end of the temporary enhanced premium tax credits that were introduced during the COVID-19 pandemic.

Those additional savings ended after 2025. The amount of financial help you receive for 2027 will depend on factors like your household income, household size, and the plans available where you live.

That means you shouldn't assume that your 2027 premium will be the same as your 2026 premium.

When you apply or renew coverage, use your best estimate of your household income and update your Marketplace application if your circumstances change. Your eligibility for premium tax credits and other savings can be affected by changes in income or household information.

Does insurance cover telehealth?

If you're comparing plans for 2027, whether insurance covers telehealth is a reasonable question to ask before choosing a plan.

The answer depends on the specific plan and service. Marketplace plans cover essential health benefits, but the details of how a particular service is covered, including your cost-sharing and provider network, can vary.

If you regularly use virtual urgent care, online primary care, mental health services, or other telehealth services, check whether telehealth visits are covered, whether your preferred telehealth provider is in network, your copay or coinsurance for virtual visits, whether a deductible applies, whether the plan treats virtual and in-person visits differently, and whether prescriptions from a telehealth visit are covered under your pharmacy benefit.

You can also check your plan's Summary of Benefits and Coverage or contact the insurer directly if the information is unclear. For more on the relationship between virtual care and insurance, see our guide on does insurance cover telehealth.

Don't compare plans by premium alone

A low monthly premium doesn't necessarily mean a plan will cost less overall.

Consider your total healthcare costs, including premiums, deductibles, copayments, coinsurance, and the out-of-pocket maximum. Plan networks also matter because some plans charge substantially more when you use providers outside the network.

For 2027, check whether your primary care doctor, specialists, hospital, urgent care center, pharmacy, preferred medications, and telehealth providers are covered by the plan you're considering.

If you take regular medications or expect frequent medical visits, a plan with a higher premium but lower cost-sharing may work differently for your budget than a low-premium plan with a high deductible.

Could you still get a surprise medical bill?

Marketplace plans have protections against many types of unexpected out-of-network bills, but those protections don't mean every healthcare bill will be predictable.

The federal No Surprises Act generally protects people with private health insurance from surprise bills for most emergency services and certain out-of-network services provided at in-network facilities. It also limits certain out-of-network cost-sharing and balance billing.

However, you can still owe deductibles, copayments, and coinsurance for covered care.

The law also doesn't mean every service from every provider is automatically covered at the in-network rate. Your plan's network and benefit rules still matter.

Before receiving non-emergency care, especially when a specialist, facility, or additional provider may be involved, ask who is in network and what your expected cost will be.

If you don't have insurance or choose not to use it, the rules are different. In many situations, providers must give you a Good Faith Estimate of expected charges when you schedule care in advance. If your final bill is at least $400 more than the estimate from that provider, you may be able to dispute it through the federal process. For more on cash-pay costs, see our guide on how much is a doctor visit without insurance.

What happens if you miss the December 15 deadline?

Missing the federal Marketplace open enrollment deadline doesn't necessarily mean you have to remain uninsured for the entire year.

You may qualify for a Special Enrollment Period after certain life events, including losing other health coverage, getting married, having a baby, or moving. Eligibility depends on the specific circumstances.

Medicaid and CHIP also have year-round enrollment for people who qualify.

But you generally can't wait until you become sick and then sign up for a Marketplace plan simply because you need medical care. That's why the annual enrollment deadline matters.

What should you compare during open enrollment?

Before choosing a 2027 plan, make a short list of the healthcare services you actually use.

Then compare plans based on:

  • Monthly premium. This is what you pay to keep the insurance active, whether or not you use healthcare that month.
  • Deductible. This is what you generally pay for covered services before the plan begins paying its share, though some services may be covered before you meet the deductible.
  • Copays and coinsurance. These determine how much you pay when you actually receive care.
  • Out-of-pocket maximum. This limits how much you pay for covered, in-network services during the plan year, subject to the plan's rules.
  • Provider network. Check whether your doctors, hospitals, urgent care centers, and other providers are included.
  • Prescription coverage. Look at the plan's drug formulary and check whether your medications are covered and what tier they fall into.
  • Telehealth. If you use virtual care regularly, check whether it's covered and what you'll pay for a visit.

Conclusion

The biggest open enrollment 2027 changes are the shorter federal Marketplace enrollment period and the continued effects of changes to Marketplace financial assistance.

For federal Marketplace coverage, open enrollment runs from November 1 through December 15, 2026, with January 1, 2027 coverage available to people who enroll by the December 15 deadline and pay their first premium.

State-based Marketplaces can have different dates, so check the Marketplace serving your state before assuming December 15 is your deadline.

When comparing plans, look beyond the monthly premium. Check your doctors, medications, deductible, out-of-pocket maximum, urgent care coverage, and whether the plan covers the telehealth services you actually use.

And remember that having insurance doesn't mean every medical bill will be free or predictable. Understanding your network and cost-sharing rules before you need care can help you avoid unnecessary expenses and better understand what your plan actually covers.

Frequently Asked Questions

For Marketplace plans (HealthCare.gov and state exchanges), open enrollment for 2027 coverage typically runs from November 1, 2026, through January 15, 2027 in most states. Some state-based marketplaces have different dates, so check your state's exchange.

For Medicare, the Annual Enrollment Period runs from October 15 through December 7, 2026 for coverage starting January 1, 2027.

For employer-sponsored plans, open enrollment dates are set by your employer and can happen at any time during the year. Check with your HR department for your specific window.

For Medicaid and CHIP, you can enroll or make changes any time throughout the year. There isn't a limited window.

For Marketplace plans, if you miss the open enrollment deadline, you generally can't enroll in a plan until the next year's open enrollment window unless you qualify for a Special Enrollment Period.

A Special Enrollment Period may be available if you've had a qualifying life event like losing other health coverage, getting married, having a baby, moving, or experiencing certain other changes.

Medicaid and CHIP don't have limited enrollment windows, so you can apply any time if you qualify based on your income and household situation.

For Medicare, missing the Annual Enrollment Period can mean waiting for the Medicare Advantage Open Enrollment Period (January through March) or the next Annual Enrollment Period, depending on what changes you want to make.

Often, yes, but not always.

If your current plan is still available for 2027, you may be automatically re-enrolled if you don't take action during open enrollment. Auto-renewal typically happens with the same or a similar plan from the same insurer.

But your automatically renewed plan may not be the best fit for the next year. Premiums, deductibles, copays, covered services, provider networks, and prescription drug coverage can change from year to year. Even if you like your current plan, reviewing your options during open enrollment often reveals better fits or savings.

If your current plan is being discontinued, you'll typically get a notice explaining your options and any auto-enrollment into a similar plan.

Usually only if you qualify for a Special Enrollment Period.

Qualifying life events that may trigger a Special Enrollment Period include losing other health coverage (from a job, family member's plan, Medicaid, or another source), getting married or divorced, having a baby or adopting a child, moving to a new area, becoming a US citizen, and certain changes in income or household size.

You typically have 60 days from the qualifying event to enroll in or change your Marketplace plan. If you have employer coverage, check your HR department for their specific rules and deadlines.

Medicaid and CHIP eligibility can be applied for or updated at any time throughout the year.

Most private insurance plans cover at least some telehealth services, but coverage details vary by plan. Different plans may treat virtual urgent care, primary care, mental health, and specialist visits differently.

Medicare covers a range of telehealth services, though specific coverage can depend on the type of service and where you're located. Medicaid telehealth coverage varies significantly by state.

If telehealth access is important for how you plan to use care in 2027, check whether specific plans cover the type of virtual care you're likely to need, whether telehealth visits have the same copay as in-person visits, and whether the plan includes specific telehealth providers or lets you choose.

For a full breakdown of how insurance handles virtual care, see our guide on does insurance cover telehealth.