4 costly health insurance mistakes to avoid when choosing a 2027 plan

4 costly health insurance mistakes to avoid when choosing a 2027 plan From hidden costs to coverage gaps, avoid these health insurance mistakes in 2027. Advertisement Updated: 10:51 AM CST Nov 11, 2026 Editorial Standards ⓘ Courtenay Tucker News Video Curation Team Manager 4 costly health insurance mistakes to avoid when choosing a 2027 plan From hidden costs to coverage gaps, avoid these health insurance mistakes in 2027. Updated: 10:51 AM CST Nov 11, 2026 Editorial Standards ⓘ Courtenay Tucker News Video Curation Team Manager Millions of Americans are about to pick their health insurance for 2027. Whether your coverage comes through an employer, the ACA Marketplace or Medicare, the choice involves more than comparing monthly prices. A few wrong assumptions could leave you paying more or without the coverage you expected. Louise Norris, a health policy analyst who creates guides to help consumers navigate their coverage options, shares four things to consider before you enroll. Advertisement 1. Check that your doctor is in the plan's network Having the same insurance company doesn't guarantee your doctor takes the specific plan you're choosing. "You shouldn't assume that just because your doctor was in-network with company XYZ when you had employer-sponsored coverage that they will be with individual market coverage, because they might not," Norris said. This catches many people leaving job-based coverage, such as those retiring early or becoming self-employed. Employer networks can be broader, sometimes nationwide. Norris says there's often a learning curve, so check your doctors every year. Look beyond the monthly premium, too. Compare the deductible, the out-of-pocket maximum and other coverage costs. Most people need some care, but not enough to hit their out-of-pocket maximum. 2. Account for changes to your household or income Marketplace subsidies are tied to a benchmark plan in your area. When that plan's premium changes, so does your subsidy, so your net premium will almost certainly change for 2027. It could go up or down depending on where you live and your income. Your own circumstances matter, too. "Maybe you've had a kid who's aged off of your plan, and so now your household is smaller. That affects your subsidy amount. Maybe your income has changed or you're projecting an income change for 2027," Norris said. "All these factors will change how much you're paying." Don't assume your plan will stay the same, even if you're happy with it. If it's being discontinued, the Marketplace may choose a replacement for you, but Norris says it's not in your best interest to rely on that. Comparison shop every year. There is some good news. Despite the sticker shock many felt for 2026, most Marketplace enrollees still qualify for a subsidy that covers most of the premium. Some states also offer their own subsidies on top of the federal ones, which you get by applying through the Marketplace. 3. Don't assume you earn too much for financial help ACA subsidy eligibility is based on a specific calculation of your household income called modified adjusted gross income (MAGI). Certain eligible contributions and deductions can lower that amount and potentially help you qualify for financial assistance, including: The self-employed health insurance deduction, for the portion you pay yourself Pre-tax retirement contributions, including traditional IRAs, solo 401(k)s and SEP IRAs Health savings account (HSA) contributions All Bronze plans in the Marketplace are HSA-compatible. In 2027, someone with family coverage can put up to $9,000 into an HSA, which comes off their income dollar for dollar. That matters most if you're just over the line. Subsidies generally end above 400% of the federal poverty level, and if you're far above it, there isn't much you can do. "A pre-tax retirement account or a health savings account will reduce your income, and depending on how old you are and where you live that could translate into thousands of dollars in subsidies that you get," Norris said. But if you're close to the limit, ask a tax advisor whether those contributions could help you qualify. HSAs aren't for everyone. Contributions can offer tax advantages, and withdrawals for qualified medical expenses are tax-free, but you need to be able to afford to fund the account. They're "certainly not a magic bullet," says Norris. 4. Get qualified help before you enroll Whether you're researching an employer plan, an ACA Marketplace plan or Medicare, get help before you sign up. Navigators can explain terminology and how plans work. State-licensed insurance agents and brokers can compare and recommend plans, depending on their licensing and insurer appointments. Their services are generally free to consumers, although brokers may receive commissions from insurance companies. "You are not saving any money by not getting help," Norris said. "And getting help can be the thing that really helps you end up in a plan that better meets your needs." Don't wait until the last minute, since help can get backed up as deadlines approach. Questions to ask before you choose a plan Before enrolling, bring these questions to an advisor, navigator, insurance broker or your employer's benefits team. The right questions can help you understand what you're paying for and avoid unexpected expenses. For any plan Are my preferred doctors, specialists and hospital in the plan's network? How can I confirm that? Are my prescriptions covered, and at what cost? Beyond the premium, what will I pay in deductible, copays, coinsurance and out-of-pocket maximum? What happens if I need care out-of-network or out-of-state? What changed in this plan from last year? For Employer-Sponsored Insurance Plans Of the plans my employer offers, which one provides the best overall value based on my healthcare needs and expected expenses? If I anticipate needing surgery, ongoing treatment or frequent prescriptions, which plan would leave me with the lowest overall costs? Would a high-deductible health plan paired with a Health Savings Account (HSA) make financial sense for me? Does my employer contribute to the account? If I'm covering a spouse or dependents, should I compare the cost of covering everyone under one plan versus having different coverage options? For the ACA Marketplace How are my household size and expected 2027 income affecting my eligibility for subsidies? Could HSA or pre-tax retirement contributions lower my income and raise my subsidy? Am I eligible for premium tax credits or other financial assistance, and how much will I actually pay each month after those subsidies are applied? If my current insurer is leaving the Marketplace or my plan is being discontinued, what other plans are available to me? Are my current doctors, specialists and preferred hospitals in-network for the 2027 plan I'm considering? Are my prescription medications covered? If so, how much will I pay for them under this plan? What will my total financial exposure be if I have a major medical expense, including my deductible, coinsurance, and annual out-of-pocket maximum? Would a different metal-tier plan (Bronze, Silver or Gold) actually save me money based on my healthcare needs? For Medicare Based on my healthcare needs and budget, would I be better off with Original Medicare and a Medigap policy, or Medicare Advantage? What will my total annual costs look like, including premiums, deductibles, copays, coinsurance and potential out-of-pocket expenses? Are my current doctors, specialists and preferred hospitals included in the Medicare Advantage plan's network? Can I access providers outside that network? Are my prescription medications covered, what will they cost, and which pharmacies can I use? If I choose Original Medicare, should I purchase a separate Part D prescription drug plan and Medigap coverage? What services require prior authorization or referrals,