By Qamar S, 15 years in US medical billing · Last reviewed October 18, 2026
To choose a health insurance plan, start with how much care you expect next year, check that your doctors and medicines are covered, then compare the total yearly cost (12 months of premiums plus what you’d pay when you use care), not just the monthly premium. The cheapest premium is often the most expensive plan if you get sick.
Deadlines for 2027 coverage: HealthCare.gov Open Enrollment runs November 1, 2026 to January 15, 2027 (December 15 for coverage starting January 1). Employer open enrollment is usually in October or November; check your HR emails. Medicare has its own window, October 15 to December 7: see Medicare Open Enrollment 2027.
Step 1: Estimate how much care you’ll use
| Your situation | What usually fits |
|---|---|
| Healthy, rarely see a doctor | Lower premium, higher deductible (bronze or an HSA-eligible plan) |
| A few visits and a regular prescription | Middle ground (silver), especially with cost-sharing reductions |
| Ongoing condition, pregnancy or planned surgery | Higher premium, lower deductible and out-of-pocket max (gold) |
Step 2: Check your doctors and hospitals
Search each plan’s provider directory for your doctors, your nearest hospital and any specialists. Then call the doctor’s office to confirm they take that exact plan for 2027. Directories are often out of date.
Step 3: Check your medicines
Look up each prescription in the plan’s drug list (formulary). Note the tier and whether it needs prior authorization. A drug on a high tier can cost more each month than the difference in premiums.
Step 4: Pick the plan type
- HMO: lowest cost, must use the network and usually need referrals.
- PPO: more freedom and out-of-network coverage, higher premiums.
- EPO: network only, but usually no referrals.
See PPO vs HMO for a full comparison.
Step 5: Compare total yearly cost
Add up three numbers for each plan you’re considering:
- Premiums: monthly premium after any tax credit × 12.
- Expected costs: what you’d pay in deductibles, copays and coinsurance for the care you expect.
- Worst case: the out-of-pocket maximum, in case of a big surprise.
Our health plan cost comparison tool does this for you. If the terms are confusing, read deductible vs copay vs coinsurance.
Step 6: Choose your metal tier (Marketplace plans)
Bronze plans cover about 60% of costs on average, silver 70%, gold 80% and platinum 90%. If your income is under 250% of the poverty level, a silver plan can come with cost-sharing reductions that make it better than gold. See bronze vs silver vs gold.
Step 7: Check the extras that save money
- HSA eligibility if you pick a high-deductible plan. See HSA vs FSA.
- Employer vs Marketplace: if your job offers coverage, see employer insurance vs Marketplace.
- Premium tax credits: update your income estimate on HealthCare.gov. See why premiums are rising in 2027.
Common mistakes to avoid
- Letting your plan auto-renew without checking for changes.
- Choosing by premium alone.
- Assuming your doctor is in network because they were last year.
- Forgetting dental, vision or a spouse’s coverage options.
From 15 years in billing: most of the surprise bills I’ve seen came from one of two things: a doctor who wasn’t in the new plan’s network, or a medicine that needed prior authorization. Ten minutes of checking before you enroll saves hours of phone calls in January.
Frequently asked questions
What is the most important thing when choosing a health plan?
Total yearly cost for your situation, combined with whether your doctors and medicines are covered. A low premium doesn’t help if your care isn’t covered.
Is a high-deductible plan a good idea?
It can be if you’re healthy and can afford the deductible, especially if you pair it with an HSA. If you expect regular care, a lower deductible usually costs less overall.
Should I choose bronze or silver?
Bronze has lower premiums but higher costs when you use care. Silver is often better if you qualify for cost-sharing reductions (income under 250% of the poverty level) or expect regular care.
When can I change my health plan?
During Open Enrollment, or within 60 days of a qualifying life event such as losing coverage, moving, marriage or having a baby. See our special enrollment period guide.
Sources: HealthCare.gov: How to pick a health insurance plan · HealthCare.gov: Health plan categories · KFF: 2027 premium changes
This guide is educational and is not legal, financial or insurance advice. MedBillGuide is not connected to Medicare, CMS or any government agency, and we do not sell insurance. See our Disclaimer.