Health Insurance, Made Simple.
Plain-English education on the ACA Marketplace for 2027: how subsidies work, what plans cover, when to enroll, and how to avoid costly mistakes. Then, if you want hands-on help, we can walk you through every step — free.
What it covers
The 10 essential benefits every Marketplace plan must include.
How subsidies work
Premium tax credits that can bring your cost to $0 a month.
Metal tiers, decoded
Bronze, Silver, Gold, Platinum — what each one really means.
Key 2027 dates
Open enrollment windows and deadlines you can't miss.
What Is the ACA Marketplace?
Four things every family should understand before picking a plan.
What it is
The ACA Marketplace (also called the Exchange) is the government-run shopping site — HealthCare.gov or your state's site — where individuals and families buy health insurance. It was created by the Affordable Care Act (Obamacare).
Who can use it
Anyone legally present in the U.S. who doesn't get affordable coverage from a job, Medicare, or Medicaid. Self-employed, small-business owners, early retirees and gig workers use it most.
What plans must cover
Every plan covers 10 essential benefits: doctor visits, hospital care, emergency care, prescriptions, maternity and newborn care, mental health, rehab, lab services, preventive care and pediatric care. Pre-existing conditions are always covered — no exceptions.
When you can enroll
Open enrollment runs once a year. Outside that window you need a qualifying life event (married, had a baby, lost job coverage, moved) for a Special Enrollment Period.
Key Dates for 2027
Missing a deadline can leave you uninsured for months — these are the dates that matter.
Nov 1, 2026
Open enrollment opens
The first day you can sign up for a 2027 plan on HealthCare.gov and most state Marketplaces.
Dec 15, 2026
Coverage starts Jan 1
On HealthCare.gov, enroll by this date and your 2027 coverage begins January 1. Many state-run Marketplaces allow later starts — some even start Jan 1 with a mid-December to mid-January deadline.
Jan 15, 2027
Open enrollment closes
Last day to enroll in most states. After this, you generally must wait (or qualify for a Special Enrollment Period).
Feb 1, 2027
Later start date
Plans chosen between Dec 16 and Jan 15 usually begin February 1.
Special Enrollment Periods (SEP)
You can enroll or switch plans any time of year if you experience a qualifying life event, usually with 60 days before or after the event:
Lost job-based coverage or Medicaid
Got married or divorced
Had a baby, adopted, or fostered a child
Moved to a new county or ZIP code
Turned 26 and aged off a parent's plan
Became a U.S. citizen or lawfully present
Release from jail, AmeriCorps start/end
Exact dates vary by state. California, New York, Colorado, New Jersey, Washington D.C. and a few others keep enrollment open into late January or beyond. We'll confirm the exact window for your state.
Immigration status and tax credits
For noncitizens: green card holders and the other eligible groups below may qualify. Only those eligible for tax credits can use them to lower premiums.
Eligible for tax credits
- U.S. citizens
- Green card holders (LPRs)
- Cuban/Haitian entrants
- Eligible COFA residents (Compact of Free Association)
Not eligible for tax credits
- O-1 / O-3, H-1B / H-4, R-1 / R-2
- F-1 / F-2, J-1 / J-2, L-1 / L-2, TN, and similar
- TPS, asylees, refugees, parolees and other statuses
These groups may still purchase Marketplace insurance, but cannot use tax credits to lower premiums.
Mixed-status families
When family members have different immigration statuses, only those who meet the eligibility requirements can receive tax credits. Example: parents on O-1 / O-3 visas are not eligible for tax credits, while their U.S. citizen child is eligible. Subsidies are calculated for the eligible family members only.
Subsidies: How Plans Become Affordable
Most people who buy their own coverage get financial help. Here's what's available.
Premium Tax Credits
The main subsidy. It lowers your monthly premium based on your household income and family size. The bigger the gap between your income and the cost of coverage in your area, the bigger the credit. Many households end up paying $0 per month.
Cost-Sharing Reductions
An extra subsidy that lowers your deductible, copays and out-of-pocket maximum. It applies only to Silver plans and only when your income falls roughly in the lower-to-middle band. If you qualify, a Silver plan often beats a Gold plan on real cost.
Medicaid & CHIP
If your income is very low, you may qualify for Medicaid (or CHIP for children) instead of a Marketplace plan — often with little or no cost. In states that expanded Medicaid, most adults under 138% of the poverty line qualify.
Subsidy rules change with income, household size, and each year's federal and state policy. The fastest way to know your real number is to run your zip code, household size and income estimate — it takes about two minutes.
Metal Tiers, Decoded
Every Marketplace plan is a Bronze, Silver, Gold or Platinum. The metal is about the split of costs between you and the plan — not quality.
You pay ~40% · Plan pays ~60%
Lowest monthly premium, highest costs when you get care. Good if you rarely visit doctors and just want protection from big bills.
You pay ~30% · Plan pays ~70%
The only tier that gets extra cost-sharing reductions. With subsidies it's often the best value — sometimes $0 premium with a low deductible.
You pay ~20% · Plan pays ~80%
Higher premium, much lower costs when you use care. Good if you see doctors regularly or expect a procedure.
You pay ~10% · Plan pays ~90%
Highest premium, smallest bills at the doctor. Only available in some areas, and usually not the best value even with subsidies.
Deductible
What you pay out of pocket before the plan starts sharing costs. Bronze deductibles can top $7,000; Gold can be $1,000 or less.
Out-of-pocket max
The most you can pay in a year for covered care. After you hit it, the plan pays 100%. Same federal limit across tiers.
Network
Which doctors and hospitals accept the plan. A cheap plan with your doctor out-of-network costs more in the end. Always check.
Income limits and what you pay
Coverage year 2027 uses the 2026 federal poverty guidelines (FPL). Tax credits generally apply from 100% to 400% FPL.
10.22%
of household income
Employer coverage affordability. The chart considers employer coverage unaffordable when its cost exceeds this threshold. Family coverage affordability is based on the cost of family coverage.
Annual income by household size
| Household | 100% FPL | 138% FPL | 150% FPL | 200% FPL | 250% FPL | 300% FPL | 400% FPL |
|---|---|---|---|---|---|---|---|
| 1 | $15,960 | $22,025 | $23,940 | $31,920 | $39,900 | $47,880 | $63,840 |
| 2 | $21,640 | $29,863 | $32,460 | $43,280 | $54,100 | $64,920 | $86,560 |
| 3 | $27,320 | $37,702 | $40,980 | $54,640 | $68,300 | $81,960 | $109,280 |
| 4 | $33,000 | $45,540 | $49,500 | $66,000 | $82,500 | $99,000 | $132,000 |
| 5 | $38,680 | $53,378 | $58,020 | $77,360 | $96,700 | $116,040 | $154,720 |
| 6 | $44,360 | $61,217 | $66,540 | $88,720 | $110,900 | $133,080 | $177,440 |
| 7 | $50,040 | $69,055 | $75,060 | $100,080 | $125,100 | $150,120 | $200,160 |
| 8 | $55,720 | $76,894 | $83,580 | $111,440 | $139,300 | $167,160 | $222,880 |
Each additional person over 8 adds $5,680 to 100% FPL.
Expected premium contribution (% of income)
Under 100% FPL
Ineligible for credit
100% FPL
2.15%
133% FPL
3.23%
138% FPL
3.54%
150% FPL
4.30%
200% FPL
6.78%
250% FPL
8.66%
300–400% FPL
10.22%
Over 400% FPL
Ineligible for credit
Out-of-pocket maximums
| Plan | Income level | Individual | Family |
|---|---|---|---|
| All plans | All incomes | $12,000 | $24,000 |
| CSR Silver 73% | 201–250% FPL | $9,600 | $19,200 |
| CSR Silver 87% | 151–200% FPL | $4,000 | $8,000 |
| CSR Silver 94% | 100–150% FPL | $4,000 | $8,000 |
Employer coverage is considered unaffordable above 10.22% of income. Source: IRS Rev. Proc. 2026-26 and CMS 2027 parameters, via Beyond the Basics.
Compare 2027 plans on HealthSherpaGet Ready to Apply or Re-Enroll
Have this information ready before you start. To apply or re-enroll, visit HealthCare.gov or call the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325).
0 of 13 ready
Download the PDF checklistProtect your personal information
Never share your information with anyone offering cash, gifts or other perks. HealthCare.gov is the official place to get affordable Marketplace insurance. Tips: HealthCare.gov/protect-from-fraud-and-scams.
1-800-318-2596 (TTY: 1-855-889-4325)
Source: CMS Product No. 11896, September 2025. Health Insurance Marketplace® is a registered service mark of the U.S. Department of Health and Human Services.
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This page is for educational purposes only and is not insurance, legal, or tax advice. Plan details, subsidy rules, premiums and deadlines change every year and vary by state. Always confirm details with HealthCare.gov, your state Marketplace, Medicare.gov, or a licensed agent before making decisions. Kingdom Steward Solutions is an independent enrollment assistance organization.
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