TL;DR
- ✓Open enrollment on HealthCare.gov runs November 1, 2026 through January 15, 2027. Pick a plan by December 15 if you want coverage to start January 1.
- ✓Check your doctors, prescriptions, and whole year cost, not just the monthly price.
- ✓Marketplace plans never ask health questions and may come with income based help. Private plans may offer wider networks, depending on the plan, but may ask health questions.
- ✓1099 earners and small business owners may want to compare a private option side by side before deciding.
- ✓Taxes matter too. Talk with your tax pro about premium tax credits, the self employed health insurance deduction, and HSAs.
The short answer: Your checklist should cover four things: who you need to see, what you need to take, what the year may really cost you, and how the plan fits your taxes. Run that list against both a Marketplace plan and a private plan, and the better fit usually shows itself.
Why this year deserves a real checklist
Open enrollment can feel like speed dating. Everyone smiles, and nobody mentions the deductible until the third date.
This year it pays to slow down. The extra premium help that many Marketplace shoppers had from 2021 through 2025 expired and, as of late October 2026, Congress has not brought it back. For 2027, households earning more than 400% of the federal poverty level (a yearly income line the government sets based on household size) generally get no premium tax credit at all. Insurers have also asked for a median premium increase of about 15% for 2027.
None of that means panic. It means compare. If you're on a Marketplace plan, we'll figure out your next step together. If you're looking at private, we'll figure that out too.
Your printable open enrollment checklist
Grab a pen and check off each one.
- My doctors are in network. Look up each one by name.
- My hospital is covered. Know which hospital you would want in an emergency.
- My prescriptions are on the list. Check each medication and its cost tier.
- I know my deductible. That is the amount you pay for covered care before the plan starts sharing the cost.
- I know my out of pocket maximum. That is the most you would pay for covered care in a year, your worst case number.
- I did the whole year math. Twelve months of premium plus the deductible.
- I estimated my 2027 income carefully. This matters for any Marketplace tax credit.
- I asked my tax pro. About deductions, credits, and whether an HSA fits.
- I know my deadline. December 15 for a January 1 start on HealthCare.gov.
Marketplace vs private: an honest side by side
Every plan is different, so treat this as a starting point.
| Marketplace (ACA) plans | Private plans | |
|---|---|---|
| Coverage | Must cover the ten essential health benefits, including maternity, mental health, and prescriptions. Preexisting conditions are covered. | Varies by plan. May not cover everything an ACA plan does, so read the benefits closely. |
| Networks | Many plans are HMO or EPO style with local networks, depending on your area. | Some offer broad PPO networks that may travel with you, depending on the plan. |
| Cost and subsidies | Premium tax credits may lower your monthly price if your income qualifies. No credit above 400% of the poverty level for 2027. | No premium tax credits. Pricing may be lower for healthy applicants, depending on the plan. |
| Health questions | None. You cannot be turned down for your health. | May ask health questions, and your answers may affect approval or price. |
| When you can join | Open enrollment, or a special enrollment period after a life event. | Many accept applications year round, depending on the plan. |
| Tax angles | Premium tax credits are settled on your tax return. Bronze and catastrophic plans now count as HSA eligible. | Premiums may count toward the self employed health insurance deduction. HSA eligibility depends on the plan. |
| Who it may fit | People with ongoing health conditions, or whose income qualifies for meaningful help. | Healthy 1099 earners and small business owners above the subsidy line who want a wider network. |
Why 1099 earners and small business owners may want to look at private
When you work for yourself, there is no HR department picking a plan for you. If your income lands above the subsidy line, you may pay the full Marketplace price anyway. Then a private plan may offer a broader network for a similar or lower price, depending on your health and the plan.
The tradeoff is real: private plans may use health questions and may not cover everything an ACA plan does. That is why a side by side comparison matters.
The tax side, in plain words
Three things to check with your tax pro, since every situation is different:
- ✓Premium tax credits. These only come with Marketplace plans. They are based on your estimated income, and they get settled on your tax return. If your 1099 income ends up higher than you guessed, you may have to pay some back.
- ✓The self employed health insurance deduction. If you are self employed, you may be able to deduct the premiums you pay for yourself and your family, generally when you are not eligible for an employer plan.
- ✓HSAs. A health savings account lets you save for medical costs with tax advantages, if you have an HSA eligible plan. Starting in 2026, bronze and catastrophic plans count, and some private plans may qualify too.
Questions to ask before you pick a plan
- ✓Are all of my doctors and my hospital in this network?
- ✓What does a specialist visit cost before and after the deductible?
- ✓How are my prescriptions covered, and is there a separate drug deductible?
- ✓What is my out of pocket maximum, and what does it include?
- ✓Does this plan ask health questions, and what happens if my health changes later?
Frequently asked questions
When is open enrollment for 2027?
On HealthCare.gov, it runs November 1, 2026 through January 15, 2027. Choose a plan by December 15 for coverage that starts January 1. Some states that run their own Marketplace use different dates.
Can I buy a private plan outside open enrollment?
Often, yes. Many private plans accept applications year round, depending on the plan, though they may ask health questions first.
Will I lose my tax credit if I choose a private plan?
Premium tax credits only come with Marketplace plans. Whether that matters depends on your income, so run the numbers with your tax pro.
Let's run your checklist together
You do not have to do this alone. In a free 2027 plan review, we will walk through this checklist side by side, Marketplace and private, so you can choose with confidence.
Book your free 2027 plan review or call 561-660-9894.
Your Health is Your Wealth. 💜
Christine Kieffer, Licensed Health Insurance Strategist
This post is for general education only and is not tax or legal advice. Plan availability, benefits, and eligibility vary by state, plan, and applicant. Please check with your tax pro about your own situation. NPN 19652136 · This is a solicitation for insurance.
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