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How do you choose a health plan at open enrollment?

Compare the estimated total for a full year on each plan, which is twelve premiums plus what you would pay for the care you expect to use, up to the plan's out-of-pocket maximum. A lower premium can cost more over a year if you use a lot of care, and a higher premium can cost more if you use very little.

Free, no account. Checked October 31, 2026.

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Find four numbers on every plan

HealthCare.gov names the pieces of a yearly cost. The premium is the monthly amount you pay whether or not you get care. The deductible is what you pay for covered services before the plan starts to pay, except free preventive services.

Copayments and coinsurance are your share each time you get care, such as $20 for a visit or 30% of a hospital charge. The out-of-pocket maximum is the most you pay for covered in-network services in a plan year, and then the plan pays 100% of covered benefits.

Estimate your own likely use

HealthCare.gov suggests thinking about the amount and types of services and prescriptions your household will likely use, then picking a low, medium or high level of care. Start from last year's bills and add anything you know is coming, such as a planned procedure, a new prescription or a birth.

Price each plan at low, medium and high use.

Add up the full year

A plan's yearly cost is twelve premiums plus what you pay for care. You pay the deductible first, then your coinsurance share of the rest, and the care part stops growing once you reach the out-of-pocket maximum.

The worst case is twelve premiums plus the full out-of-pocket maximum. The best case is twelve premiums alone. The gap between those two numbers shows how much the plan depends on your use.

Check the worst case against your savings

Premiums do not count toward the out-of-pocket maximum, and neither do services your plan does not cover, out-of-network care, or charges above the allowed amount. For Marketplace plans in plan year 2027 the maximum is no more than $12,000 for one person or $24,000 for a family, up from $10,600 and $21,200 in 2026.

Many plans set it lower than the cap. Compare the maximum with cash you could reach in a bad year.

Where a health savings account fits

A health savings account (HSA) can be used only with a qualifying high-deductible health plan. For 2027 the IRS says that means an annual deductible of at least $1,750 for self-only coverage or $3,500 for family coverage, and an out-of-pocket maximum no higher than $8,700 or $17,400.

The 2027 HSA contribution limits are $4,500 for self-only coverage and $9,000 for family coverage, as set in Rev. Proc. 2026-24. Employer contributions count toward the limit.

Know the dates

HealthCare.gov lists Open Enrollment for 2027 coverage as November 1 to January 15. Enroll or change plans by December 15 for coverage that starts January 1, or by January 15 for coverage that starts February 1.

State marketplaces and employer plans can use different windows. Check the dates on the plan materials you received.

A worked example

Sample, not your numbers

Two plans at three levels of care

Sample numbers, not real plans. Plan A has a $400 monthly premium, a $1,000 deductible, 20% coinsurance and a $5,000 out-of-pocket maximum. Plan B has a $300 premium, a $4,000 deductible, 20% coinsurance and an $8,000 maximum. Care is in-network, and the amounts are what the plan allows.

Plan A, twelve premiums
$4,800
Plan B, twelve premiums
$3,600
$500 of care: Plan A year, Plan B year
$5,300 and $4,100
$4,000 of care: Plan A year, Plan B year
$6,400 and $7,600
$30,000 of care: Plan A year, Plan B year
$9,800 and $11,600

Plan B costs $1,200 less in premiums and wins only when care is low. At $4,000 of care Plan A costs $1,200 less, because its share of the care is $1,600 against $4,000. At $30,000 both plans reach their out-of-pocket maximum, so each year equals twelve premiums plus that maximum. Your own use decides which plan costs less.

Run your own numbers

Enter two or three plans and a level of care to see each plan's year and worst case side by side.

Common questions

What is the difference between a deductible and an out-of-pocket maximum?

The deductible is what you pay for covered services before the plan starts to pay its share, except free preventive services. The out-of-pocket maximum is the most you pay in a plan year for covered in-network services, and it includes your deductible, copayments and coinsurance.

Do premiums count toward the out-of-pocket maximum?

No. HealthCare.gov says the limit does not include your monthly premiums, services your plan does not cover, out-of-network care, or costs above the allowed amount for a service.

What is the 2027 out-of-pocket limit for Marketplace plans?

No more than $12,000 for an individual or $24,000 for a family, according to HealthCare.gov. A given plan can set its maximum lower than that cap.

When is open enrollment for 2027 coverage?

HealthCare.gov lists November 1 to January 15. Enroll by December 15 for coverage starting January 1, or by January 15 for coverage starting February 1. State marketplaces and employers can set their own dates.

What are the 2027 HSA contribution limits?

$4,500 for self-only coverage and $9,000 for family coverage, per IRS Rev. Proc. 2026-24. You can contribute only while covered by a qualifying high-deductible health plan.

Go further in the course

Chapters 1 to 3 are free, no card needed. Chapter 3 helps you set a monthly budget and a cash cushion, which is what the worst-case number is measured against.

Keep reading

Sources

Figures checked on October 31, 2026. Figures are for plan year 2027 as published on the dates above, and the example uses made-up plans with one coinsurance rate and no copays, drug tiers or network limits. The health plan chooser lab still models 2026 HSA and out-of-pocket limits. Subsidies, Medicare and plan-specific rules are not covered, and nothing here recommends a plan.

Education, not financial, tax or legal advice. The example uses sample numbers, and your own situation will differ.