Jill On Money: The annual health coverage crunch — choosing your 2027 plan

Rising medical costs, combined with the end of enhanced premium tax credits, have pushed coverage prices higher, making the yearly enrollment season especially costly.

After looking at Medicare, it is worth turning to benefits enrollment for everyone else. About 154 million Americans receive coverage through employer plans, and according to the Kaiser Family Foundation’s 2025 Employer Health Benefits Survey, workers contributed an average of $1,440 a year for individual coverage and $6,850 for family coverage.

The premium is only part of the bill. Deductibles must also be considered; last year, the average deductible for single coverage was $1,886. On top of that, enrollees often face copayments, which are fixed dollar amounts, or coinsurance, which is a percentage of the covered cost. For doctor visits, KFF reported average copays of $27 for primary care and $45 for a specialist, while average coinsurance was 19 percent.

Because the numbers are so large, it is important to review your options carefully. First, determine whether your current plan or your health needs have changed. Make sure your doctors and prescriptions are still covered, and if they are not, look for alternatives.

Many employers offer High Deductible Health Plans, or HDHPs, which trade lower premiums for higher out-of-pocket costs before insurance begins paying. These plans are often paired with Health Savings Accounts, or HSAs, which provide a triple tax advantage to help cover those larger deductibles.

That tax treatment works in three ways: contributions go in before taxes, money in the account grows tax-free, and qualified medical withdrawals are not taxed. If you change jobs, you can keep the HSA and use it much later. Annual HSA contribution limits for 2027 are set at $4,500 for self-only coverage and $9,000 for family coverage. Those age 55 or older, and not enrolled in Medicare, can contribute an additional $1,000.

HSAs should not be confused with Flexible Spending Accounts, or FSAs, another workplace savings option. These accounts let workers set aside up to $3,400 pre-tax in 2026 for unreimbursed health expenses, and the amount is expected to rise. FSA funds generally must be used during the plan year, although some employers offer a grace period of up to 2.5 extra months or allow a carryover of up to $680 into the next year.

Affordable Care Act

People without coverage through an employer, Medicare, Medicaid or the Children’s Health Insurance Program can shop for insurance through the Affordable Care Act Marketplace. Still, visiting HealthCare.gov may bring sticker shock, and some consumers question the word “affordable” in the program’s name.

Higher medical costs and the expiration of enhanced premium tax credits have driven prices up. For 2026, the average monthly premium payment after tax credits, including people who received none, rose 58 percent from $113 to $178, according to KFF. For 2027, Marketplace insurers are proposing a median premium increase of 15 percent.

The maximum annual out-of-pocket limit for 2027 is also rising sharply, to $12,000 for self-only coverage and $24,000 for coverage other than self-only. That represents a 13.2 percent increase from the 2026 limits of $10,600 and $21,200, respectively.

To cope with the higher costs, many Marketplace enrollees have shifted from silver plans to bronze plans, which lower premiums but raise deductibles. All Marketplace bronze and catastrophic plans remain HSA-eligible in 2027. It is also worth checking with your state, since some are offering subsidies for people who cannot afford their coverage.

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