ACA Marketplace
Individual and family health insurance (ACA Marketplace)
The short answer
ACA marketplace plans are comprehensive health insurance for people who do not get coverage from a job. They cover pre-existing conditions and essential health benefits, and many households with incomes from 100% to 400% of the poverty level qualify for a premium tax credit. Open enrollment for 2027 coverage runs November 1, 2026 to January 15, 2027 in most states.
A licensed agent calls you at no cost.
Updated and reviewed by the licensed agents at Health Insurance Solutions in Orlando, Florida. How we research and review
Individual & Family at a glance
- Open enrollment
- Nov 1 to Jan 15
- Pick a plan by December 15 for coverage that starts January 1. A few states use different dates.
- Special enrollment
- 60 days
- After a qualifying life event such as losing coverage, moving, getting married or having a baby.
- Help with the price
- Up to 400% of poverty
- Households with a credit pay 2.15% to 10.22% of income for the benchmark silver plan. Above 400%, savings stop.
- Cost of our help
- $0
- An agent does not add a fee to your premium. Marketplace plans are priced the same through an agent.
Who is an ACA marketplace plan for?
Marketplace plans are comprehensive health insurance under the Affordable Care Act. They cover pre-existing conditions, preventive care and essential benefits. Many households qualify for a tax credit that lowers the monthly premium. We estimate it, compare networks and drugs, and enroll you correctly.
- Freelancers and anyone who is self-employed
- Families who don't have employer coverage
- Anyone who lost job-based coverage, moved, married, or had a baby
- Early retirees not yet eligible for Medicare
What does an ACA marketplace plan cover?
Usually included
- Doctor visits, specialists, hospital stays and emergency care
- Prescription drugs, mental health and substance use care, and maternity and newborn care
- Preventive care such as vaccines and screenings, with no copay from in-network providers
- Lab tests, rehabilitation, and children's services including dental and vision
- People with pre-existing conditions: plans cannot deny you or charge you more for your health
Usually not included
- Adult dental and vision, which marketplace plans do not have to include (see our dental and vision page)
- Long term custodial care
- Planned care from out-of-network doctors on HMO and EPO plans
- Cosmetic procedures
How much does an ACA marketplace plan cost?
Your price depends on your age, your ZIP code, the plan you pick and your household income. A premium tax credit lowers the monthly premium, and you can use it on any metal level.
With a tax credit
For 2027, a household with a premium tax credit pays 2.15% to 10.22% of its income for the benchmark silver plan, and the credit covers the rest.
Above 400% of the poverty level
The extra savings that ran from 2021 through 2025 have ended, so households above 400% of the poverty level get no credit.
Bronze, silver, gold, platinum
On average a bronze plan pays 60% of costs, silver 70%, gold 80% and platinum 90%. Lower levels cost less each month and more when you use care.
Your yearly limit
Every plan caps what you pay for covered in-network care. By law the cap is $12,000 for one person and $24,000 for a family in 2027.
Prices are moving
Insurers proposed a median increase of about 15% for 2027, so compare plans again even if you are renewing.
2027 health insurance subsidy calculator
Enter your state, household size and income to see your 2027 expected premium, your savings and whether Medicaid may apply.Health plan cost calculator
See what you would pay out of pocket for a medical bill under a plan's deductible and coinsurance.Health plan comparison calculator: yearly cost of two plans
Enter two plans' premiums, deductibles and out of pocket maximums to see which costs less for the care you expect.How is a marketplace plan different from short-term and fixed indemnity plans?
Marketplace plans are the only individual plans that must cover pre-existing conditions and can come with a tax credit. Short-term and fixed indemnity plans can cost less each month, but they work differently.
| ACA marketplace plan | Short-term plan | Fixed indemnity plan | |
|---|---|---|---|
| Counts as minimum essential coverage | Yes | No | No |
| Required to cover pre-existing conditions | Yes | No | No |
| Premium tax credit available | Yes | No | No |
| Yearly limit on what you pay for covered care | Yes | Not required | No |
| How it pays | Pays or limits what you owe for covered care | Pays covered care up to the plan's limits | A set cash amount for each covered day, visit or service |
| When you can enroll | Open enrollment, or after a qualifying life event | Usually any time, under your state's rules | Usually any time of year |
When is a marketplace plan not the right choice?
- You can get affordable job based coverage. You usually cannot get a tax credit then, and the job plan is often the better value.
- You are eligible for premium free Medicare Part A. Medicare is usually the better fit, and you generally cannot get a credit once you have it.
- Your income is below your state's Medicaid limit. Medicaid may cost you less, and our state guides show each state's rules.
- You need care for a health condition and open enrollment is closed. Check special enrollment first, because short-term and fixed indemnity plans can exclude it.
How do we help you pick an ACA marketplace plan?
Estimate your savings
We look at expected household income to estimate your tax credit and any cost-sharing savings.
Check your network
Before you pick a plan, we confirm your doctors are in network and your drugs are covered.
Enroll and verify
We complete the application with you and handle any document requests from the Marketplace.
Get help
What's your ZIP code?
Plans and prices depend on where you live.
Common questions
Does it cost extra to use an agent?
No. A licensed agent does not add a fee to your premium. Marketplace plans are priced the same whether you enroll through an agent or on your own. Agents are generally paid by the insurance company, not by you.
When is open enrollment for 2027 health insurance?
Open enrollment for 2027 coverage starts November 1, 2026 and ends January 15, 2027 in most states. Choose a plan by December 15, 2026 for coverage that starts January 1, 2027. A few state marketplaces use different dates, and our state pages list each one.
Can I get health insurance outside open enrollment?
Yes, if you have a qualifying life event such as losing other coverage, moving, getting married or having a baby. You usually have 60 days from the event to pick a plan.
How much help can I get paying for a plan in 2027?
If your household income is between 100% and 400% of the federal poverty level, you may qualify for a premium tax credit. For 2027, eligible people pay between 2.15% and 10.22% of household income for the benchmark silver plan. Above 400%, there is no credit.
Do marketplace plans cover pre-existing conditions?
Yes. Marketplace plans cannot turn you down or charge you more because of your health, and they cannot make you wait for benefits related to a pre-existing condition.
What is the difference between bronze, silver, gold and platinum?
The level shows how you and the plan split costs on average: bronze 60%, silver 70%, gold 80% and platinum 90%. Lower levels have lower monthly premiums and higher costs when you use care. The level says nothing about the quality of care.
Do I have to pay back my premium tax credit?
Yes, if too much was paid, and there is no longer a limit. Starting with tax year 2026, the return you file in 2027, you repay the full extra amount. That can happen when your income ends up higher than you estimated or your household changes and you do not report it.
Guides that go deeper
Talk to a licensed agent
We compare plans, explain the tradeoffs and help you enroll. It costs you nothing.
Sources
Rules change. Confirm dates, limits and eligibility with the source, your state insurance department or a licensed agent before you decide. We last checked these on .
- HealthCare.gov: Dates and deadlines for 2027 coverage(opens in a new tab)
- HealthCare.gov: What Marketplace health insurance plans cover(opens in a new tab)
- HealthCare.gov: Health plan categories, Bronze, Silver, Gold and Platinum(opens in a new tab)
- HealthCare.gov: Coverage outside open enrollment(opens in a new tab)
- IRS Revenue Procedure 2026-26 (2027 premium tax credit percentages)(opens in a new tab)
- CMS: 2027 payment notice parameters, maximum cost sharing(opens in a new tab)