How to Pick Your Health Insurance

On this page

• Step 1: See where you can get coverage
• Step 2: Decide who to cover
• Step 3: Check for savings
• Step 4: Check your doctors and drugs
• Step 5: Compare total costs
• Step 6: Enroll on time
• Plan for a bad year, not just a normal one
• Check quality and service
• How many insurers to compare, and where to shop
• Watch out for plans that look too cheap
• Frequently asked questions

Step 1: See where you can get coverage

• Your job. Employers usually pay most of the premium. See is it cheaper to get health insurance through your employer.
• A spouse’s or parent’s job. You can stay on a parent’s plan until 26.
• The ACA marketplace. For people without affordable job-based coverage, including the self-employed.
• Medicaid or CHIP. In most states, adults with incomes up to 138% of the poverty level qualify, and children qualify at higher incomes.
• Medicare. At 65, or earlier with certain disabilities.

Job-based coverage counts as affordable in 2027 if your share for self-only coverage is no more than 10.22% of household income (9.96% in 2026). If your offer is affordable, you generally can’t get a premium tax credit on the marketplace.

Step 2: Decide who to cover

Should everyone be on one plan, or should family members split up? Sometimes one person takes a job-based plan and the rest of the family buys a marketplace plan. Compare covering all family members under the same policy with other options in family health insurance. If you’re married and wondering about removing a spouse from a plan, see can a spouse be dropped from health insurance while still married.

Step 3: Check for savings

Marketplace premium tax credits are available if your household income is between 100% and 400% of the federal poverty level. For 2027 coverage, that’s up to $63,840 for one person and $132,000 for a family of four. Cost-sharing reductions lower deductibles on silver plans if your income is under 250%. The enhanced subsidies from 2021 to 2025 have expired, so many people are paying more this year.

Step 4: Check your doctors and drugs

Search each plan’s provider directory and drug list. Confirm with your doctor’s office that they’re in network for that specific plan. See how to find out if a doctor is covered by your insurance.

Step 5: Compare total costs

Cost	What to look at
Premium	What you pay every month, after any tax credit
Deductible	What you pay before the plan shares costs
Copays and coinsurance	Your share of each visit, prescription or bill
Out-of-pocket maximum	The most you’d pay in a year for covered, in-network care
Network type	HMO and EPO plans cost less but limit you to the network; PPOs cost more

Estimate a normal year and a bad year for each plan. A plan with a higher premium can cost less overall if you use a lot of care.

Step 6: Enroll on time

For 2027 coverage, open enrollment on HealthCare.gov runs from November 1, 2026 to January 15, 2027. Sign up by December 15 for coverage that starts January 1. Some state marketplaces have different dates. Outside open enrollment, you need a qualifying life event, like losing other coverage, getting married or having a baby.

Plan for a bad year, not just a normal one

Add each plan’s yearly premium to its out-of-pocket maximum. That’s the most you’d pay for covered, in-network care in a very bad year. The out-of-pocket maximum can be as high as $10,600 for one person in 2026 and $12,000 in 2027. If you couldn’t cover that, a plan with lower cost-sharing may be worth a higher premium. See whether a high or low deductible is better.

Your situation matters too:

• Tobacco: insurers can charge tobacco users up to 50% more, and premium tax credits don’t cover the extra.
• Age: older adults can pay up to 3 times as much as younger adults for the same plan.
• Travel and activities: if you travel a lot or play contact sports, look closely at emergency coverage and care away from home.
• Under 30: a catastrophic plan may have the lowest premium, though you can’t use a tax credit on it.

Check quality and service

HealthCare.gov gives each plan an overall rating of 1 to 5 stars, based on medical care, member experience and plan administration, and NCQA rates plans each year too. Insurers also differ in how they handle claims: HealthCare.gov insurers denied 19% of in-network claims in 2024, with rates ranging from 3% to 36% by insurer, according to KFF. See the best health insurance companies and our insurer guides, like Blue Cross Blue Shield and Oscar.

How many insurers to compare, and where to shop

Compare every insurer selling plans in your area. The average state had about nine Marketplace insurers in 2026, but 165 counties had just one, and insurers enter and leave every year. For 2027, Cigna is leaving the Marketplace in all 11 of its states; see is Cigna leaving the Marketplace.

• The Marketplace (HealthCare.gov or your state’s site) is the only place to get premium tax credits and cost-sharing reductions.
• Insurers and brokers sell off-exchange plans that follow the same ACA rules, but without a tax credit. See how to buy health insurance outside the ACA exchanges.
• Licensed agents and brokers can compare plans for you at no charge, since insurers pay them. Ask whether they can show you every insurer in your area.

Watch out for plans that look too cheap

Short-term plans, fixed indemnity plans and health care sharing ministries can cost much less than ACA plans, but they can refuse to cover pre-existing conditions, cap what they pay or leave out whole categories of care. Ask any seller, “Is this an ACA-compliant plan?” For real ways to save, see the cheapest ways to get health insurance.

Ready to compare? See plans and prices by ZIP code.

Frequently asked questions

What’s the most important thing when choosing health insurance?

Whether the plan covers the doctors and drugs you need at a total cost you can handle, including a bad year.

Should I choose the plan with the lowest premium?

Not automatically. Low-premium plans usually have high deductibles. If you use a lot of care, a plan with a higher premium may cost less overall.

Can I buy health insurance any time of year?

Marketplace plans can only be bought during open enrollment or after a qualifying life event. Medicaid and CHIP accept applications all year.

How many health insurance companies should I compare?

All of the ones selling plans in your area. Most states had about nine Marketplace insurers in 2026, but some counties had only one, and the lineup changes every year.

How do I know what level of coverage I need?

Estimate how much care you use in a normal year, then add each plan’s premium to its out-of-pocket maximum to see what a bad year would cost. If you’d struggle to cover that, a gold or silver plan may be worth the higher premium; see bronze, silver, gold and platinum plans.

This article is general information, not insurance or tax advice. Savings and deadlines depend on your state and income. Last reviewed September 2026.