Open enrollment for 2027 health coverage is open now. If you buy your own insurance, this is the one window each year to switch plans without a qualifying event. This year the rules changed more than usual, so last year's plan is not automatically the right answer. Here is how to compare plans the way an agent does.
The 2027 Dates and What Changed
Utah uses the federal Marketplace, so enrollment runs on HealthCare.gov. Open enrollment started November 1, 2026 and ends January 15, 2027. To have coverage on January 1, you need to enroll by December 15 and pay your first premium. If you enroll between December 16 and January 15, coverage starts February 1.
Three things are different for 2027:
- The enhanced subsidies expired. The larger premium tax credits that ran from 2021 through 2025 ended December 31, 2025. For 2027, help is limited to households between 100% and 400% of the federal poverty level. Congress has debated restoring them, but as of this writing no extension has become law.
- The out-of-pocket maximum went up. The most a Marketplace plan can make you pay in 2027 is $12,000 for an individual and $24,000 for a family, up from $10,600 and $21,200.
- Utah's carrier lineup changed. Five insurers offer Marketplace plans in Utah for 2027, down from six. Statewide rates rose about 6.7% on average before subsidies, which is lower than most states, but individual plans moved more than that in both directions.
Start With Total Cost, Not the Premium
The premium is the number everyone sorts by, and it is the least useful one on its own. A plan's real cost is the premium plus what you pay when you actually use it. Three numbers tell you that:
- Deductible: What you pay before the plan starts sharing costs. Many plans cover primary care and generic drugs with a copay before the deductible, so check what is exempt.
- Coinsurance and copays: Your share after the deductible is met.
- Out-of-pocket maximum: The ceiling on what you pay for covered in-network care in a year. This is your worst-case number.
Metal tiers are a shortcut for this. Bronze plans cover roughly 60% of the average person's costs, Silver about 70%, Gold about 80%, and Platinum about 90%. The lower the tier, the lower the premium and the higher the deductible. A useful exercise is to add up twelve months of premium plus the deductible for each plan, then compare that figure against a bad year where you hit the out-of-pocket max. If you rarely see a doctor, Bronze often wins. If you have a chronic condition, take a daily medication, or are planning surgery or a baby, Gold frequently costs less over the year.
One quirk worth knowing: because of how subsidies are calculated, a Gold plan sometimes costs about the same as a Silver plan in a given county. Do not assume the tier order. Compare the actual quotes.
Check the Network Before Anything Else
Utah's individual market runs on narrow networks. Every carrier builds its plans around specific hospital systems and physician groups, and a plan that looks cheap can be a bad fit if your doctor, your kids' pediatrician, or the hospital you would actually drive to is out of network.
Do not rely on the plan name. Look up each doctor and facility in the carrier's 2027 provider directory for that specific plan, or call the office and ask which 2027 Marketplace plans they accept. Most Marketplace plans are HMOs or EPOs with no out-of-network coverage at all except emergencies, so a wrong guess here is expensive.
Prescriptions and the Fine Print
If anyone in your household takes a regular medication, pull up each plan's drug list, called the formulary. Confirm the drug is covered, which tier it sits on, and whether it needs prior authorization or a cheaper alternative first. A brand-name drug on a specialty tier can cost more per month than the difference in premium between two plans.
While you are in the plan documents, check whether you need a referral to see a specialist, how telehealth is covered, and whether the plan is HSA-eligible. Under a 2025 federal law change, Marketplace Bronze and Catastrophic plans count as HSA-eligible, and the 2027 contribution limits are $4,500 for an individual and $9,000 for a family. Catastrophic plans are generally only available to people under 30 or those with a hardship exemption.
Get the Subsidy Math Right
The premium tax credit is based on your estimated 2027 household income and the cost of the second-lowest Silver plan in your area. For 2027, your expected contribution toward that benchmark plan runs from about 2.15% of income at the low end to 10.22% near 400% of the poverty level. Above 400%, the credit drops to zero. For a single person that line is $63,840, and for a family of four it is $132,000.
That cliff is the single biggest trap this year. Earning a few hundred dollars over the line can mean losing thousands in credits, and if you underestimate your income, you may owe some of the credit back at tax time. If you are self-employed or your income varies, estimate carefully and update HealthCare.gov during the year if things change. Contributions to a traditional IRA, HSA, or retirement plan lower the income that counts, which can keep you under the line.
If your income is under 250% of the poverty level, there is a second benefit most people miss: cost-sharing reductions that lower your deductible and out-of-pocket max, but only if you pick a Silver plan. At that income, Silver is almost always the right tier even when Bronze looks cheaper.
Do Not Let It Auto-Renew
If you do nothing, HealthCare.gov will renew you into your current plan or, if that plan was discontinued, into one it picks for you. With carriers leaving, networks shifting, and subsidies recalculated, that is a poor bet in 2027. Set aside an hour, run the numbers, and make an active choice before December 15.
Working with a licensed agent costs you nothing extra. Marketplace premiums are the same whether you enroll on your own or through us, and we can run every carrier side by side, verify your doctors and prescriptions, and make sure your income estimate puts you on the right side of the cliff. If you would like a second set of eyes before the deadline, we are happy to help.