If you buy your own health insurance, Open Enrollment is your annual opportunity to review your coverage and choose a health plan for the coming year.
Whether you’re self-employed, an early retiree, work for an employer that doesn’t offer health insurance, or simply purchase coverage on your own, there are several things worth reviewing before choosing your 2027 health plan.
For Tennessee residents using the federal Health Insurance Marketplace, Open Enrollment begins:
November 1, 2026
And you’ll actually have two important deadlines to remember.
December 15, 2026
Enroll in or change your Marketplace plan by December 15 for your new coverage to begin January 1, 2027.
January 15, 2027
This is the final day of Marketplace Open Enrollment. If you enroll in or change plans December 16 through January 15, your new coverage generally begins February 1, 2027.
So while you technically have until January 15 to enroll, December 15 is an especially important date if you want your selected coverage in place on January 1.
After January 15, you generally need to qualify for a Special Enrollment Period to enroll in or change Marketplace coverage.
Who Should Pay Attention to Marketplace Open Enrollment?
Marketplace health insurance isn’t only for one particular type of person.
We help Tennessee individuals and families who need to purchase their own health insurance for all kinds of reasons.
You may be:
- Self-employed
- A small-business owner
- An independent contractor
- An early retiree who isn’t eligible for Medicare yet
- Working for an employer that doesn’t offer health insurance
- A family looking for individual health insurance
- Losing other health coverage
- Currently enrolled in a Marketplace plan and reviewing 2027 options
If you don’t have access to appropriate coverage through an employer or government program, the Health Insurance Marketplace may be one place to look for comprehensive individual or family health insurance.
Marketplace eligibility depends on several factors, including residency and immigration status, and people enrolled in Medicare cannot also enroll in a Marketplace health or dental plan.
Already Have Marketplace Coverage? Don’t Assume 2027 Will Look the Same
This is especially important for people who already have an ACA Marketplace plan.
You may love the coverage you have now.
That doesn’t mean you should automatically renew it without reviewing 2027.
Your:
Premium could change.
Tax credit could change.
Deductible could change.
Doctor network could change.
Prescription coverage could change.
Other plans available to you could change.
And perhaps most importantly, your own household or income may have changed.
The Marketplace recommends updating your expected income and household information and comparing the coverage available to you rather than assuming your current plan remains your best option.
Marketplace Subsidies Are Based on Your Expected 2027 Household Income
This is one of the most important—and sometimes confusing—parts of Marketplace coverage.
If you’re eligible for a Premium Tax Credit, that credit can reduce the amount you pay each month for your health insurance.
But the Marketplace doesn’t simply look at what you earned last year.
Savings are generally based on your expected household income for the year you’re receiving coverage. For 2027 coverage, that means estimating your expected 2027 household income.
That’s particularly important for:
- Self-employed people
- Business owners
- Commission-based workers
- People retiring during the year
- Households with variable income
- People whose work situation is changing
If your income isn’t predictable, don’t panic.
You’re generally making a good-faith estimate based on what you reasonably expect to earn.
And if your income changes during the year, you should update your Marketplace application so your estimated financial assistance can be adjusted.
2027 Marketplace Subsidies May Look Different
This deserves special attention this year.
From 2021 through 2025, federal law temporarily expanded eligibility for the Premium Tax Credit beyond the traditional income limit.
That temporary expansion ended after 2025.
Under current IRS guidance, households generally need income between 100% and 400% of the federal poverty level to qualify for the Premium Tax Credit, along with meeting the other eligibility requirements.
That means some households—particularly those with incomes above the applicable limit—may see a significant difference compared with the Marketplace assistance they received in earlier years.
Don’t assume your 2027 premium will be the same as 2026.
Your exact cost depends on your household, income, age, location, available plans and eligibility for financial assistance.
This is one reason we think a fresh review is particularly important for 2027.
Don’t Look Only at the Monthly Premium
This is probably the biggest mistake we see when people shop for health insurance.
They line up the plans and immediately ask:
“Which one has the lowest monthly premium?”
That’s certainly an important number.
But it’s only one number.
A health insurance plan with a lower monthly premium may have:
- A higher deductible
- Higher doctor copays
- Higher prescription costs
- Different coinsurance
- A higher out-of-pocket maximum
- A different provider network
Sometimes paying a little more each month gives a family coverage that better matches how they actually use healthcare.
Other times, the lower-premium option makes perfect sense.
The goal isn’t necessarily to find the cheapest premium.
It’s to find a balance between premium, benefits, network and potential healthcare costs that makes sense for your situation.
Check Your Doctors Before Choosing a 2027 Plan
If keeping a particular doctor is important to you, don’t assume every Marketplace plan works with that provider.
Provider networks can vary among insurance companies—and sometimes among different plans offered by the same company.
Before enrolling, make a list of the healthcare providers that matter to your household.
That may include:
Primary care doctors
Pediatricians
OB/GYNs
Specialists
Therapists or mental health providers
Preferred hospitals
Other facilities you regularly use
For a family of five, for example, the healthcare needs of five people need to fit the coverage—not just the person filling out the application.
That’s why we prefer starting with the family and then looking at plans.
Review Your Prescriptions Too
Don’t forget medications.
If you or someone in your family takes regular prescriptions, check how those medications are covered under the plans you’re considering.
Pay attention to:
- Whether the drug is on the formulary
- Drug tier
- Copay or coinsurance
- Deductible requirements
- Prior authorization
- Quantity limits
- Preferred pharmacies
A health plan that looks inexpensive until you add an important medication may not be as attractive as it first appeared.
Bronze, Silver or Gold: Which Marketplace Plan Is Better?
Marketplace plans are commonly grouped into metal categories such as Bronze, Silver and Gold.
The metal level doesn’t tell you the quality of the doctors or healthcare you’ll receive.
Instead, the categories generally reflect how the plan and member split healthcare costs.
That means Gold isn’t automatically “better” than Bronze, and Bronze isn’t automatically the smartest choice because it may have a lower premium.
The right balance depends on how you expect to use your coverage.
Someone who rarely uses healthcare may evaluate the tradeoffs differently from a family with regular specialist visits and prescriptions.
And there is another important wrinkle with Silver plans: eligible Marketplace consumers may qualify for cost-sharing reductions, which can lower deductibles, copayments and other out-of-pocket costs—but those additional savings are generally available only when enrolled in a Silver plan.
That can make Silver worth a closer look for households that qualify.
Self-Employed? Your Income Estimate Deserves Extra Attention
If you work for yourself, Marketplace applications can be a little more complicated.
Your income may not arrive in a neat, identical paycheck every two weeks.
One month is fantastic.
The next month isn’t.
You may also have legitimate business expenses that affect your taxable income.
Marketplace savings are based on household income using Modified Adjusted Gross Income (MAGI) rules.
For self-employed consumers, accurately estimating income can therefore be an important part of the application process.
And if you’re unsure how a particular business or tax situation affects your MAGI, that’s an excellent question for your tax professional.
We’re insurance agents—not your CPA—and we like keeping everybody in their proper lane. 😉
What Happens If You Estimate Your Income Wrong?
This is important.
Premium Tax Credits can be paid in advance to your insurance company to reduce what you pay each month.
Later, those advance credits are reconciled when you file your federal income tax return.
If the income or household information used to calculate your advance credit turns out to be different from your actual circumstances, your final tax credit can be different too.
And beginning with the 2026 tax year, the previous repayment caps on excess advance Premium Tax Credits no longer apply in the same way they did for earlier years. Current IRS guidance warns that excess advance credits can result in repayment when you file.
That’s another reason to:
Estimate carefully and update your Marketplace application when your circumstances change.
Should You Automatically Renew Your Current Marketplace Plan?
We wouldn’t recommend assuming that’s the best choice.
Your current coverage may still be excellent.
But Open Enrollment gives you an opportunity to compare.
Ask:
Did my premium change?
Did my subsidy change?
Did my deductible change?
Are my doctors still in network?
Are my prescriptions still covered appropriately?
Have my family’s healthcare needs changed?
Are there other 2027 options worth considering?
If everything still works well, keeping your plan may make perfect sense.
Just make that decision after reviewing it, rather than by accident.
What Should You Have Ready Before Shopping for 2027 Coverage?
You don’t need to spend an afternoon assembling a filing cabinet. 😄
Start with:
Household information
Know who will be included on your tax household and who needs health coverage.
Expected 2027 income
Have a reasonable estimate of household income for the year.
Doctor list
Include providers that are particularly important to each person needing coverage.
Prescription list
Include medication names, dosages and frequency.
Current health insurance information
If you already have coverage, have your current plan information available.
Questions
Think about what you liked—and didn’t like—about your 2026 coverage.
That’s enough to have a productive conversation.
Can a Health Insurance Agent Help With Marketplace Coverage?
Yes.
HealthCare.gov specifically recognizes licensed agents and brokers as one way consumers can receive help applying for and enrolling in Marketplace coverage. Agents and brokers are generally compensated by the insurance companies whose plans they sell.
An experienced health insurance agent can help you:
- Complete or update your Marketplace application
- Understand your eligibility results
- Compare the insurance options they represent
- Review provider networks
- Review prescriptions
- Compare premiums and out-of-pocket costs
- Understand plan differences
- Complete enrollment
And importantly, you have someone to call later when you have an insurance question.
Marketplace Health Insurance Help From Acuity Health Advisors
Acuity Health Advisors is a locally owned, independent health insurance agency based in Murfreesboro, Tennessee, serving individuals and families throughout Middle Tennessee.
We’re not only a Medicare agency.
We also help individuals and families who need their own health insurance navigate Marketplace coverage.
That includes:
Self-employed individuals
Small-business owners
Families
Independent contractors
Early retirees
People without employer-sponsored health insurance
Current Marketplace members reviewing their coverage
As an independent agency, we work with multiple insurance companies and can help you compare the health insurance options we represent.
And our help doesn’t disappear after you enroll.
Need Health Insurance for 2027?
Marketplace Open Enrollment in Tennessee runs from:
November 1, 2026 – January 15, 2027
Remember: Enroll or make your plan change by December 15 for coverage beginning January 1. Enroll or make changes from December 16 through January 15, and your selected coverage generally begins February 1.
If you need individual or family health insurance—or already have Marketplace coverage and want to review your options for 2027—give Acuity Health Advisors a call.
📞 Call Acuity Health Advisors at 615-919-1009
We’ll help you review your coverage, expected income, doctors, prescriptions and the health insurance options we represent.
There is no additional cost to you for our help.