ACA Open Enrollment 2027: Your Complete Guide to Renewing, Comparing, and Choosing Health Insurance in Maine and New Hampshire
Health insurance costs are changing, some plans are disappearing, and the coverage you have today might look very different in January. Here's what you need to know before making your decision.
Every fall, millions of Americans face the same question: Should I keep my current health insurance or look for something better?
For some, the decision is relatively simple. For others, it's a maze of monthly premiums, deductibles, prescription coverage, provider networks, and financial assistance.
And for 2027, there are some particularly important changes to understand.
Health insurance premiums are increasing, certain insurance companies are leaving Marketplace programs, and changes to federal premium tax credits are affecting what many households pay for coverage.
Whether you're renewing an existing policy, purchasing insurance for the first time, self-employed, or transitioning away from employer-sponsored coverage, taking time to review your options could make a significant difference in your healthcare expenses.
At Northwoods Insurance Solutions, we believe understanding your coverage shouldn't require a dictionary and a calculator just to get started.
Let's break down what matters, what's changing, and how to prepare for the year ahead.
First, What Is ACA Open Enrollment?
The Affordable Care Act (ACA) established Health Insurance Marketplaces where eligible individuals and families can shop for comprehensive health coverage.
These plans cover essential health benefits, including preventive care, emergency services, hospitalizations, prescription medications, maternity care, mental health services, and more.
ACA-compliant Marketplace plans also provide important consumer protections.
For example, insurance companies cannot deny you coverage or charge you more because you have diabetes, a history of cancer, heart disease, or another pre-existing medical condition.
Open Enrollment is the annual opportunity to sign up for a new Marketplace plan, change your existing coverage, or renew for the coming year.
In Maine, residents use CoverME.gov.
In New Hampshire, residents use HealthCare.gov.
Both marketplaces allow eligible applicants to compare insurance plans, review costs, and determine whether financial assistance is available.
Important 2027 ACA Open Enrollment Dates
If you want health insurance for 2027, these deadlines deserve a spot on your calendar.
November 1, 2026: Open Enrollment Begins
You can start a new application, update your existing information, compare available plans, or renew your coverage.
December 15, 2026: Deadline for January 1 Coverage
This is the most important date for individuals who want their coverage to begin January 1, 2027.
If you are changing plans, this deadline helps ensure your new coverage is scheduled to begin at the start of the year.
January 1, 2027: New Coverage Begins
Coverage generally takes effect for people who enrolled by December 15 and paid their first premium according to their insurer's instructions.
January 15, 2027: Open Enrollment Ends
This is the last day of the regular enrollment period.
Plans selected from December 16 through January 15 generally begin February 1, 2027.
After Open Enrollment ends, most people need a qualifying life event to enroll in or change Marketplace coverage.
Our advice? Don't wait until the last few days. Reviewing your options early gives you more time to check doctors, medications, and costs before making a decision.
Why Is Health Insurance Getting More Expensive in 2027?
If you've received a renewal notice showing a higher premium, you're certainly not alone.
Health insurance companies consider several factors when setting their rates, including rising healthcare costs, increased use of medical services, prescription drug expenses, and payments negotiated with healthcare providers.
In Maine, the Bureau of Insurance approved an average 14.8% premium rate increase for individual-market policies in 2027.
That's an average across the market, not necessarily the amount your individual premium will increase.
Your actual monthly cost depends on factors such as your age, location, insurance company, selected plan, household size, and any financial assistance available to you.
For example, two individuals living in different Maine counties may see different plan options and monthly premiums.
Your costs can also change even when you haven't switched insurance companies.
One important distinction: A premium increase and an increase in what you personally pay are not always the same thing.
If you qualify for premium tax credits, your monthly payment may be partially offset by federal financial assistance.
However, the amount of that assistance may also change.
That's why it's important to compare your actual 2027 premium after any eligible savings instead of relying solely on the percentage increase shown in a notice.
What's Happening With ACA Subsidies in 2027?
This is one of the most important topics for anyone purchasing health insurance through the Marketplace.
Premium tax credits are federal financial assistance designed to make health insurance more affordable for eligible households.
If you qualify, you may be able to apply your tax credit toward your monthly premium, reducing the amount you pay out of pocket each month.
However, there is an important change affecting eligibility and affordability.
Enhanced Federal Premium Tax Credits Have Expired
The federal government temporarily expanded ACA premium tax credits beginning in 2021, allowing more households to qualify for assistance and increasing savings for many people.
Those enhanced credits expired at the end of 2025.
The original ACA premium tax credits remain available in 2027, but the expanded assistance is no longer in effect.
Under the rules currently in place, premium tax credits generally apply to qualifying households with incomes between 100% and 400% of the federal poverty level, subject to other eligibility requirements and certain exceptions.
Households earning more than 400% of the federal poverty level are generally no longer eligible for these credits.
For some individuals and families, particularly those who previously qualified for enhanced financial assistance, this can mean paying considerably more for health insurance.
In Maine, CoverME.gov reported that members experienced average monthly premium increases of nearly $180 following the expiration of enhanced credits in 2026.
That does not mean everyone's premium increased by $180 or that another increase of that amount will happen in 2027. It illustrates how changes in financial assistance can affect household budgets.
The important takeaway: Don't assume you no longer qualify for assistance, and don't assume you'll receive the same amount as last year.
Your eligibility should be reviewed using your estimated 2027 household income and current Marketplace rules.
What If Your Income Changes During the Year?
Marketplace financial assistance is based partly on your estimated annual household income.
If you expect to earn more or less in 2027, updating your application is essential.
This is particularly important for self-employed individuals, seasonal workers, freelancers, and households with variable income.
If you receive more advance premium tax credits than you ultimately qualify for, you may have to repay the difference when filing your federal income taxes.
Beginning with tax year 2026, federal rules also eliminated the previous repayment limits for excess advance premium tax credits.
That makes keeping your income estimate accurate especially important.
If your employment changes, you receive a raise, your business income increases, or someone joins or leaves your tax household, report those changes to the Marketplace promptly.
An insurance professional can help you understand how your estimated income affects available plan options. A qualified tax professional can assist with specific tax consequences.
Major Health Insurance Changes for Maine Residents in 2027
Maine's individual health insurance market is experiencing several significant changes this enrollment season.
If you currently have coverage through CoverME.gov, it's worth understanding whether any of them affect you.
Mending Health Is Leaving Maine's Marketplace
Mending Health, formerly known as Taro Health, will no longer offer individual health insurance through CoverME.gov for 2027.
If you currently have a Mending Health plan, your 2026 coverage remains in effect through December 31, 2026.
For members with automatic re-enrollment, CoverME.gov is matching their coverage with another available plan.
However, an automatically selected replacement is not necessarily identical to the coverage you previously had.
Your new plan could have a different monthly premium, deductible, provider network, or prescription drug coverage.
If you use Direct Primary Care services, pay especially close attention. Not every replacement plan includes the same arrangements.
If you currently have Mending Health, review your replacement plan before December 15 rather than assuming the automatic selection is your best option.
Anthem PPO Plans Are No Longer Available Through CoverME.gov
Another important change affects Anthem members.
Anthem is no longer offering its individual PPO plans through Maine's Marketplace for 2027.
Current Marketplace PPO members are being moved to Anthem HMO plans as part of the renewal process.
What's the difference?
A PPO, or Preferred Provider Organization, generally offers greater flexibility to receive care from providers both inside and outside the plan's network, although out-of-network care typically costs more.
An HMO, or Health Maintenance Organization, generally limits coverage to in-network providers except for emergencies and certain other situations. Some HMO plans also require referrals for specialist appointments.
For someone who regularly sees specialists, receives treatment outside their local area, or travels for medical appointments, that distinction can matter.
Anthem may still offer PPO options outside Maine's Marketplace, but financial assistance available through CoverME.gov cannot be applied to an off-Marketplace plan.
Before accepting a replacement policy, confirm that the doctors, specialists, and hospitals you use participate in the new network.
Maine's Clear Choice Plans Offer Expanded Benefits
There's also some positive news for consumers.
For 2027, Maine's Clear Choice plans include expanded coverage for several everyday healthcare services before the deductible is met.
Depending on the plan, this may include primary care, behavioral health services, urgent care, generic prescriptions, chiropractic services, and physical, occupational, or speech therapy.
Most Clear Choice plans also cover specialist visits before the deductible.
Silver, Gold, and Platinum Clear Choice plans provide prescription drug coverage before the deductible is met, subject to the individual plan's cost-sharing requirements.
These benefits can be particularly valuable for individuals who regularly visit doctors or need ongoing medications.
A plan with a slightly higher monthly premium may offer better overall value if it reduces what you spend receiving routine medical care.
Important Changes for New Hampshire Residents
New Hampshire residents also need to pay close attention during the 2027 enrollment period.
One significant change is that Ambetter from NH Healthy Families is leaving New Hampshire's ACA Marketplace after December 31, 2026.
Anyone currently enrolled in an affected Ambetter Marketplace plan should carefully review their renewal notices and choose replacement coverage.
For 2027, New Hampshire's Marketplace includes plans offered by Anthem, WellSense, and Harvard Pilgrim Health Care.
Available options, premiums, and provider networks vary by location.
If you're transitioning to a different insurance company, confirm that your preferred physicians, hospitals, and prescriptions are covered under the replacement plan.
This is particularly important when transitioning between insurance networks, even if both companies offer similar deductibles or monthly premiums.
New Hampshire residents should use HealthCare.gov to review available plans and determine eligibility for financial assistance.
Renewing Your Current Health Insurance? Review These Details First.
Automatic renewal can be convenient, but convenience shouldn't replace an informed decision.
Even if your coverage renews automatically, your benefits and costs may change.
Before accepting your 2027 renewal, make sure you understand the following.
Your Monthly Premium
How much will your coverage cost each month after any financial assistance?
Compare your current monthly payment with the 2027 renewal amount.
Then compare the renewal with other plans available in your area.
Your Deductible
Your deductible is the amount you generally pay for certain covered medical services before your insurance starts sharing those costs.
Not all services are subject to the deductible, so review the details carefully.
A plan with a lower monthly premium may have a substantially higher deductible.
For someone who needs frequent care, that can make a difference.
Your Out-of-Pocket Maximum
Your out-of-pocket maximum is the most you generally pay for covered, in-network medical services during a plan year through applicable deductibles, copayments, and coinsurance.
Once you reach that limit, the plan pays 100% of covered in-network benefits for the remainder of the plan year.
For 2027, the federal maximum for Marketplace plans is $12,000 for individual coverage and $24,000 for family coverage. Individual plans may have lower limits.
Keep in mind that monthly premiums, noncovered services, and most out-of-network costs do not count toward this maximum.
Your Provider Network
Are your current doctors, specialists, hospitals, and preferred medical facilities still in-network?
Don't assume that because a healthcare provider accepts a particular insurance company, they participate in every plan offered by that company.
Check the specific plan network.
This is especially important in rural areas of Maine and New Hampshire, where provider access and travel distances may influence which plan is most practical.
Your Prescription Coverage
If you take regular medications, review the plan's prescription drug formulary.
A formulary is the list of medications a health plan covers.
Check whether your prescriptions are included, whether prior authorization is required, what your copayments may be, and whether your preferred pharmacy is in-network.
If you take expensive brand-name or specialty medications, differences between formularies can be particularly significant.
Your Expected Medical Needs
Think about the year ahead.
Are you planning a surgery? Managing an ongoing medical condition? Expecting a baby? Starting a new medication? Receiving regular physical therapy or specialist treatment?
Your expected healthcare needs should be part of your insurance decision.
The best plan on paper isn't necessarily the best plan for your actual life.
Bronze, Silver, Gold: Which Health Insurance Plan Is Best?
Marketplace health insurance plans are generally divided into categories known as metal levels.
These levels describe how costs are shared between you and your insurer. They do not represent the quality of doctors or healthcare services.
Bronze Plans: Lower Premiums, Higher Costs When You Need Care
Bronze plans generally have lower monthly premiums but higher deductibles and out-of-pocket costs.
They may appeal to individuals who use relatively little medical care and want to keep their monthly premiums lower.
However, it's important to consider whether you could comfortably manage a substantial medical expense if you became seriously ill or injured.
Silver Plans: A Balance Between Premiums and Out-of-Pocket Costs
Silver plans generally offer a middle ground between monthly premiums and healthcare expenses.
They are also especially important for individuals who qualify for cost-sharing reductions.
These additional savings can lower deductibles, copayments, coinsurance, and out-of-pocket maximums.
But there's a catch: For most people eligible for income-based cost-sharing reductions, these savings are available only when choosing a Silver Marketplace plan.
If you qualify, a Silver plan may provide considerably better value than a lower-premium Bronze plan.
Gold Plans: Higher Premiums, Lower Costs for Medical Care
Gold plans generally have higher monthly premiums but lower costs when you receive covered medical services.
For people who regularly visit specialists, manage chronic conditions, or expect significant healthcare needs, Gold coverage may be worth comparing.
Rather than selecting a plan based on the lowest premium, consider the total financial picture.
Catastrophic Plans: Limited Eligibility and High Deductibles
Catastrophic health insurance plans are designed primarily to protect against significant medical expenses.
They generally have lower premiums and very high deductibles.
For 2027, eligibility generally requires being under age 30 or qualifying for an approved hardship or affordability exemption.
Catastrophic plans are not available in every area, and premium tax credits cannot be applied to them.
If you qualify for premium tax credits or cost-sharing reductions, another Marketplace plan may provide better value.
A New Opportunity: Health Savings Accounts and Bronze Plans
Another feature worth exploring is the ability to pair qualifying health insurance with a Health Savings Account, or HSA.
All Bronze and Catastrophic Marketplace plans are now HSA-compatible, and certain other plans may also qualify.
An HSA allows eligible individuals to set aside money with tax advantages for qualified medical expenses.
These funds may be used for expenses such as deductibles, copayments, and certain prescription, dental, and vision costs.
Unlike some other healthcare spending accounts, HSA funds generally roll over from year to year instead of expiring at the end of the calendar year.
For 2027, the annual HSA contribution limits are $4,500 for self-only coverage and $9,000 for family coverage, with additional catch-up contributions potentially available for eligible individuals age 55 or older.
HSA contribution eligibility has additional requirements, so qualifying health coverage alone does not guarantee that everyone can contribute.
An HSA may be worth exploring for someone who wants to prepare for future healthcare expenses while taking advantage of available tax benefits.
How to Compare Plans Without Choosing Based on Price Alone
One of the biggest mistakes people make when shopping for health insurance is focusing exclusively on the monthly premium.
A lower monthly payment can be appealing, but it doesn't always mean the plan will cost less over the course of a year.
Consider this hypothetical example.
Plan A has a monthly premium of $300, a higher deductible, and higher copayments for certain services.
Plan B has a monthly premium of $375 but lower deductibles and copayments.
Plan B costs an additional $75 per month, or $900 over the year.
If you rarely visit the doctor, Plan A may be more economical.
But if you receive frequent medical treatment and Plan B reduces your annual out-of-pocket expenses by more than $900, the higher-premium plan could save you money overall.
These numbers are simply an illustration, not actual plan quotes.
The key is to compare your estimated total annual cost, including premiums and expected costs for covered medical services.
Also consider the worst-case scenario.
How much could you reasonably afford to pay if you experienced a major illness or injury?
That's an important question when comparing out-of-pocket maximums.
Self-Employed or Running a Small Business? ACA Coverage May Be an Option.
If you own a small business, work independently, freelance, or operate as a contractor, you may not have access to employer-sponsored health insurance.
That doesn't mean your only choice is to go without coverage.
Eligible self-employed individuals can purchase ACA-compliant health insurance through the Marketplace.
Your eligibility for financial assistance is generally based on your projected annual household income, not simply your gross business revenue.
For self-employed individuals, properly estimating your income can be more complicated because business expenses and changing profits affect the calculation.
Suppose your business had a particularly strong year in 2026, but you expect lower income in 2027.
Using last year's income without considering your current circumstances may produce an inaccurate estimate of your eligibility for financial assistance.
Likewise, underestimating income could result in repayment of excess advance premium tax credits.
Taking time to develop a realistic income estimate is an important part of selecting coverage.
And if you're a small employer considering healthcare benefits for employees, your options may be different from those available to someone buying individual coverage.
A review of your business structure, number of employees, and coverage goals can help identify what options are worth exploring.
What If Your Employer Offers Health Insurance?
Having access to employer-sponsored health insurance can affect your eligibility for Marketplace financial assistance.
If your employer offers a health plan that meets federal affordability and minimum value standards, you generally won't qualify for premium tax credits for yourself, even if you choose to buy Marketplace coverage instead.
For 2027, the federal affordability percentage is 10.22% of household income for the applicable employer coverage test.
However, household members may have different eligibility depending on the cost of available family coverage.
For example, coverage offered through one spouse's employer may be affordable for the employee but not for the entire family.
In some circumstances, other household members may qualify for Marketplace financial assistance.
This is an area where reviewing the actual employer coverage offer is important before making assumptions about eligibility.
What If You Don't Have Health Insurance Right Now?
If you're currently uninsured, Open Enrollment is your opportunity to explore coverage for 2027.
You do not need to have held a previous policy to apply for Marketplace insurance.
You also do not need to wait until you're sick or facing a medical expense to recognize the importance of coverage.
Health insurance helps protect you financially from unexpected medical costs while making routine and preventive healthcare more accessible.
For individuals who have postponed getting coverage because of cost concerns, it's worth comparing current plan options and checking your eligibility for assistance.
You may discover options that are more manageable than you anticipated.
If your income is low, you may qualify for Medicaid coverage, known as MaineCare in Maine or Medicaid in New Hampshire, rather than a Marketplace plan.
Medicaid and Children's Health Insurance Program applications can generally be submitted throughout the year.
Eligibility depends on program rules and your household circumstances.
What You'll Need Before Applying for 2027 Coverage
Gathering some basic information before comparing plans can make enrollment much easier.
Household information: Have the names, dates of birth, and applicable identifying information for household members who will be included in your application.
Estimated 2027 household income: Include expected wages, self-employment income, and other income that must be reported under Marketplace rules.
Current insurance information: If you're renewing, have your existing plan details and renewal notice available.
Provider information: Write down the names of your preferred doctors, specialists, hospitals, and other healthcare providers.
Prescription information: Have the names and dosages of any medications you take regularly.
Employer coverage details: If you or a household member have access to insurance through work, gather information about the coverage and its cost.
With these details available, comparing your options becomes much more productive.
Five Common Health Insurance Enrollment Mistakes to Avoid
1. Assuming Your Current Plan Hasn't Changed
Even when your insurance company stays the same, the benefits, networks, and costs associated with your plan may change. Always review your renewal documents.
2. Choosing the Lowest Monthly Premium
A low premium may come with higher deductibles, copayments, or out-of-pocket exposure.
Compare what you could spend over the entire year, not just each month.
3. Forgetting to Check Doctors and Prescriptions
This can lead to unexpected costs or disruptions in care.
Verify your providers and medications under the specific plan you're considering.
4. Failing to Update Your Income
Outdated income estimates can affect your financial assistance and potentially result in repayment obligations when you file your taxes.
Update your Marketplace application whenever your household circumstances change.
5. Waiting Until the Deadline
Last-minute enrollment can leave little time to resolve application issues, review plan documents, or clarify coverage questions.
Starting early gives you more time to make an informed decision.
Frequently Asked Questions About ACA Open Enrollment for 2027
Do I Have to Renew My ACA Health Insurance Every Year?
Many Marketplace plans offer automatic re-enrollment, but you should still review your coverage annually.
Your premium, deductible, provider network, and financial assistance may have changed.
Even if your plan renews automatically, another available plan may better fit your needs.
Can I Change Insurance Companies During Open Enrollment?
Yes. During Open Enrollment, eligible Marketplace applicants can compare available insurance companies and select a different plan.
Before switching, confirm the new plan's coverage details and effective date.
Can I Get ACA Health Insurance If I Have a Pre-Existing Condition?
Yes. ACA-compliant Marketplace plans cannot deny you coverage or charge you a higher premium based on your pre-existing medical conditions.
This protection applies to conditions such as diabetes, heart disease, cancer, asthma, and other medical histories.
Is Preventive Care Covered Before I Meet My Deductible?
Most Marketplace plans cover certain recommended preventive services without cost-sharing when provided by an in-network healthcare professional and when applicable coverage requirements are met.
This may include certain screenings, immunizations, and preventive visits.
Other services performed during the same appointment may still involve charges, so review your plan's coverage rules.
Do ACA Plans Include Dental and Vision Insurance?
ACA-compliant Marketplace coverage includes certain pediatric dental and vision benefits.
Adult dental and vision coverage is not necessarily included in every medical plan.
Separate dental or vision insurance may be available, depending on your location and needs.
Can I Get Marketplace Insurance If I'm Close to Retirement?
Yes, eligible individuals who are not yet enrolled in Medicare may purchase Marketplace coverage, including people who retire before age 65.
However, Medicare eligibility and enrollment can affect your Marketplace coverage and financial assistance.
If you're approaching age 65, it's important to coordinate your health insurance decisions with Medicare enrollment requirements.
What If I Lose My Health Insurance After Open Enrollment Ends?
Certain qualifying life events may allow you to enroll during a Special Enrollment Period.
Examples can include losing qualifying employer-sponsored coverage, getting married, having a baby, or moving to a new coverage area.
Most qualifying events have specific eligibility rules and enrollment time limits.
If you've recently experienced a major life change, you may have more options than you realize.
Can I Work With a Local Insurance Broker Instead of Figuring Everything Out Myself?
Yes. A licensed insurance professional who assists with Marketplace coverage can help explain insurance terminology, compare available policies, and discuss important considerations such as provider networks, deductibles, and expected healthcare needs.
Working with someone who understands the local insurance landscape can be especially valuable when you're comparing unfamiliar plans or navigating a major coverage change.
Local Guidance Can Make a Complicated Decision Easier
Health insurance is personal.
What works for a healthy 25-year-old may not make sense for a family with young children, a self-employed business owner, or someone approaching retirement.
And the lowest advertised premium doesn't always translate into the lowest overall cost.
The right insurance decision starts with understanding your needs, available coverage, household budget, and expectations for the coming year.
At Northwoods Insurance Solutions, Crystal Labbe helps individuals and families throughout Maine and New Hampshire explore their insurance options with straightforward, personalized guidance.
Whether you're facing an unexpected premium increase, losing your current Marketplace plan, purchasing health insurance for the first time, or simply wondering whether better coverage is available, you don't have to sort through the details alone.
Crystal can help you compare options, understand insurance terminology, and identify important questions before choosing a policy.
Open Enrollment is already underway, and December 15 is the key deadline for January 1, 2027 coverage.
Take the opportunity to review your options before making a decision that affects your healthcare and finances for the coming year.
Northwoods Insurance Solutions
Crystal Labbe | Independent Insurance Broker
Serving Maine and New Hampshire
290 Main Street, Norway, Maine 04268
Call or Text: 207-413-9712
Website: northwoodsinsurance207.com
Office visits by appointment.
This article provides general educational information based on Marketplace guidance available as of November 5, 2026. Insurance availability, eligibility, premiums, benefits, and financial assistance vary by household and location. Confirm your specific options and current rules through the appropriate Marketplace, insurance carrier, or qualified professional.
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