Your main coverage options
| Situation | Usual coverage | When you can enroll |
|---|---|---|
| Working, employer offers a plan | Employer group plan | Employer's annual enrollment or after a qualifying life event |
| Self-employed or no job-based coverage | ACA Marketplace plan (subsidies based on income) | Nov 1, 2026–Jan 15, 2027 in most states for 2027 coverage |
| Age 65+ or certain disabilities | Medicare (Original or Medicare Advantage) plus drug coverage | Initial 7-month window; then Oct 15–Dec 7 each year |
| Need dental, vision or cash benefits | Standalone dental, vision or supplemental policies | Varies by insurer |
Source: healthinsurance.org open enrollment guide (Oct 2026); Medicare.gov. Some states set different Marketplace deadlines.
Marketplace coverage after the subsidy change
The enhanced premium tax credits that capped benchmark premiums for higher earners expired at the end of 2025. For 2026, subsidies stop above 400% of the federal poverty level: $62,600 for a single person or $128,600 for a family of four. Below that, you pay a set share of income for the benchmark silver plan. For 2027, that share ranges from 2.15% to 10.22% of household income. If you buy your own coverage, update your income estimate at open enrollment and compare plans rather than letting your plan auto-renew.
A high-deductible plan can pair with a health savings account. For 2026 you can contribute up to $4,400 for self-only coverage or $8,750 for a family. Our health insurance costs guide covers premiums, deductibles and out-of-pocket maximums.
Medicare at 65
In 2026, the standard Part B premium is $202.90 a month with a $283 deductible, then usually 20% coinsurance. Original Medicare has no yearly out-of-pocket cap unless you add supplemental coverage. That leads to the main choice:
- Original Medicare plus a Medigap policy and Part D drug plan. You can see any provider that takes Medicare. Your best chance to buy Medigap without medical underwriting is the six-month window that starts when you are 65 or older and enrolled in Part B.
- Medicare Advantage. Private plans that cap in-network out-of-pocket costs (no more than $9,250 in 2026; $5,421 on average) and often add dental and vision benefits, but use networks and prior authorization. In 2026, 55% of eligible people were enrolled.
Part D drug costs are capped at $2,100 out of pocket in 2026. Compare plans every fall during open enrollment, October 15 to December 7. See our Medicare plans guide.
Dental, vision and supplemental coverage
Original Medicare does not cover routine dental care or routine eye exams and glasses, and ACA plans are not required to include adult dental. Individual dental plans averaged $49.60 a month in 2026 data. They typically pay 100% for preventive care, about 80% for basic work like fillings and 50% for major work like crowns, with annual maximums often $1,000–$2,000 and waiting periods for major care. Our dental insurance guide shows how to work out whether a plan pays off.
Supplemental policies such as accident, critical illness and hospital indemnity pay fixed cash amounts. They must disclose that they are not a substitute for comprehensive major medical insurance.
Common mistakes
- Choosing by premium alone. Compare deductibles, out-of-pocket maximums, drug coverage and whether your doctors are in network.
- Missing enrollment windows. Outside open enrollment, you generally need a qualifying life event to sign up or switch.
- Skipping Medigap at 65 and wanting it later. After your Medigap open enrollment period, insurers in most cases can use medical underwriting.
- Treating supplemental or discount plans as health insurance. They pay limited, fixed amounts.
Free help
For Medicare, every state has a State Health Insurance Assistance Program offering free, unbiased counseling (1-877-839-2675). For Marketplace plans, HealthCare.gov or your state's own exchange is where you compare plans and apply for premium subsidies. You can also call 1-800-MEDICARE with Medicare questions or to report suspected marketing violations.
Guides in this section
Frequently asked questions
When is open enrollment for 2027 health coverage?
For Marketplace plans, open enrollment runs from November 1, 2026, to January 15, 2027, in most states. Some states differ: Idaho ends December 15, and New York, Pennsylvania, Illinois and D.C. run to January 31, 2027. Medicare's annual open enrollment is October 15 to December 7.
Can I still get help paying Marketplace premiums?
Yes, if your household income is at or below 400% of the federal poverty level, which was $62,600 for one person and $128,600 for a family of four in 2026. The enhanced subsidies that extended help above that level expired at the end of 2025.
What does Medicare cost in 2026?
Most people pay no Part A premium. Part B's standard premium is $202.90 a month with a $283 deductible, then usually 20% coinsurance. The Part A hospital deductible is $1,736 per benefit period. Part D drug costs are capped at $2,100 out of pocket for the year.
Does Medicare cover dental and vision?
Original Medicare does not cover routine dental care, such as cleanings and fillings, or routine eye exams and glasses. Many Medicare Advantage plans include some dental and vision benefits, or you can buy standalone dental and vision plans.
Is supplemental insurance a replacement for health insurance?
No. Accident, critical illness and hospital indemnity policies pay fixed cash amounts and must disclose that they are not a substitute for comprehensive major medical insurance. They can help with deductibles or lost income alongside a regular health plan.
Sources
- Medicare.gov – Medicare costs
- Medicare.gov – Joining a health or drug plan
- Medicare.gov – Medigap guaranteed issue rights
- Medicare.gov – Dental services
- KFF – Medicare Advantage in 2026
- KFF – Medicare Advantage fact sheet
- Holland & Knight – CMS finalizes CY2027 MA and Part D rule
- healthinsurance.org – Will you receive an ACA premium subsidy?
- healthinsurance.org – Open enrollment
- IFEBP – IRS releases 2026 HSA and HDHP amounts
- Becker's Dental Review – Average dental insurance premiums by state
- NCOA – State Health Insurance Assistance Program
Rates, fees and terms change often. Figures were checked in October 2026; confirm current details with the provider before you apply.