Marketplace plan costs for 2027: premium, tax credit and out-of-pocket worksheet
For 2027, the IRS caps what you pay for a benchmark silver plan at 2.15% to 10.22% of household income if that income is between 100% and 400% of the poverty line. Above 400%, the rules checked here allow no premium tax credit. Your real yearly cost is that net premium plus your medical spending, which a 2027 plan can cap at no more than $12,000 for one person.
Open enrollment for 2027 begins November 1, 2026 on HealthCare.gov, and the site itself says the 2027 income levels and savings figures will be posted that day. You do not have to wait to understand the math, though. The parameters that drive it are already published: the IRS applicable percentage table for 2027, the HHS poverty guidelines that apply to 2027 coverage, and the federal out-of-pocket limit for 2027 plans. The worksheet below puts those together at stated incomes, using a hypothetical premium so the arithmetic is clear.
Two 2027 rule changes from Public Law 119-21 belong at the start of any estimate. From tax years beginning after December 31, 2026, section 71301 limits the premium tax credit, among lawfully present immigrants, to lawful permanent residents, Cuban and Haitian entrants, and people living in the United States under a Compact of Free Association; other lawfully present immigrants are no longer eligible for the credit. And under section 71305, an advance credit that turns out to be too large must be repaid in full. The premium figures below are invented for the arithmetic, and nothing here recommends a plan or metal level.
The two halves of a year of coverage
A Marketplace plan costs you money in two separate ways, and a fair comparison adds both.
- Fixed cost: twelve months of premium, minus any premium tax credit. You pay it whether or not you use care.
- Variable cost: what you pay when you use care: deductible, coinsurance and copays, up to the plan's out-of-pocket maximum. Our guide to the deductible and the out-of-pocket maximum works through that side in detail.
The rest of this guide is mostly about the fixed half, because that is where 2027's published tax credit rules apply, and then puts the two halves together.
How the 2027 premium tax credit is calculated
The credit is not a discount off whatever plan you pick. It is built from a reference plan and your income, in four steps set out in 26 CFR 1.36B-3.
- Find your income as a percentage of the poverty line. Divide expected 2027 household income by the poverty guideline for your household size.
- Find your applicable percentage from the 2027 IRS table below. Within each band it rises in a straight line, rounded to the nearest hundredth of a percent.
- Compute your required share of the benchmark plan: applicable percentage times household income, divided by 12 for a monthly figure.
- Subtract it from the benchmark premium. The benchmark is the second-lowest-cost silver plan offered to your household in your rating area. The credit for a month is that difference, but never more than the premium of the plan you actually enroll in.
The 2027 applicable percentage table
| Household income as % of poverty line | Applicable percentage, start of band | End of band |
|---|---|---|
| Less than 133% | 2.15% | 2.15% |
| 133% to under 150% | 3.23% | 4.30% |
| 150% to under 200% | 4.30% | 6.78% |
| 200% to under 250% | 6.78% | 8.66% |
| 250% to under 300% | 8.66% | 10.22% |
| 300% to 400% | 10.22% | 10.22% |
Source: IRS Revenue Procedure 2026-26, section 3.01, for taxable years beginning in 2027. For comparison, Revenue Procedure 2025-25 set the 2026 table at 2.10% in the lowest band and 9.96% at the top. Both checked October 22, 2026. The top band in both tables ends at 400% of the poverty line.
The poverty guideline that applies
26 CFR 1.36B-1(h) says the poverty line for the credit is the most recently published HHS guideline as of the first day of open enrollment for the coverage year. Open enrollment for 2027 starts November 1, 2026, so 2027 coverage uses the 2026 guidelines. For the 48 contiguous states and the District of Columbia, HHS lists them as $15,960 for one person, $21,640 for two, $27,320 for three and $33,000 for four. Alaska and Hawaii have their own, higher figures.
The 400% line
The same regulations define who can claim the credit: 26 CFR 1.36B-2(b) describes an applicable taxpayer as one whose household income is at least 100% and not more than 400% of the poverty line. The IRS instructions for the 2025 Form 8962 say that for tax year 2025 taxpayers above 400% may be allowed a credit, reflecting the expanded eligibility that applied through that year. The 2027 table and the regulation as checked here contain no band above 400%. If Congress changes the rule before or during 2027, HealthCare.gov's November figures will reflect it; check them before relying on this section.
The worksheet at four incomes
The inputs below are stated assumptions, not real prices: a single adult in the 48 contiguous states, a hypothetical benchmark silver premium of $600 a month ($7,200 a year) for that adult in their area, and the 2027 IRS table with the 2026 poverty guideline of $15,960. Real benchmark premiums vary widely by age and location.
| Income (single adult) | % of poverty line | Applicable % | Required share per year | Credit per year (hypothetical $7,200 benchmark) | You pay for the benchmark per year |
|---|---|---|---|---|---|
| $23,940 | 150% | 4.30% | $1,029.42 | $6,170.58 | $1,029.42 |
| $39,900 | 250% | 8.66% | $3,455.34 | $3,744.66 | $3,455.34 |
| $63,840 | 400% | 10.22% | $6,524.45 | $675.55 | $6,524.45 |
| $71,820 | 450% | none | n/a | $0 | $7,200.00 |
Two patterns stand out. Below 400%, the amount you pay for the benchmark does not depend on the premium at all: it is your required share, set by income. A higher benchmark premium in your area makes the credit bigger, not your payment. And at the 400% line the credit can drop from hundreds of dollars to zero with a small income change, because the rules checked here contain no gradual phase-out above that point. In this example, $7,980 more income moves the household from paying $6,524 to paying $7,200 for the same plan.
Working an income inside a band
Most incomes fall inside a band, not at its edge, so the straight-line rule matters. Take a hypothetical single adult at 175% of the poverty line, an income of $27,930. The 150% to 200% band runs from 4.30% to 6.78%, and 175% is halfway, so the applicable percentage is halfway too: 4.30% plus half of the 2.48-point spread, which is 5.54%. The required share is 5.54% of $27,930, or $1,547.32 a year, about $128.94 a month. With the same hypothetical $600 benchmark, the credit would be $7,200 minus $1,547.32, which is $5,652.68 a year.
A household of three
Household size changes the poverty line, which changes everything after it. Take a hypothetical family of three with expected 2027 income of $54,640. The 2026 guideline for three people is $27,320, so the household is at exactly 200% of the poverty line, the start of the 200% to 250% band, with an applicable percentage of 6.78%. The required share is $3,704.59 a year, about $308.72 a month. If the benchmark silver premium for this family were a hypothetical $1,500 a month, $18,000 a year, the credit would be $14,295.41 and the family would pay its required share for the benchmark plan. The same $54,640 earned by a single adult would be about 342% of the one-person guideline, with an applicable percentage of 10.22%. Same income, very different result, because the poverty line scales with household size.
If an employer offers you coverage
A job-based offer can make you ineligible for the Marketplace credit, even if you decline it, when the offer counts as affordable. The IRS sets the affordability benchmark each year as the required contribution percentage: 9.96% for plan years beginning in 2026 under Revenue Procedure 2025-25, and 10.22% for 2027 under Revenue Procedure 2026-26. The IRS Form 8962 instructions also note that affordability for family members is now based on the employee's cost to cover the employee and those family members, not only the employee. If an employer offer is part of your decision, ask the employer for the 2027 premium for each coverage tier in writing and compare it with that percentage of household income.
Adding the variable half: a full-year view
Now add what you would pay for care. The plan below is hypothetical: a silver plan at the $600 benchmark premium with a $5,000 deductible, 20% coinsurance and a $9,000 out-of-pocket maximum, which is under the $12,000 federal limit for 2027 that HealthCare.gov lists. Use the 250% household from the worksheet, paying $3,455.34 a year for this plan.
| Hypothetical care year | Allowed amounts for covered in-network care | You pay for care | Net premium | Year total |
|---|---|---|---|---|
| Little care | $500 | $500 | $3,455.34 | $3,955.34 |
| Moderate care | $10,000 | $6,000 | $3,455.34 | $9,455.34 |
| Heavy care | $80,000 | $9,000 (the maximum) | $3,455.34 | $12,455.34 |
The moderate year is $5,000 in deductible plus 20% of the remaining $5,000. The heavy year stops at the plan's maximum. The worst case for this household, for covered in-network care, is therefore about $12,455 for the year: the net premium plus the maximum. That pair of numbers, net premium and maximum, is the quickest way to compare any two plans once 2027 listings appear.
The silver detail: cost-sharing reductions
At lower incomes, Marketplace plans can come with cost-sharing reductions. HealthCare.gov says you must pick a plan in the silver category to get them, and that they lower deductibles, copayments, coinsurance and the out-of-pocket maximum; plans in other categories still get the tax credit but not these savings. The 2027 income ranges and reduced amounts were not posted when this guide was checked, so the worksheet does not model them. If your income is in the lower bands, compare the silver plan's deductible and maximum as shown to you on HealthCare.gov after November 1, because they may be far below the plan's standard figures.
Choosing a plan below the benchmark
The credit is calculated from the benchmark but can be used on other plans. Under 26 CFR 1.36B-3(d), the monthly credit is the lesser of your chosen plan's premium and the benchmark premium minus your required share. Continuing the 250% example with its credit of $3,744.66 a year: a hypothetical bronze plan at $400 a month ($4,800 a year) would cost $1,055.34 a year after the credit. A plan whose premium is below the credit costs nothing in premium, but the unused part of the credit is not paid to you.
The lower premium usually comes with a higher deductible and maximum. That is a trade the full-year view makes visible: the bronze plan saves $2,400 a year in premium in this example, and costs more in any year with substantial care. The worked comparison of two plans across three spending years in our deductible guide shows how to lay that out.
When the estimate and reality differ
The credit is usually paid in advance to the insurer each month, based on the income you estimate when you enroll. It is reconciled when you file taxes on Form 8962. The IRS instructions say that if the advance payments were more than the credit you qualify for, you must repay the excess, and for tax years beginning after December 31, 2025 there is no longer a cap on that repayment (Public Law 119-21, section 71305); if they were less, you can claim the rest. Three habits keep the reconciliation small:
- Estimate household income for 2027, not 2026; HealthCare.gov stresses that savings are based on the income estimate for the coverage year.
- Report income or household changes to the Marketplace during the year, so the advance payments adjust.
- If your income is near 400% of the poverty line, treat the credit as uncertain: a small change near that line can remove it entirely, and with the repayment cap gone, the whole advance credit for the year could be owed back at tax time.
Dates for 2027 enrollment
| Date | What happens (HealthCare.gov states) |
|---|---|
| November 1, 2026 | Applications for 2027 coverage open; 2027 income levels and savings are posted. |
| December 15, 2026 | Last day to enroll or change plans for coverage starting January 1, 2027. |
| January 15, 2027 | Open enrollment ends. |
State-run Marketplaces can set their own deadlines. Check your state's site if it does not use HealthCare.gov.
Reading a 2027 plan listing once it is posted
When the 2027 plans appear, each listing gives the inputs this worksheet needs, but not always in the order you need them. Work through a listing in this sequence, and write each figure next to the plan's name.
- Premium after the estimated credit. This is the monthly figure built from your income estimate. Multiply by 12. If you change the income estimate, this number changes for every plan at once, because the credit is the same dollar amount whatever plan you pick, up to each plan's premium.
- Deductible. Note whether it is shown per person or per family, and whether some services, such as primary care or generic drugs, are covered before it.
- Out-of-pocket maximum. This is the number that ends your share of covered in-network costs. Under the 2027 federal limit it cannot exceed $12,000 for one person.
- Coinsurance and copays for the services you expect to use, from the plan's Summary of Benefits and Coverage.
- Network and drug list. Confirm that the clinicians, hospital and drugs you rely on are covered in network. Out-of-network care and non-covered services do not count toward the maximum.
With those five figures you can fill the full-year table above for any plan: net premium for the year, plus your expected care cost under that plan's deductible and coinsurance, never more than its maximum. Doing it for two or three plans takes a few minutes and shows the real trade between them more clearly than the premium alone. A listing's premium can make a plan look like the obvious choice in a year you expect little care and the wrong one in a year with a planned procedure, and the worksheet is how you see which kind of year you are planning for.
A checklist for comparing 2027 plans
- Your 2027 household income estimate and household size.
- The benchmark silver premium shown for your household, and your credit.
- For each plan you consider: premium after credit, deductible, coinsurance, copays, out-of-pocket maximum (no more than $12,000 individual or $24,000 family in 2027).
- Whether your doctors, hospital and drugs are in network and covered, because out-of-network costs and non-covered services do not count toward the maximum.
- Your worst-case year: net premium plus the maximum.
- Written confirmation from the plan of any figure you are relying on that the listing does not show.
If you will pay part of the deductible from a health savings account, the eligibility rules in our HSA and FSA guide apply only to plans that qualify as high deductible health plans. Section 71307 of Public Law 119-21 treats every bronze and catastrophic plan sold as individual coverage through an Exchange as a high deductible health plan for months beginning after December 31, 2025, so those plans now qualify; for silver and higher tiers, check the listing before assuming an account is allowed. For a procedure you already know is coming in 2027, our billing questions checklist helps you get the plan's and the provider's estimate in writing after you enroll. The insurance cost guides collect the rest of the plan math on this site.
Before you enroll for 2027: six common questions
When can I sign up for a 2027 Marketplace plan?
HealthCare.gov says you can apply for 2027 coverage starting November 1, 2026. December 15 is the last day to enroll or change plans for coverage that starts January 1, and open enrollment ends January 15 on HealthCare.gov. States that run their own Marketplace can set different dates.
What share of my income will I pay for the benchmark plan in 2027?
It depends on your household income as a percentage of the federal poverty line. IRS Revenue Procedure 2026-26 sets the 2027 applicable percentages from 2.15% below 133% of the poverty line up to 10.22% from 300% to 400%. The percentage rises in a straight line within each band.
Can I get a premium tax credit in 2027 if my income is above 400% of the poverty line?
Under the rules checked for this guide, no. 26 CFR 1.36B-2(b) defines an applicable taxpayer as having household income from 100% to 400% of the poverty line, and the IRS 2027 applicable percentage table stops at 400%. The 2025 Form 8962 instructions show that the above-400% eligibility applied for tax year 2025.
Which poverty guidelines apply to 2027 coverage?
Under 26 CFR 1.36B-1(h), the poverty line is the most recently published HHS guideline as of the first day of open enrollment for the coverage year. For 2027 coverage that is the 2026 guideline, which is $15,960 for one person in the 48 contiguous states and DC.
Does the tax credit have to be used on a silver plan?
No. The credit is calculated from the second-lowest-cost silver plan in your area, but you can apply it to another metal level. Under 26 CFR 1.36B-3(d), the credit for a month is the lesser of your chosen plan's premium or the benchmark premium minus your required share, so a cheaper plan can bring the premium you pay down to zero.
What happens if my income ends up different from my estimate?
Advance credits paid during the year are reconciled on Form 8962 when you file taxes. The IRS instructions say that if the advance payments were more than the credit you qualify for, you must repay the excess. Section 71305 of Public Law 119-21 removed the cap on that repayment for tax years beginning after December 31, 2025, so for 2026 and 2027 coverage the full excess is repayable. Reporting income changes to the Marketplace during the year reduces the gap.
Official sources used
- Internal Revenue Service, Revenue Procedure 2026-26, 2027 applicable percentage table and required contribution percentage (10.22%). Checked October 22, 2026.
- Internal Revenue Service, Revenue Procedure 2025-25, 2026 applicable percentage table. Checked October 22, 2026.
- Electronic Code of Federal Regulations, 26 CFR 1.36B-1(h) (poverty line), 1.36B-2(b) (applicable taxpayer, 100% to 400%), and 1.36B-3(d), (f), (g) (premium assistance amount, benchmark plan, applicable percentage). Checked October 22, 2026.
- Internal Revenue Service, 2025 Instructions for Form 8962: above-400% eligibility for tax year 2025, prior-year poverty lines, reconciliation of advance credit. Checked October 22, 2026.
- Public Law 119-21, sections 71301, 71305 and 71307: eligible-alien limit on the credit (taxable years after December 31, 2026), repeal of the repayment limitation (taxable years after December 31, 2025), and bronze and catastrophic plans treated as HSA-qualifying (months after December 31, 2025). Checked October 22, 2026.
- HHS Office of the Assistant Secretary for Planning and Evaluation, 2026 poverty guidelines. Checked October 22, 2026.
- HealthCare.gov, Save on out-of-pocket costs: cost-sharing reductions only with silver plans. Checked October 22, 2026.
- HealthCare.gov, Dates and deadlines and Lower costs; Out-of-pocket maximum (2027: $12,000 individual, $24,000 family). Checked October 22, 2026.
Cost arithmetic with hypothetical premiums. Not tax, legal or insurance advice, and not a recommendation of any plan. Marketplace figures posted for your household control.
Once you have a short list of 2027 plans, run each one's deductible and maximum through the three-year spending comparison to see which trade between premium and risk your household is making.