Marketplace health insurance enrollment opens Sunday

DUANE CROSS
MCO Publisher•Editor

The cheapest health insurance plan isn't always the least expensive one to live with. A lower monthly premium can mean a deductible that takes a bigger bite out of the family budget. Or you might discover that the doctor you've been seeing for years is no longer covered.

With open enrollment for 2027 health insurance beginning Sunday, Nov. 1, the Tennessee Department of Commerce & Insurance is encouraging residents to look carefully at their options before making a decision.

The enrollment window runs through Jan. 15, 2027, for Tennesseans purchasing individual coverage through the federal Health Insurance Marketplace. But anyone who wants coverage to begin on New Year's Day has an earlier deadline.

Two deadlines, two start dates

The federal Marketplace, operated through HealthCare.gov, allows individuals and families to purchase insurance that meets Affordable Care Act requirements. Open enrollment is the annual opportunity to sign up for coverage, renew an existing policy, or switch plans.

The important dates for 2027 coverage are:

• Sunday, Nov. 1: Open enrollment begins. Consumers can enroll in, renew, or change Marketplace plans.

• Tuesday, Dec. 15: Deadline to select a plan for coverage beginning Jan. 1, 2027.

• Friday, Jan. 15: Open enrollment ends. Plans selected after Dec. 15 and by Jan. 15 generally take effect Feb. 1, 2027.

There's another step consumers shouldn't overlook. Selecting a plan doesn't automatically activate coverage. The first premium must be paid directly to the insurance company by its deadline before the policy takes effect.

Once open enrollment closes, most consumers must wait until the next enrollment period to purchase or change Marketplace coverage. Exceptions are available for qualifying life events, including marriage, the birth of a child, or the loss of other health insurance.

A cheaper premium can cost more

State insurance officials are urging Tennesseans to look beyond the monthly premium when comparing policies. Deductibles, copayments, and out-of-pocket limits can make a substantial difference in what a family ultimately spends on medical care. A policy that costs less each month might leave a patient paying considerably more when an unexpected illness or injury sends them to the hospital.

Provider networks deserve particular attention for Moore County residents who travel outside the county for specialized medical care.

TDCI recommends contacting physicians and hospitals directly to confirm they participate in a prospective plan's network. Consumers shouldn't assume that a doctor covered under their current policy will remain covered next year.

Those who already have Marketplace insurance should review their renewal information rather than simply allowing an existing policy to roll over. Insurance companies can change premiums, benefits, and provider networks from one year to the next.

Financial assistance may be available

Some Tennesseans may qualify for federal premium tax credits that reduce the cost of Marketplace coverage. Eligibility depends on household circumstances, including estimated annual income. HealthCare.gov allows consumers to compare available plans and determine whether they qualify for financial assistance.

Returning customers should update their projected 2027 income and household information before renewing. Changes in earnings or family circumstances can affect the amount of assistance available, and inaccurate estimates may lead to adjustments when federal income taxes are filed.

Marketplace enrollment isn't Medicare enrollment

The upcoming Marketplace enrollment period should not be confused with Medicare's annual open enrollment, which is already underway.

Medicare beneficiaries have from Oct. 15 through Dec. 7 to review or change their Medicare Advantage and prescription drug coverage for 2027.

Medicare plans are not purchased through the federal Health Insurance Marketplace. Those seeking information about Medicare coverage can visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227).

Where to get help

Tennesseans can compare Marketplace plans, review available financial assistance, and enroll online at HealthCare.gov or by calling 1-800-318-2596.

Free assistance is available through trained Marketplace Navigators, who help consumers understand their options and complete enrollment applications. Residents may also consult a properly licensed insurance agent.

Questions specifically concerning insurance rate increases can be directed to TDCI's Consumer Insurance Services division at (615) 741-2218.

Better to find out in November that your family doctor isn't covered than discover it when the bill arrives in February.