How we calculate

What we use. 2027 tax credit rules from the IRS (Rev. Proc. 2026-26), 2026 federal poverty guidelines, each state's Medicaid and CHIP income limits (KFF, January 2026), the 2025 federal law (Public Law 119-21) with changes in effect for 2027, and plan prices from CMS's Marketplace public use files. Rules checked Oct. 16, 2026.

What we assume. Your income estimate holds for the year. Married couples file jointly. Your Medicaid household matches your tax household. Yearly cost estimates use typical prices for doctor visits and prescriptions.

What we don't cover yet. States that run their own marketplace (we don't estimate for them yet), state-funded programs, and some details like stand-alone dental.

2027 numbers

Poverty line by household size

2026 HHS guidelines, used for 2027 tax credits. Alaska and Hawaii use higher lines.

Household size48 states and DCAlaskaHawaii
1$15,960$19,950$18,360
2$21,640$27,050$24,890
3$27,320$34,150$31,420
4$33,000$41,250$37,950
5$38,680$48,350$44,480
6$44,360$55,450$51,010
7$50,040$62,550$57,540
8$55,720$69,650$64,070
Each additional person+$5,680+$7,100+$6,530

Tax credit by income

You're expected to pay a share of household income toward the benchmark silver plan (the second-lowest-cost silver plan where you live). The credit covers the rest of its premium.

Household income, % of the poverty lineYou pay, % of income
Under 100%No credit
100% to under 133%2.15%
133% to under 150%3.23% to 4.30%
150% to under 200%4.30% to 6.78%
200% to under 250%6.78% to 8.66%
250% to under 300%8.66% to 10.22%
300% to 400%10.22%
Over 400%No credit in 2027

Within a range, the share rises evenly with income.

Job coverage

Job coverage that costs 10.22% of household income or less and meets minimum value counts as affordable. Affordable job coverage rules out the credit, even if you turn it down.

Out-of-pocket maximums

PlanOne personFamily
Any plan$12,000$24,000
Silver with extra savings, 100% to 150% of the poverty line$4,000$8,000
Silver with extra savings, over 150% to 200%$4,000$8,000
Silver with extra savings, over 200% to 250%$9,600$19,200

HSA limits

$4,500 for one person, $9,000 for a family, plus $1,000 if you're 55 or older.

Open enrollment

Nov. 1, 2026 to Jan. 15, 2027 on HealthCare.gov. Enroll by Dec. 15, 2026 for coverage starting Jan. 1.

Coverage Decider Score

0–100 for your household: 50 points for expected yearly cost against the cheapest plan you can buy, 20 for protection in a bad year (the out-of-pocket maximum against your bad-year limit), 20 for fit (your doctors, prescriptions, travel and referral answers) and 10 for CMS's quality rating (unrated plans count as 3 stars). A plan missing a must-keep doctor or prescription scores 40 at most; a plan whose year would cost more than a fifth of your income scores 59 at most. 90+ Excellent fit · 75–89 Good · 60–74 Fair · under 60 Poor.

PartWeightMeasures
Cost50Dollars of expected yearly cost above the cheapest plan you can buy, on a scale of the larger of $2,000, 10% of income and the cheapest year
Protection20Out-of-pocket maximum vs your bad-year limit, or vs the lowest out-of-pocket maximum on offer when no plan gets under that limit
Fit20Doctors and drugs covered (must-haves count most), travel coverage, referral rules
Quality10CMS star rating (3 stars when unrated)

How we pick your top 3

Plans over your budget, or missing a must-keep doctor or must-have prescription, are out. If that leaves none, we loosen the budget first, then doctors and prescriptions one at a time, and say so.

A plan is also out when another costs about the same each month with an equal or lower deductible and out-of-pocket maximum, a network at least as broad and the same doctor and drug coverage.

From the rest we take the best-scoring plan at each metal level: bronze or catastrophic, silver, and gold or platinum. A level with nothing left gives its slot to the next-best plan. A plan that costs more than another in every case we model gets in only within $3,000 a year, or 25%, of the cheapest year. The three are ordered by the score shown; between plans held to the same cap, the higher score before the cap goes first.

Each badge goes to the plan that holds it: Best fit, Lowest cost this year, Lowest in-network maximum and Lowest monthly. "Of these 3" means it holds that spot only among the three.

Yearly cost estimates

A plan's yearly cost is its premiums after the credit plus what you pay for care. We price each service at a rough national figure, then apply the plan's deductible, copays and coinsurance. These prices rank plans and size the range; they don't predict a bill.

ServicePrice we use
Primary care visit$150
Specialist visit$250
Urgent care visit$200
Emergency room visit$2,200
Overnight hospital stay$16,000
Therapy or counseling session$130
Generic prescription, each fill$15
Brand-name prescription, each fill$450
Specialty drug, each fill$5,500
Surgery or procedure$6,500
Having a baby$13,000

Visits scale with how you expect next year to compare with the last: less ×0.6, same ×1, more ×1.5. The low and high estimates use 0.6× and 1.5× the expected visits. Prescriptions you fill every month don't scale, and planned events (a procedure, a baby) are in every estimate.

Skip the care questions and we use a typical adult year for each person: 2 primary care visits, 1 specialist visit and 1 generic prescription filled each month.

Care is spread evenly across the months; planned events land in their month. Most you'd pay in network is a year of premiums after the credit plus the out-of-pocket maximum. Out-of-network care, services the plan doesn't cover and credit you pay back at tax time aren't capped.

Sources