Your deductible is the fixed amount you pay for covered services before your insurance starts sharing costs. For example, with a $2,000 deductible, you pay the first $2,000 in full. After meeting your deductible, your insurer covers a percentage via coinsurance until you reach the out-of-pocket maximum — the absolute annual cap on your costs. Once you hit the OOP max, insurance covers 100% of covered in-network services for the remainder of the plan year.

Choose an HMO if you're comfortable staying in-network, want lower premiums, and are okay getting referrals to see specialists. Choose a PPO if you have existing doctors or specialists you want to keep, travel frequently, or need out-of-network coverage flexibility. For families with children who see multiple specialists, a PPO's referral-free access often justifies the higher premium. Use our health plan comparison calculator above to model both options against your expected annual usage.

A Health Savings Account (HSA) is only available with an HSA-eligible HDHP. It offers a triple tax advantage: contributions are pre-tax or tax-deductible, growth is tax-free, and withdrawals for qualified medical expenses are tax-free. The 2026 IRS contribution limits are $4,300 for individuals and $8,550 for families. Unlike FSAs, HSA funds roll over indefinitely and can be invested in index funds for long-term growth. Select HDHP in Step 1 to see your personalized HSA tax savings estimate in the results panel.

It depends on whether your doctor participates in the new plan's network. Before enrolling, use your insurer's online provider directory to verify your specific doctors are in-network. PPO plans offer the widest network flexibility, including out-of-network coverage at higher cost-sharing. HMO and EPO plans restrict coverage to in-network providers only, with emergency care as the exception. If keeping a specific physician is a priority, select PPO in Step 1 and verify network inclusion before committing during open enrollment.

The ACA Open Enrollment Period (OEP) for 2026 marketplace plans ran November 1–January 15, 2026. Outside OEP, you can enroll only through a Special Enrollment Period (SEP) triggered by a qualifying life event: losing employer coverage, getting married, having a child, moving to a new coverage area, or gaining citizenship status. Medicaid and CHIP have year-round enrollment. Employer plan enrollment windows vary by company and typically occur in the fall.

Metal tiers describe how costs split between you and the insurer — not the quality of care. Bronze (60/40) has the lowest premium but highest out-of-pocket exposure. Silver (70/30) is the ACA benchmark and the only tier eligible for cost-sharing reductions. Gold (80/20) provides more predictable costs for regular medical users. Platinum (90/10) makes financial sense only if you consistently hit your out-of-pocket maximum each year. Use our health insurance premium calculator above to estimate your true total annual cost at each tier.