If you buy your own health insurance, there’s a real chance the company that covers you today won’t be covering you in January.
As of Oct. 7, 11 insurers had announced they’re pulling out of the Affordable Care Act Marketplaces for 2027, in some states or all of them, according to nonprofit KFF.
The biggest is Cigna. It’s leaving all 11 states where it sells, and it had over 350,000 people in on-exchange plans in the first quarter of 2026.
If you retired before 65 or work for yourself, this is your problem. When an insurer walks, your plan ends Dec. 31. And the backup plan the system has in mind for you may not be one you’d ever pick.
Open enrollment on HealthCare.gov starts Nov. 1. To have new coverage on Jan. 1, you need to choose by Dec. 15, and the window closes Jan. 15. If your state runs its own exchange, KFF notes the dates may differ, so check.
Here are five moves to make before that Dec. 15 deadline — starting with the one that takes five minutes.
1. Find out if your insurer is leaving
Start with your mailbox. HealthCare.gov says a notice will arrive saying whether you’re being moved automatically into the same plan or a different one, and your insurer will mail its own explanation of your choices. That isn’t junk mail. Open it.
Don’t want to wait? Here are the exits trade reports from Becker’s Payer Issues and healthinsurance.org have tracked for 2027:
- Cigna: Arizona, Colorado, Florida, Georgia, Illinois, Indiana, Mississippi, North Carolina, Tennessee, Texas and Virginia
- Molina: shrinking from 14 states to six
- CareSource: Indiana, Ohio and West Virginia
- PacificSource: Idaho, Montana and Oregon
- Medica: Iowa, Kansas and Oklahoma
- Baylor Scott & White: Texas, roughly 100,000 enrollees
- Providence Health Plan: Oregon
- UnitedHealthcare: Georgia
- Cox HealthPlans: Missouri
- ConnectiCare: Connecticut, where it’ll sell only off the exchange
- Centene: Delaware and New Hampshire, plus its Sunshine State Health Plan in Florida
- Mending, formerly Taro Health: Maine and Oklahoma
Yes, that’s more than 11 names. Trade publications count exits a little differently than KFF does, and the lists keep growing.
What to do: Starting Nov. 1, log in to HealthCare.gov or your state’s exchange and look at your 2027 options. If your insurer’s name is missing, you have your answer.
2. Don’t let auto-enrollment choose for you
Here’s the part that worries me. If you don’t act by Dec. 15, HealthCare.gov will automatically put you back in a plan, and that coverage begins Jan. 1.
If your insurer isn’t offering anything similar next year, HealthCare.gov says it’ll move you into a “comparable” plan from a different company.
Comparable to what? It’s a plan you didn’t shop for, from an insurer you didn’t vet. Whether it covers your cardiologist or your blood-pressure pills is something you’ll find out the hard way, at the pharmacy counter, if you never look.
And don’t count on even that safety net everywhere. In Connecticut, roughly 3,700 ConnectiCare members will have to choose a new insurer’s plan themselves to keep Marketplace coverage, according to healthinsurance.org.
In Florida, Sunshine State Health Plan members who don’t choose will be moved to an Ambetter plan — picked for them, not by them.
What to do: Treat Dec. 15 as your real deadline and make the choice yourself. A default is a decision someone else made for you.
3. Recheck your doctors and your drugs
A new insurer means a new network and a new list of covered drugs. The plan that looks identical on price can be a very different animal when you need care.
Before you sign up, pull up the plan’s provider directory and search for every doctor you see, plus the hospital you’d want in an emergency. Then check the drug list for each prescription you take, by name and dose.
Directories aren’t always current, so call your doctors’ offices and ask a simple question: “Will you be in network with this exact plan in 2027?” Give them the plan’s full name, not just the insurer’s.
And if a new insurer turns down a claim next year, don’t just eat the bill. Here are five steps to fight a denied insurance claim.
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4. Price the whole year, not just the premium
Shopping by monthly premium alone is how people get burned. You need to know what a bad year would cost.
Start with the premium. Insurers proposed a median increase of 15% for 2027, KFF found. On a $700 monthly premium, that’s another $105 a month, or $1,260 a year. Call it $24 a week, every week, before you’ve seen a single doctor.
Then look at the out-of-pocket maximum.
For 2027, the most a Marketplace plan can make you pay out of pocket for covered, in-network care is $12,000 for one person and $24,000 for a family, according to Centers for Medicare & Medicaid Services guidance. That’s the legal ceiling. Plans can set a lower one.
Now add the two together. Say that $700 plan goes up 15% to $805 a month and has a $12,000 cap. A rough year could cost you $21,660. A pricier plan with a much lower cap might come out ahead.
If you want the bigger picture on what’s driving costs, here’s why health insurance premiums are rising.
5. Mind the subsidy cliff
The extra-generous premium tax credits expired when 2025 ended, KFF notes, and the old cliff is back. HealthCare.gov says incomes from 100% to 400% of the federal poverty level qualify for help.
The 2026 Health and Human Services poverty guideline is $15,960 for one person, and HealthCare.gov explains that the previous year’s numbers drive next year’s Marketplace savings. By our math, 400% is $63,840 for a single person in the lower 48, $79,800 in Alaska and $73,440 in Hawaii.
Cross that line by a dollar and your tax credit can disappear. I covered how to manage your income around it in this article on early retirees and the 2027 premium hike.
The bottom line
Insurers aren’t leaving because of anything you did. It’s a business decision. But if you sit still, you’re the one who pays for it — in a plan you didn’t pick, with doctors you may not get to keep.
One more warning: when you shop, type HealthCare.gov or your state exchange’s address yourself instead of clicking an ad. The Federal Trade Commission has warned that Medicare scammers are buying their way into search results by posing as official sites. Don’t give anyone running the same trick a shot at you.
If you’re between a paycheck and Medicare, health coverage is one of the retirement decisions worth getting right. Make this one by Dec. 15.
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