Open enrollment is one of the most important windows on the healthcare calendar — a chance to review what your plan actually covers, compare costs, and make sure your coverage still fits your life. For 2027, that review may be more important than usual. Health insurance rules, premiums, and plan structures can change from year to year, and several significant policy shifts are making their way through the marketplace that may affect what plans look like, what they cover, and what they cost. Depending on whether you get coverage through an employer, the ACA Marketplace, or Medicare, your experience of these changes will vary.
This guide walks through the key areas to review before re-enrolling or selecting a new plan, including what to watch for in premiums, provider networks, prescriptions, and dental coverage. It also covers an important reality that often catches people off guard: health insurance changes do not always close dental coverage gaps, and in 2027, the policy landscape around adult dental coverage has shifted in ways that leave many people without a reliable path to affordable dental care through their medical plan. Dental savings plans remain a practical, year-round option — and understanding the difference matters.
What to Check Before 2027 Open Enrollment
Reviewing your coverage before re-enrolling takes about an hour and can save you hundreds or thousands of dollars over the course of the year. Even if your plan name has not changed, the underlying terms may have. Before you re-enroll for 2027, plan to confirm the following: monthly premiums and whether they have increased; deductibles and out-of-pocket maximums for the new plan year; whether your doctors, specialists, dentists, and hospitals are still in-network; whether your current prescriptions remain covered and at what tier; any changes to dental or vision benefits embedded in your health plan; annual maximums, waiting periods, and coverage rules for dental services; and total expected annual cost, not just the monthly premium.
Because rules and costs are subject to change year to year, it is worth confirming all details directly with your marketplace, employer HR department, or insurer before finalizing your selection. Do not assume that a familiar plan name means identical terms.
Potential Health Insurance Changes to Watch in 2027
Premiums and Deductibles
Even if you stay on the same plan, your premium may look different in 2027. Enhanced premium tax credits that had expanded ACA affordability for many households expired at the end of 2025, contributing to a significant average premium increase for 2026 marketplace plans. Depending on your income, plan type, and state, your 2027 premiums may continue to reflect that shift.
Deductibles can also change from year to year. A plan that felt affordable last year may require more out-of-pocket spending before coverage kicks in. When comparing plans during open enrollment, look at total annual cost — the combination of your monthly premium multiplied by 12, plus your expected deductible and copay spending — rather than focusing only on the lowest monthly payment.
Provider Networks
Networks are not static. Physicians, hospitals, specialists, and dental providers can move in or out of an insurer’s network at any time, and plan networks are renegotiated annually. If you have a primary care physician, a specialist you see regularly, or a dentist you prefer, do not assume they are still in-network for 2027. Check the insurer’s provider directory before re-enrolling, and if possible, call the provider’s office directly to confirm their participation status. Seeing an out-of-network provider can mean dramatically higher costs, or no coverage at all depending on your plan type.
Prescription Drug Coverage
Drug formularies — the lists of medications a plan covers — change from year to year. A medication that was covered at a low copay in 2026 may be moved to a higher tier or removed from the formulary entirely in 2027. If you take regular prescriptions, look up each medication in the plan’s drug formulary during the open enrollment period and compare tier assignments and estimated out-of-pocket costs across plans before making your decision.
Dental and Vision Benefits
This is the area where consumer expectations most frequently diverge from reality. Many people assume that enrolling in health insurance means their dental care is covered. For most adults, it is not. Standard medical plans typically do not include routine adult dental services — and as discussed below, federal policy changes for 2027 have narrowed the path for states to expand adult dental coverage through the ACA marketplace. Vision coverage is similarly limited or absent in many health plans. Reviewing what your health plan actually covers for dental and vision, and whether you need separate coverage, should be a priority during open enrollment.
How 2027 Open Enrollment Affects Dental Coverage
For most adults, dental coverage is a separate purchase from health insurance. It may come through an employer’s dental benefit, a standalone dental insurance plan purchased through the ACA marketplace, a Medicare Advantage plan that bundles dental benefits, or a private dental savings plan. Understanding which type you have — and what it actually covers — is essential going into 2027.
One significant shift worth understanding: a Biden administration rule that had opened the door for states to add routine adult dental services as an Essential Health Benefit (EHB) under the ACA was reversed in the 2027 final rule from the Centers for Medicare and Medicaid Services. Under ACA rules, Essential Health Benefits come with important consumer protections: no dollar limits, a cap on annual out-of-pocket costs, and eligibility for federal subsidies. The reversal reinstates a prohibition on insurers including adult dental as an EHB, meaning adult dental coverage cannot be built into marketplace health plans with those protections attached. States can still mandate adult dental coverage through other mechanisms, but doing so requires them to absorb the costs themselves — a financial disincentive that has historically kept many states from expanding dental mandates.
What this means practically: for 2027, adults shopping on the ACA marketplace should not expect their health insurance plan to close the dental coverage gap. Standalone dental plans remain available through the marketplace and may be worth comparing during open enrollment. However, it is also worth knowing that one widely accessible option — dental savings plans — is not tied to open enrollment at all and can be joined at any time of year.
How to Review Your Dental Options for 2027
Whether you are comparing standalone dental insurance through the marketplace or evaluating a plan offered through your employer, the review process is similar. Start by estimating your expected dental needs for the coming year. If you anticipate routine cleanings and exams only, a basic plan may suffice. If you expect major work — crowns, implants, a root canal, orthodontics — coverage caps and waiting periods matter significantly.
As you compare dental plans, consider the following: whether your current dentist is in the plan’s network, since out-of-network care can be far more expensive or uncovered entirely; whether the plan has a waiting period before major services are covered, as some plans require six to twelve months of membership before covering crowns or root canals; what the annual maximum benefit is, since most traditional dental insurance plans cap coverage at $1,000 to $1,500 per year and a single crown or root canal can approach or exceed that limit; whether orthodontic benefits are included and whether there is a lifetime maximum; and the total annual cost of the plan — premiums plus expected out-of-pocket spending.
Compare that total annual cost against your estimated dental spending for the year. Talk to your dentist if you need help figuring out what your dental care needs may be in the near future.
What to Do If You Miss Open Enrollment
If the open enrollment window closes before you have enrolled or made changes, you are not necessarily without options. For health insurance through the ACA marketplace or an employer, a qualifying life event — losing other coverage, getting married or divorced, having a child, moving to a new coverage area — may trigger a Special Enrollment Period that allows plan changes outside the standard window. Check with your marketplace or HR department to determine whether a recent life change qualifies.
For dental coverage specifically, the situation is more flexible. Standalone dental insurance plans available outside the marketplace may have their own enrollment rules, and some can be purchased year-round. Dental savings plans have no open enrollment requirement at all: they can be joined at any point during the year and typically activate within a few business days.
Dental Savings Plans as a Year-Round Option
Dental savings plans, also called dental discount plans, are and alternative to traditional insurance. They work differently: members pay an annual membership fee and receive pre-negotiated discounts on dental procedures at participating dentists. There are no claims to file, no waiting periods, no annual maximums, and no deductibles. The plans are accepted by more than 70% of dental practices nationwide.
Plans available through DentalPlans.com start at $79.95 annually for an individual — roughly $7 per month — and average around $128 per year. Family plans average around $170 annually. By comparison, a basic individual dental insurance policy typically runs about $350 to $384 per year, and a family plan around $550 to $600 annually, and both come with caps, waiting periods, and claims processes that savings plans avoid entirely.
Members report saving an average of 50% on their dental care through these plans. Because activation typically takes just a few business days and there is no enrollment window to time, dental savings plans are one of the most accessible ways to reduce out-of-pocket dental costs regardless of where you are in the calendar year. They can also be used alongside existing dental insurance, stepping in to cover costs once an insurance plan’s annual maximum has been reached.
