ACA Open Enrollment Is Open. Compare 2027 Plans by Your Specialty Medication
When can you enroll in 2027 Marketplace coverage?
Open Enrollment for 2027 Marketplace coverage started November 1, 2026 in most states. On HealthCare.gov, enroll by December 15 for coverage that starts January 1. Open Enrollment ends January 15; coverage for people who enroll from December 16 through January 15 generally starts February 1. Confirm your state's dates if you do not use HealthCare.gov (HealthCare.gov dates and deadlines; CMS Plan Year 2027 Marketplace fact sheet, Oct 30, 2026; Infusion Access Foundation 2027 guide). Dates could still change, so December 15 is the safest target. A 2025 CMS rule would have ended Open Enrollment on December 15 for 2027 coverage. A federal judge vacated that shortened period in June 2026 in City of Columbus v. Kennedy, and an appeal is pending in the Fourth Circuit. CMS has confirmed the January 15, 2027 end date for this season on HealthCare.gov. If your coverage comes from a job-based plan, that is a different checklist. This post is for Marketplace plans.
Why is premium alone a weak way to choose if you take a specialty medication? The plan with the lower monthly price can still place your medication on a high-cost tier, require a new prior authorization, or leave you paying more before the plan shares costs. KFF's October 30, 2026 briefing on 2027 Open Enrollment flags another year of double-digit benchmark premium increases and notes that insurer exits outnumber new entrants, so reading the full benefit design matters even more for specialty medication (KFF). Coverage from Julie Appleby at CBS News / KFF Health News (Oct 23, 2026) adds practical friction for people who use brokers on the federal Marketplace: new identity and authorization steps, and a reminder not to let a plan auto-renew without checking deductibles and other costs. Agents who were not registered with the federal Marketplace for 2026 cannot help with 2027 enrollment until February at the earliest, after Open Enrollment ends (CBS News / KFF Health News; KFF Health News). Advocates who focus on infusion and specialty drugs make the same point: confirm that your exact medication is covered, whether it needs prior authorization, and whether the plan will require a fresh approval even if you are already stable on therapy (Infusion Access Foundation). For what happens when formulary or prior-authorization rules block a fill, see specialty drug access denials and what happens when insurance denies a specialty medication.
What should you check on every 2027 plan for your specialty medication?
How can Ellen® help during ACA open enrollment?
Once you know a plan's deductible, coinsurance or copay, and out-of-pocket maximum, enter those details with your medication in EllenRx®'s Cost Estimator to see an estimated yearly out-of-pocket cost under that plan's rules. If a denial letter arrives after you enroll, upload it to the Denial Decoder or start from I Was Denied. If the approved cost is still too high, try the Financial Assistance finder. Your next step: before December 15, check your exact specialty medication on each 2027 drug list, then open the Cost Estimator with the deductible and cost-sharing numbers from the plan you are seriously considering.