By the Kryder Cares Data Desk · Reviewed by Kris Kryder, licensed agent · Updated
Key points
- Ohio uses the federal marketplace; 2027 Open Enrollment is Nov 1, 2026 – Jan 15, 2027 (enroll by Dec 15 for Jan 1).
- The enhanced tax credits ended after 2025; the 400%-of-poverty limit is back for 2026 and 2027.
- There’s no repayment cap on excess advance credits for tax years after 2025.
- 2027 out-of-pocket maximum: $12,000 self-only, $24,000 family.
Where Ohioans shop, and when
Ohio doesn’t run its own exchange — it isn’t on CMS’s list of state-based Marketplaces — so Ohio residents use the federal marketplace. The same is true for Michigan, Indiana and Florida, the other states where Kris is licensed.
For 2027 coverage, Open Enrollment starts November 1, 2026. Enroll or change plans by December 15 for coverage starting January 1, 2027; enroll between December 16 and January 15, 2027 and coverage starts February 1. Outside that window, you need a Special Enrollment Period — generally 60 days after a qualifying life event such as losing other coverage, moving, marriage or a new baby, and 90 days after losing Medicaid or CHIP. the federal marketplace may ask for documents. The monthly low-income Special Enrollment Period is not available for plan year 2026 onward.
What changed for 2026 and 2027
The enhanced premium tax credits that had expanded help for several years expired after 2025. According to the IRS, that means two changes for 2026 and later:
- The 400%-of-poverty limit is back. Households with income above 400% of the federal poverty level generally don’t qualify for a premium tax credit.
- No repayment cap. For tax years after 2025, if you receive more advance credit during the year than you’re entitled to, you may have to pay back the full excess at tax time. Report income changes to HealthCare.gov promptly.
How the premium tax credit is figured
The credit is based on your expected household income for the year compared with the federal poverty level (FPL). Coverage for 2026 uses the 2025 poverty guidelines — $15,650 for one person plus $5,500 for each additional person. The credit is set so you pay no more than an applicable percentage of your income for the benchmark Silver plan; the IRS publishes the percentages each year.
| Household income (% of FPL) | 2026 | 2027 |
|---|---|---|
| Up to 133% | 2.10% | 2.15% |
| 133% – 150% | 3.14% – 4.19% | 3.23% – 4.30% |
| 150% – 200% | 4.19% – 6.60% | 4.30% – 6.78% |
| 200% – 250% | 6.60% – 8.44% | 6.78% – 8.66% |
| 250% – 300% | 8.44% – 9.96% | 8.66% – 10.22% |
| 300% – 400% | 9.96% | 10.22% |
If an employer offers you coverage the IRS considers affordable — costing no more than 9.96% of household income in 2026 or 10.22% in 2027 for self-only coverage — you generally can’t get a premium tax credit on the Marketplace.
Metal levels: Bronze, Silver, Gold and Platinum
Marketplace plans are grouped by how they split costs with you, measured by average actuarial value — the share of covered costs the plan pays for a typical population. A lower metal level usually means a lower premium and higher costs when you get care.
| Metal level | Plan pays on average | You pay on average |
|---|---|---|
| Bronze | 60% | 40% |
| Silver | 70% | 30% |
| Gold | 80% | 20% |
| Platinum | 90% | 10% |
Cost-sharing reductions: why Silver can matter
If your income is up to 250% of FPL, you may also qualify for cost-sharing reductions, which lower deductibles and copays — but only if you choose a Silver plan. The reductions raise a Silver plan’s actuarial value to 94% at 100–150% FPL, 87% at above 150–200%, and 73% at above 200–250%.
Every Marketplace plan has a yearly out-of-pocket maximum: $10,600 self-only and $21,200 family in 2026, rising to $12,000 and $24,000 in 2027. Cost-sharing reductions lower it further.
Before you auto-renew
Premiums, networks and tax credits change every year, so review your 2027 renewal instead of letting it roll over. Update your expected income, check that your doctors and prescriptions are still covered, and compare Bronze, Silver and Gold totals. If you’re leaving a job, compare COBRA — which can cost up to 102% of the plan’s cost — with Marketplace options. If you’re nearing 65, see our turning-65 checklist, because Marketplace help generally ends once you’re eligible for Part A.
How Kris helps
Kris helps individuals, families and the self-employed across northwest Ohio compare Marketplace plans from the companies she represents and enroll on the federal marketplace-connected tools. Start on the ACA Marketplace page, read her 2027 Open Enrollment article, or see all individual and family health options. Kris is a licensed agent, not a tax adviser; ask your tax preparer about reconciling credits.
Your next step
Have questions about your own situation? Contact Kris or schedule a no-cost meeting. You can also read more about ACA Marketplace Health Insurance and Short-Term Medical.
Sources
- CMS — State-based Marketplaces (list of states running their own exchange)
- Federal marketplace (CMS) — Dates and deadlines
- Federal marketplace (CMS) — Special Enrollment Period
- CMS — 2025 Marketplace Integrity and Affordability final rule (fact sheet)
- IRS — Questions and answers on the premium tax credit
- Federal marketplace (CMS) — Federal poverty level (FPL)
- IRS — Rev. Proc. 2025-25 (2026 applicable percentages, PDF)
- IRS — Rev. Proc. 2026-26 (2027 applicable percentages, PDF)
- Federal marketplace (CMS) — Health plan categories (metal levels)
- CMS — 2027 premium adjustment percentage and cost-sharing parameters (PDF)
- U.S. Department of Labor — COBRA continuation coverage
Kryder Cares is not affiliated with the federal Health Insurance Marketplace. Plan availability, premiums and savings depend on where you live and your household income. Kris enrolls you on the federal marketplace at no cost to you.
This guide is general education, not a recommendation for any specific plan or policy. Figures were current as of October 19, 2026; plan details and government amounts change every year.