The five things that decide the best plan for you
- Your doctors and hospitals. Search each plan's network for them. In-network care costs less, and out-of-network care may not be covered at all.
- Your prescriptions. Check each drug on the plan's covered drug list before you enroll.
- Total yearly cost. Twelve months of premiums plus the deductible, copays and coinsurance for the care you expect. Premiums are owed every month even when you don't use care.
- Your worst case. The out-of-pocket maximum is the most you'd pay for in-network covered care in a year. For Marketplace plans it can be up to $10,600 for one person in 2026 and $12,000 in 2027.
- Your savings. A premium tax credit lowers the premium on plans bought through the Marketplace, and extra savings on deductibles and copays apply only to Silver plans.
Network types: HMO, PPO, EPO and POS
| Type | Out-of-network care | Good fit if |
|---|---|---|
| HMO | Generally not covered except emergencies | Your doctors are in network and you're fine with a primary care doctor coordinating care. May require you to live or work in the service area. |
| EPO | Not covered except emergencies | You'll stay in network for all non-emergency care. |
| POS | You pay less in network; check the plan for out-of-network rules | You want lower in-network costs and don't mind referrals to see a specialist. |
| PPO | Covered at a higher cost, no referral needed | You want to keep a doctor outside the network or travel often. |
Choosing a metal level
| Metal level | Plan pays (about) | Often fits |
|---|---|---|
| Bronze | 60% | Little expected care, savings for a bad year, or you want an HSA |
| Silver | 70% (73% to 96% with extra savings) | You qualify for cost-sharing reductions |
| Gold | 80% | Regular visits, prescriptions or a planned procedure |
| Platinum | 90% | Heavy, predictable care and you'd rather pay more each month than at the visit |
A higher monthly premium can still be the cheaper year. Run a quiet year and a bad year for each plan you're considering. See cheapest health insurance for the math and Bronze plans for when Bronze fits.
Questions to ask before you pick
- Are my doctors, my hospital and my children's doctors in network for 2027, not just this year?
- Is each of my prescriptions on the drug list, and at what cost?
- Do I need a referral to see a specialist?
- What's the deductible, and which services are covered before it (preventive care, primary care visits, generic drugs)?
- What's the out-of-pocket maximum for one person and for my family?
- Does the plan work with a Health Savings Account?
- What would my total cost be in a quiet year and in a bad year?
Gabriel can quote Marketplace plans for your ZIP code and household, show the price after any tax credit, and open your own application with a licensed agent in most states. You choose the plan and finish the application. Gabriel doesn't rank insurers or pick a plan for you.
Gabriel is not an insurer. Health insurance quotes and enrollment are handled by Gabriel Labs, Gabriel's separately licensed insurance agency. Gabriel membership is not health insurance and doesn't replace a health plan's protection against large medical bills.
Common questions
Which health insurance company is the best?
No company is best for everyone. Insurers and networks differ by state and county, so compare the specific plans offered where you live on network, drug list and total yearly cost.
Is a PPO better than an HMO?
A PPO covers out-of-network care at a higher cost, while an HMO generally doesn't except in emergencies. If your doctors are in an HMO's network, it can cost less.
Is Gold insurance better than Bronze?
Gold pays a bigger share of costs (about 80% vs 60%) for a higher premium. It isn't better quality; it's a different trade between monthly cost and cost when you get care.
What is the best health insurance for a family?
The plan that covers every family member's doctors and prescriptions, with a family out-of-pocket maximum you could afford. Check the children's doctors too. All Marketplace plans include children's vision coverage, and children's dental coverage must be offered, either in the health plan or as a separate dental plan.
When can I switch to a better plan?
During Open Enrollment, which starts November 1 for 2027 coverage, or after a qualifying life event. See open enrollment.
Sources
- Health insurance plan and network types: HMOs, PPOs, and more HealthCare.gov
- Health plan categories: Bronze, Silver, Gold and Platinum HealthCare.gov
- Comparing plans HealthCare.gov
- Out-of-pocket maximum/limit HealthCare.gov
- What Marketplace health insurance plans cover HealthCare.gov
- Dental coverage in the Marketplace HealthCare.gov
- Cost-sharing reductions HealthCare.gov
This guide is general information, not medical advice. It does not replace a visit with a licensed clinician. Gabriel membership is not health insurance.