By Ariel Maiselman, Health & Harmony Insurance Agency
If you buy your own health insurance in Maryland, November 1 is worth putting on your calendar. That’s when open enrollment begins for 2027 coverage through Maryland Health Connection.
Before you renew, take a fresh look at what has changed for you.
Your income may be different. Your doctor may participate in a different network. A prescription that was affordable this year may cost more next year. And federal changes mean some households need to take a closer look at their financial assistance.
You deserve to understand those details before choosing a plan.
Maryland’s enrollment dates
Maryland’s current open enrollment window for 2027 coverage is November 1, 2026, through January 15, 2027.
- Enroll by December 31 for coverage beginning January 1.
- Enrollment from January 1 through January 15 generally means coverage starts February 1.
These are Maryland’s deadlines. Check Maryland Health Connection rather than relying on a national enrollment headline, and give yourself time to resolve questions before the deadline. See Maryland’s 2027 enrollment decision and coverage start dates.
What happened to financial help?
The enhanced federal premium tax credits expired at the end of 2025. That expiration is separate from the changes enacted through H.R. 1, commonly called the One Big Beautiful Bill Act.
Regular premium tax credits remain available to people who qualify. Maryland has also approved continuing state premium assistance for 2027. State help has eligibility requirements, including income limits and eligibility for federal advance premium tax credits, so it won’t fill every gap. See Maryland’s explanation of federal changes and the 2027 state assistance decision.
The practical takeaway: don’t assume all help disappeared, and don’t assume last year’s assistance will carry over unchanged.
Federal changes worth understanding
Income estimates now carry more financial risk. Starting with the 2026 tax year, the limits on repayment of excess advance premium tax credits are gone. If the credit paid toward your coverage exceeds what you qualify for when you file your tax return, you must repay the full excess. This already applies to 2026 coverage, not just the plan you choose for 2027.
Report income and household changes promptly, and ask your tax professional about your situation. See the IRS premium tax credit guidance, including Question 31.
Immigration-related financial assistance rules are also changing. Beginning January 1, 2027, federal Marketplace premium tax credits for noncitizens will be limited to people in these categories who also meet the other eligibility requirements:
- Lawful permanent residents, including green card holders.
- Cuban or Haitian entrants.
- Compact of Free Association migrants.
Other lawfully present people may still be able to buy Marketplace coverage at full price. Eligibility to enroll and eligibility for financial help are separate questions. See CMS guidance for 2027, pages 52–53.
A separate restriction began in 2026 for people below 100% of the federal poverty level who are ineligible for Medicaid because of immigration status. Medicaid has its own rules, changes and protections. If your household is affected, get an individual review rather than assuming everyone in the family has the same eligibility. See Maryland’s coverage-change information.
Your before-November-1 checklist
- Estimate your 2027 household income. Use a realistic estimate for the coverage year. If you’re self-employed, work seasonally or expect a job change, take time with this step. An old income figure can produce a very different result from what you expect.
- Check your account and contact information. Make sure you can sign in to Maryland Health Connection. Update your address, phone number and email. Read your renewal notices and respond to document requests by the stated deadline.
- Gather your information. Have recent income records, your latest tax return, current insurance information and details of available employer coverage ready. Depending on your application, identity or immigration documents may also be needed. Use the appropriate secure application process for sensitive documents.
- Make a doctors-and-prescriptions list. Include specialists, preferred hospitals, medications, dosages and your pharmacy. Check the specific 2027 plan’s network and drug coverage. A familiar insurance company name doesn’t answer those questions.
- Compare the costs of using the plan. Look at the monthly premium alongside deductibles, copays, coinsurance and the out-of-pocket maximum. Think about the appointments and prescriptions you expect to need. A lower monthly payment can come with tradeoffs that matter to you.
- Review your renewal actively. Even if your coverage can renew automatically, take a fresh look. Maryland’s insurance regulator encourages consumers to review renewal notices and compare available plans. See Maryland’s 2027 consumer guidance.
Let’s review what fits your household
At Health & Harmony, we can review your options around your doctors, prescriptions, budget and household situation. If your current plan still fits, that matters too.
Have questions before enrollment opens? Learn about our Maryland health insurance services or call (240) 832-0218.
Information reviewed October 7, 2026. Eligibility and financial assistance depend on your individual circumstances.