Reviewed by BeneHub's licensed advisor team · Agency NPN 21324782 · Updated October 2026
What happened to your subsidy
From 2021 through 2025, enhanced premium tax credits capped benchmark premiums at 8.5% of income for everyone. They expired.
For 2027 coverage, the original formula is back. Two things hit hardest:
- Above 400% of the federal poverty level, the subsidy drops to zero.
- Below that line, you're expected to pay a larger share of income than before.
Check whether you really lost it
Before you switch, confirm the numbers. Renewal notices often assume last year's income.
Update your 2027 income estimate on HealthCare.gov or your state exchange. A lower estimate, such as after retirement contributions, can bring a subsidy back.
- Contributions to a traditional IRA, SEP or solo 401(k) lower the income used for subsidies.
- HSA contributions also count, if you have an HSA-eligible plan.
- Self-employed? Your subsidy is based on net profit, not gross revenue.
Option 1: Stay on the exchange, but shop down
If you still get some subsidy, a bronze or lower-cost silver plan may keep the bill manageable.
Bronze plans carry higher deductibles, so weigh the monthly savings against what one hospital visit would cost you.
Option 2: A private underwritten PPO
Private plans are sold directly by carriers, outside HealthCare.gov. Many use national PPO networks.
Because they ask health questions, healthy applicants can pay noticeably less than a full-price exchange plan.
- Coverage can start in any month, not just January 1
- Copays for office visits on many plans
- Your price depends on age, state and health answers
Option 3: Layer simpler coverage
Some people combine a fixed or hospital indemnity plan with specified disease coverage. These pay set cash amounts rather than working like major medical.
It's lower cost, but it's not the same protection. An advisor can show you where the gaps are.
How to decide in 15 minutes
- Run your household through our ACA vs private calculator.
- If the subsidy still covers more than half the benchmark, the exchange is likely your better deal.
- If it doesn't, see the private plans available in your state.
- Talk to a licensed advisor before you cancel anything.
What to have ready before you compare
A few details make any quote faster and more accurate. Gather them before you talk to anyone, so you can compare plans on equal terms.
Write down what you pay today and what your renewal notice says for 2027. That gap is the number you're trying to close.
- Your expected 2027 household income
- Ages of everyone who needs coverage
- Your doctors, hospital and regular prescriptions
- Your current plan's deductible and out-of-pocket maximum
Common mistakes after a subsidy loss
The biggest mistake is panic-cancelling. A gap in coverage, even for a month, leaves you exposed to a full hospital bill.
The second is assuming the cheapest premium wins. Compare what each option would cost in a year you actually need care.
- Cancelling before a new plan is approved
- Ignoring the deductible and out-of-pocket maximum
- Forgetting to check your doctors and prescriptions
- Guessing your 2027 income instead of estimating it carefully
How a licensed advisor helps
An advisor compares your exchange renewal with private options in your state, using your real ages and ZIP code. If the exchange still wins, we'll tell you plainly.
We also check your doctors and prescriptions against each plan before you apply, so there are no surprises after approval.
- No fee — carriers pay us a commission
- Your premium is the same either way
- You decide when, or whether, to talk
Who this is NOT for
- Anyone whose subsidy still covers most of the premium
- People with a serious ongoing condition or planned treatment — ACA plans can't turn you down
- Anyone who is pregnant or planning to be soon
- People 65 or older, who should look at Medicare