By Marc Gilman
Questions? Call (800) 927-9326 or email marc@gilmanagency.com
Key Takeaways
Open Enrollment for 2027 Marketplace coverage began November 1. New Hampshire uses HealthCare.gov. Enroll by December 15 for coverage starting January 1. Open Enrollment is scheduled to end January 15, 2027.
Ambetter is leaving New Hampshire's Marketplace. About 11,600 people, roughly one in five Marketplace enrollees, had Ambetter coverage as of June. If you are one of them, your plan ends December 31, and you need to choose a new plan.
Three insurance companies are offering New Hampshire Marketplace plans for 2027: Anthem (including its Matthew Thornton Health Plan), Harvard Pilgrim and WellSense.
Premiums are rising. Final approved rates for New Hampshire's individual market rise about 19% on average, before any financial help.
The rules for financial help have tightened. The extra federal tax credits that ended after 2025 are still gone, and starting with 2026 taxes there is no cap on how much excess tax credit you may have to pay back. Your income estimate matters more than ever.
Who Uses the Marketplace?
The Marketplace is for people who buy their own health insurance: the self-employed, early retirees who are not yet 65, people between jobs, and workers whose employer does not offer affordable coverage. New Hampshire residents shop and enroll through HealthCare.gov, or with the help of a licensed agent.
If you are on Medicare, the Marketplace is not for you. If you are turning 65 in 2027, plan your switch to Medicare so your Marketplace coverage ends when your Medicare coverage starts, and you do not pay for both.
Change 1: Ambetter Is Leaving New Hampshire
Ambetter, offered by Centene's Celtic Insurance, is leaving New Hampshire's Marketplace at the end of 2026. It was the state's second-largest Marketplace insurer. Ambetter says members do not need to take immediate action, but every Ambetter member will need to choose new coverage for 2027.
What Ambetter members should do:
Do not cancel anything. Your plan ends on its own on December 31, 2026.
Choose a new plan by December 15 if you can. Because your plan is ending, you have until December 31 to pick a plan that starts January 1, but choosing early leaves time to fix problems.
Shop from scratch. In most cases HealthCare.gov will place you in a similar plan from another insurer if you do nothing, but that plan may not include your doctors or fit your budget. Compare all of the available plans yourself.
Check your doctors and prescriptions with the new insurer. Each company has its own network and drug list.
Don't count on fixing it later. You can still change plans in January or February, but a plan you choose then starts February 1 or March 1, and your deductible and out-of-pocket spending start over at zero.
Change 2: Premiums Are Going Up
Final 2027 rates show double-digit increases in New Hampshire's individual market. Approved rates rise about 19% on average, slightly more than insurers first requested, and some plans rise more than 20%. Insurers point to rising medical costs and higher use of care.
Nationally, KFF reports that benchmark silver premiums, which are used to calculate financial help, are up 13% on average for 2027, after a 26% increase the year before.
Out-of-pocket limits are rising too. For 2027, the most a Marketplace plan can make you pay out of pocket for covered in-network care is $12,000 for an individual and $24,000 for a family, up from $10,600 for an individual in 2026. Many plans are below those limits, but expect higher deductibles and out-of-pocket maximums on many plans.
Here is the important part: most Marketplace enrollees receive a premium tax credit, and the credit is based on the cost of the benchmark silver plan in your area. When the benchmark rises, your credit usually rises too. That means your net premium may change less than the headline increase. It also means the plan you have now may no longer be your best value. Compare before you renew.
Change 3: Financial Help Has Tightened
The extra tax credits are gone. The enhanced premium tax credits that started during the pandemic expired at the end of 2025. Under the original ACA rules now back in effect:
Households with income above 400% of the federal poverty level generally do not qualify for a premium tax credit.
Households below that level pay a larger share of their income toward the benchmark plan than they did in 2025.
There is no longer a cap on paying back excess credits. Your tax credit is paid in advance based on the income you estimate. If your actual income turns out higher, you repay the difference when you file your taxes. Starting with tax year 2026, the limits on that repayment have been eliminated. An income estimate that is too low could mean a large tax bill. If your income is near 400% of the poverty level, or near 250% for cost-sharing reductions on silver plans, be especially careful.
Some people lose eligibility. Starting in 2027, some lawfully present immigrants are no longer eligible for premium tax credits, and people denied Medicaid for not meeting new work requirements in states that have them cannot receive Marketplace tax credits.
New Hampshire has no state program that replaces the lost federal credits. The state's reinsurance program does help keep full-price premiums lower than they would otherwise be.
Change 4: Dates and Rules Are Still Moving
A federal rule would have shortened Open Enrollment for 2027, but a court vacated it in June, and HHS has appealed. For now, Open Enrollment on HealthCare.gov runs through January 15, 2027. Several other new requirements, including some income-verification rules and expanded eligibility for catastrophic plans, have been paused by the courts.
The safest approach is to enroll by December 15 and not wait for the last week.
What to Check Before You Enroll
Your 2027 income estimate. Include wages, self-employment income, Social Security, retirement withdrawals and investment income. Update HealthCare.gov during the year if it changes.
Your doctors and hospitals. Confirm each one by name with the insurer.
Your prescriptions. Check that each drug is on the plan's list, and at what cost.
Your total costs, not just the premium. Add the yearly premium to the deductible and out-of-pocket maximum. A lower premium can cost more if you need care.
Your notice from HealthCare.gov or your insurer. It shows your 2027 premium and any change to your plan.
How We Can Help
Gilman Agency helps New Hampshire residents compare Marketplace plans, estimate financial help and avoid coverage gaps, including Ambetter members who need to move and early retirees planning their transition to Medicare. Our help costs you nothing.
Call (800) 927-9326 or email marc@gilmanagency.com
This article is for general information only and is not tax or legal advice. Eligibility for financial help depends on your household income and circumstances. Plan availability, premiums and dates are subject to change; confirm details at HealthCare.gov.
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