ACA Open Enrollment Starts November 1: How to Pick a Plan That Works With Direct Primary Care

Open enrollment for 2027 Affordable Care Act Marketplace plans starts November 1 and runs through January 15 in most states, including Florida. If you want new coverage effective January 1, you need to enroll by December 15 — miss that date and your plan will not start until February 1, which can leave you with a gap in catastrophic coverage. This is the one time of year most Floridians actually think about their health insurance, and if you already have or are considering a Direct Primary Care membership, open enrollment is the right moment to make sure your insurance and your DPC membership are actually working together instead of overlapping or leaving gaps.

Here is how to approach it. Start by figuring out what you actually need insurance for. If you have a DPC membership, or are planning to get one, your primary care is already covered — unlimited visits, same-day appointments, chronic disease management, and direct access to your doctor.

That means the plan you pick during open enrollment only needs to handle what DPC does not: hospitalizations, surgeries, specialist visits, and emergency care. This changes what you should be shopping for. Instead of comparing plans based on which one has the lowest primary care copay, you should be comparing based on premium, deductible, and out-of-pocket maximum for the big stuff.

For most Orlando residents pairing DPC with a Marketplace plan, a Bronze or high-deductible Silver plan is the right tier. These plans have the lowest monthly premiums on the Marketplace, which makes sense once you remember that your DPC membership is already covering the primary care visits that drive up the value of richer plans. If you qualify for a subsidy based on your income, run the numbers both ways — sometimes a subsidized Silver plan ends up cheaper than an unsubsidized Bronze plan, so it is worth comparing both before you enroll.

If you want to pair your Marketplace plan with a Health Savings Account, confirm the plan is HSA-eligible before you enroll — not every Bronze or Silver plan qualifies, and only HSA-eligible high-deductible health plans allow you to contribute. This matters for Florida DPC members specifically because, as of the 2025 tax law changes, qualifying DPC membership fees can now be paid directly out of an HSA, as long as the monthly fee does not exceed $150 for an individual or $300 for a family. Confirming HSA eligibility during open enrollment, rather than after you have already enrolled, is the only way to make sure you can actually use this pretax savings.

If your income is unstable or you are self-employed with inconsistent year-to-year earnings, double-check your subsidy estimate on the Marketplace application. Subsidies are based on projected income, and either underestimating or overestimating it can mean a reconciliation surprise at tax time. If you are not sure what to project, use your prior year's tax return as a starting point and adjust for any known changes.

One date-related reminder worth repeating: outside of open enrollment, you generally cannot change your Marketplace plan unless you have a qualifying life event — a job loss, a move, a marriage, a new dependent. If you are even considering switching plans or adding coverage to pair with your DPC membership, November and December are the only guaranteed window to do it for the full year ahead. If you already have a DPC membership and are simply shopping for the plan to pair it with, start the process early.

Rates and plan options get finalized by insurers before November 1, but the earlier you compare options and run subsidy estimates, the more time you have to ask questions before the December 15 deadline for January 1 coverage. Open enrollment is also a good time to confirm your DPC clinic's current pricing and offerings, since some clinics update their membership tiers or add an employer program partway through the year. Browse our directory of Direct Primary Care clinics in Orlando and Central Florida to confirm your clinic's current pricing before you finalize your Marketplace plan selection for the year ahead.