The Affordable Care Act caps how much members of non-grandfathered individual and group health plans pay out of pocket each year for covered in-network essential health benefits. The cap is adjusted every year.
2027 ACA out-of-pocket maximum
| Self-only coverage | Other than self-only (family) coverage | |
|---|---|---|
| 2027 | $12,000 | $24,000 |
| 2026 | $10,600 | $21,200 |
The self-only limit applies to each person, even if you are enrolled in a family plan.
HSA-eligible high deductible health plans (2027)
An HSA-eligible plan has to meet stricter limits: a minimum deductible of $1,750 (self-only) or $3,500 (family), and an out-of-pocket maximum of no more than $8,700 (self-only) or $17,400 (family).
Your actual plan's out-of-pocket maximum may be lower than the legal limit. Check the plan's summary of benefits before you enroll.
Questions about your 2027 coverage? A licensed iHealthAgents advisor can help at no cost.
Sources: CMS 2027 premium adjustment percentage guidance (Jan. 29, 2026) and IRS Rev. Proc. 2026-24. Educational use only.
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