Health Insurance Open Enrollment in San Antonio 2027: The Nov 1 – Jan 15 Guide for Families Who Buy Their Own Coverage

If you buy your own health insurance in San Antonio — no job coverage, gig work, self-employed, early-retired, or between jobs — your one window to enroll or change plans for 2027 opens Sunday, November 1, 2026 and closes January 15, 2027.

The date that matters most is earlier: enroll or change plans by December 15, 2026 for coverage that starts January 1, 2027. Enroll December 16 – January 15 and your coverage starts February 1 — a month with no insurance at the start of the year. (You may see older pages say open enrollment ends December 15 — that rule was thrown out by a court in 2026, and CMS confirmed the window runs through January 15. December 15 is the deadline for January 1 coverage.)

This year there is a second reason not to sleepwalk through it: the bigger subsidies that kept premiums down from 2021 through 2025 are gone, and letting last year’s plan renew on its own can lock in a January premium you never chose. Here is what changed, what it costs, and where the free help is in San Antonio.

Why your premium jumped

The enhanced premium tax credits expired on December 31, 2025 and have not been renewed. For 2027, premium tax credits are again limited to households between 100% and 400% of the federal poverty level — the old “cliff” is back. Earn $1 over 400% and there is no credit at all, not a smaller one.

2027 coverage uses the 2026 poverty guidelines:

Each additional person adds $5,680 at the 100% line.

The sticker shock is real, not a scare story: insurers have proposed further increases for 2027 — a national median of about 15% has been proposed (KFF’s review of insurer filings), and final Texas rates are set when plans post, so treat any average you see as a proposal, not your price. Your actual number is the one HealthCare.gov shows for your household — which is why checking beats assuming. (We walked through the cost increases in our 2027 Marketplace checklist.)

One more number that went up: the most a 2027 plan can make you pay in a year for covered, in-network care — the out-of-pocket maximum — is now $12,000 for an individual and $24,000 for a family, up from $10,600 and $21,200 in 2026. Your monthly premiums don’t count toward it. Many plans set their cap lower, so check the plan’s own summary before you enroll.

The Silver trap — and the Silver advantage

If your income is between 100% and 250% of the poverty level, look at Silver plans first, even if a Bronze plan shows a cheaper monthly premium.

Extra savings called cost-sharing reductions — lower deductibles, copays, and out-of-pocket maximums — apply only on Silver plans. A Bronze plan can look $50 a month cheaper and then cost hundreds more the first time you fill regular prescriptions or see a specialist. Compare the total year cost (premium × 12, plus the deductible you would realistically hit), not the monthly premium alone.

If your income is above 250%, Silver loses that special advantage — compare all metal levels on total cost, doctor network, and drug list.

Do not auto-renew this year — the 5-minute checklist

Your current plan will renew on its own if you do nothing. Before you let it:

1. Re-check your premium for 2027 — last year’s price is not this year’s price, and your credit amount changes with your income estimate.
2. Check your doctors — is your clinic still in network? In San Antonio that usually means checking University Health, Methodist, and Baptist providers against the plan’s own directory, not a brochure.
3. Check your prescriptions — drug lists (formularies) change every year; a covered drug in 2026 can move tiers or drop in 2027.
4. Update your income estimate honestly — see the tax warning below. A guess that is too low is no longer a small mistake.
5. Look at at least one other plan — carriers enter and leave the Texas market; the cheapest good fit this year may be a company you have never heard of. One change to know: Cigna Healthcare and Baylor Scott & White’s individual plans are leaving the Texas Marketplace after December 31, 2026, so if you’re with either one, you must pick a new plan for 2027 — there is nothing to renew into.

The tax-time warning nobody tells you at signup

If HealthCare.gov pays part of your premium each month (the advance premium tax credit), that amount is based on the income you estimate. At tax time it is reconciled against what you actually earned.

Starting with the 2026 tax year, the repayment caps that used to limit how much excess credit you had to pay back are eliminated. If you received more advance credit than you qualified for, you repay the full excess — there is no ceiling protecting you.

Two habits protect you: estimate your income as accurately as you can (gig and self-employed readers: use your best full-year estimate, not your best month), and report income changes to HealthCare.gov during the year — a raise, a lost contract, a spouse starting work — instead of waiting for tax season.

Free help in San Antonio — real help never charges

You do not have to do this alone, and legitimate help is free:

• HealthCare.gov — Texas uses the federal Marketplace. Enroll online, or by phone at the Marketplace Call Center: 1-800-318-2596 (TTY 1-855-889-4325).
• localhelp.HealthCare.gov — the official tool to find free in-person enrollment help near your ZIP code.
• EnrollSA — (210) 977-7997, enrollsa.com — San Antonio’s enrollment coalition. The City of San Antonio’s Access to Care page also lists The Health Collaborative and MHP Salud as organizations offering free health-insurance enrollment assistance.
• For children and pregnant people who may qualify for Medicaid or CHIP (which enroll year-round, not just in this window), the City routes families to CentroMed, CommuniCare, and University Health CareLink.

Scam warning: free enrollment help never charges a fee and never cold-calls asking for your Social Security number or bank details to “hold” a plan. If someone does, hang up and enroll through HealthCare.gov or the numbers above.

If you fall in the Texas coverage gap

Texas has not expanded Medicaid. That leaves many adults earning under 100% of the poverty level in a hard spot: too little income for Marketplace credits, and not eligible for Texas Medicaid under its current rules. This guide will not pretend a paid plan fixes that.

What can still help:

• Your children or a pregnancy may qualify even when you do not — Medicaid and CHIP rules for kids and pregnant people are broader. The same HealthCare.gov application screens for them automatically.
• Low-cost care exists in San Antonio — CentroMed and CommuniCare see patients on sliding-scale fees, and University Health’s CareLink program helps Bexar County residents who qualify.
• Dial 2-1-1 (or 877-541-7905) for local help programs — food, utility, and clinic referrals — while you are uninsured.

Not sure which side of the line your household falls on? Run our free checker first — it screens the programs Texans actually qualify for, including Medicaid and CHIP for the kids: Check what you qualify for →

And if you’d like a person to walk your options with you, our free Apply for Me program builds you a personalized guide to the benefits your family may qualify for.

Helpful links & phone numbers

• HealthCare.gov — enroll or change plans: healthcare.gov
• Find free local enrollment help: localhelp.healthcare.gov
• Marketplace Call Center: 1-800-318-2596 (TTY 1-855-889-4325)
• EnrollSA (San Antonio): (210) 977-7997 — enrollsa.com
• City of San Antonio Access to Care: sa.gov Access to Care page
• Texas 2-1-1: dial 2-1-1 or 877-541-7905 — 211texas.org
• San Antonio Benefits eligibility checker: Check what you qualify for
• Apply for Me: Apply for Me application

FAQ

What if I miss January 15?
Outside open enrollment you generally need a qualifying life event (losing coverage, marriage, a baby, a move) for a Special Enrollment Period. Medicaid and CHIP take applications all year — if your income dropped, apply anyway.

I am self-employed / gig work. What income do I put?
Your best estimate of your net household income for 2027. Because repayment caps are gone (see the tax warning above), an optimistic guess can become a real tax bill. Update it on HealthCare.gov whenever your work changes materially.

Can my kids be on CHIP while I buy a Marketplace plan?
Yes — that split is common in Texas. The HealthCare.gov application screens children for Medicaid/CHIP separately from your own Marketplace eligibility.

Is Medicare part of this?
No — Medicare has its own window (October 15 – December 7). If you are 65 or turning 65, see our Medicare open enrollment guide instead of this post.

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