Open enrollment is almost here, making this a good time to take a fresh look at your health coverage. Even if you’re happy with your current plan, costs, benefits, provider networks and prescription drug coverage can change from year to year.
Taking time to review your options can help you avoid surprises and choose coverage that fits your healthcare needs and budget.
Know Your Marketplace and Enrollment Dates
Washington, D.C., Maryland and Virginia each operate their own state-based Health Insurance Marketplace. Residents should use their jurisdiction’s official Marketplace, rather than HealthCare.gov, to compare plans, apply for financial assistance and enroll in coverage.
Open enrollment periods for 2027 coverage are:
- Washington, D.C.: November 1, 2026–January 31, 2027. Visit DC Health Link.
- Maryland: November 1, 2026–January 15, 2027. Visit Maryland Health Connection.
- Virginia: November 1, 2026–January 29, 2027. Visit Virginia’s Insurance Marketplace.
Deadlines for coverage to begin on a specific date vary. Review the information provided by your Marketplace and enroll as early as possible.
Start Reviewing Your Coverage Early
CareFirst BlueCross BlueShield (CareFirst) serves communities across Washington, D.C., Maryland and Northern Virginia. Plan availability may vary by location.
Before open enrollment begins, review your current plan and consider what may have changed during the past year. This could include your household size or composition, medications or expected health care needs.
When comparing plans, look beyond the monthly premium. Review the deductible, provider network, prescription drug coverage and other possible out-of-pocket costs.
You should also consider each plan’s metal level: Bronze, Silver, Gold or Platinum. Metal levels describe how healthcare costs are shared between the plan and its members. They do not reflect the quality of care or size of a plan’s provider network. All Marketplace plans cover the same essential health benefits.
In general:
- Bronze plans have lower monthly premiums but higher out-of-pocket costs when you need care.
- Silver plans fall in the middle and may provide additional savings on deductibles, copayments and coinsurance for eligible individuals.
- Gold and Platinum plans have higher monthly premiums but lower out-of-pocket costs when you receive care.
For 2027, consumers may see new income and eligibility checks, changes to premium tax credit eligibility and more variation in plan designs and costs. Update your household and income information, respond to any requests for documentation and carefully compare your available options.
Each Marketplace offers tools to help you compare plans based on benefits, costs, preferred doctors and prescription drugs. Visit DC Health Link, Maryland Health Connection, and Virginia Health Exchange to explore your options.
Health Insurance Terms to Know
Understanding a few common health insurance terms can make it easier to compare plan benefits, estimate your potential costs and choose coverage that fits your needs.
Costs
Premium: The amount you pay each month for health insurance coverage. Premium payments do not count toward your deductible or out-of-pocket maximums.
Deductible: Depending on your plan, the amount you pay for certain services before your plan starts helping with the cost of your care.
Copayment: A fixed dollar amount you pay for a covered service, such as a doctor’s visit or prescription medication.
Coinsurance: The percentage or dollar amount you pay for covered services. Depending on your plan, you may need to reach your deductible before paying coinsurance.
Out-of-pocket maximum: The maximum amount you pay in coinsurance, copayments and deductibles for covered in-network services during a benefit period. Once you reach this limit, your CareFirst plan pays 100% of the allowed amount for covered in-network services for the rest of the benefit period.
Provider Networks
Provider network: The doctors, hospitals, labs, pharmacies and other providers or facilities that participate in your health plan.
In-network: Providers or facilities that participate in your health plan’s network. Using in-network providers can help lower your out-of-pocket costs.
Out-of-network: Providers or facilities that do not participate in your health plan’s network. Depending on your plan, these services may not be covered. You may need to pay the difference between the provider’s price and the maximum amount CareFirst will pay.
Plan Types
Health Maintenance Organization (HMO): A health plan that generally covers care only from in-network providers, except in emergencies. Depending on your plan, you may need to choose a primary care provider and get a referral to see a specialist.
Preferred Provider Organization (PPO): A health plan that lets you use in-network or out-of-network providers, though you generally pay less for in-network care. You typically do not need a referral to see a specialist.
Other Terms
Allowed benefit (also called the CareFirst member cost): The maximum amount an in-network provider can charge a CareFirst member for a specific service.
Formulary: A list of brand-name and generic prescription drugs covered by a health plan.
How CareFirst Can Help
CareFirst wants to make it easier for individuals and families to choose health coverage. Members can use CareFirst resources to review plan details, understand their benefits, find in-network providers and learn more about prescription drug coverage.
For additional support, members can explore the following attached resources:
Reviewing your coverage early and using the available resources can make open enrollment easier. Taking these steps can help you choose a plan that meets your healthcare needs and fits your budget.