For a Florida family earning well above the subsidy cliff, the best 2027 plan is usually a broad PPO such as Florida Blue’s BlueOptions, or an HSA-compatible plan that lets you save up to $9,000 tax-free. Shopping both on and off the exchange matters too, since you’ll pay full price either way. The aim is to secure the network you want and then reduce your total cost (premium plus worst-case out-of-pocket), not just the premium.
Key takeaways
- 2027 family out-of-pocket max: $24,000 for ACA plans and $17,400 for HSA-qualified HDHPs.
- 2027 family HSA limit: $9,000, plus $1,000 catch-up per eligible spouse age 55+.
- No subsidy above 400% FPL (about $132,000 for a family of four), so off-exchange plans cost the same and may offer different networks.
- BlueOptions PPO is offered for 2027 individual coverage, with out-of-network benefits and no referrals.
- The family glitch fix still stands, but it only helps households at or below 400% FPL.
Family cost limits for 2026 and 2027
| Limit | 2026 | 2027 |
|---|---|---|
| ACA out-of-pocket max (individual / family) | $10,600 / $21,200 | $12,000 / $24,000 |
| HDHP out-of-pocket max (self / family) | – | $8,700 / $17,400 |
| HDHP minimum deductible (self / family) | – | $1,750 / $3,500 |
| HSA contribution (self / family) | $4,400 / $8,750 | $4,500 / $9,000 |
| 400% FPL, family of four | About $132,000 (2026 guidelines used for 2027 coverage) | |
HealthCare.gov’s out-of-pocket maximum page confirms the 2027 $12,000 / $24,000 limits. Premiums, out-of-network care, and balance bills above the allowed amount don’t count toward the cap. That’s why the network question matters so much for families who want specific specialists.
The PPO route: BlueOptions for 2027
Florida Blue offers BlueOptions PPO for 2027 individual and family coverage. Florida Blue describes it as its largest network, with no referrals for specialists, out-of-network coverage at extra cost, and in-network access nationwide and worldwide. For a family in Jacksonville who wants Mayo Clinic Jacksonville and Baptist Health, an Orlando family that uses both AdventHealth and Orlando Health, or a Tampa household that might one day need Moffitt, that flexibility can be worth the higher premium. Plan designs and participating providers vary by county, so confirm every doctor and hospital before you enroll. Our guide to the best PPO health insurance in Florida for top hospitals compares the options.
Other 2027 Florida individual carriers include Ambetter from Sunshine Health, Oscar, UnitedHealthcare, AvMed, AmeriHealth Caritas, and Florida Blue’s myBlue HMO and BlueSelect. Cigna and Molina are leaving the individual market, so if your family is on one of those plans, plan to switch.
The HSA route: lower premiums, tax-free savings
A family on an HSA-compatible plan can contribute up to $9,000 in 2027. Since Jan. 1, 2026, Bronze and catastrophic plans also count as HSA-compatible. For higher-income families, the tax deduction and tax-free investment growth can offset a higher deductible. Families that don’t use much care, or that have cash reserves, often come out ahead. See our HSA wealth-building guide for high earners.
Pediatric dental: don’t skip the checkbox
According to HealthCare.gov’s dental coverage page, dental coverage is an essential health benefit for children 18 and under. It must be available either built into the health plan or as a separate dental plan. You aren’t required to buy it, and a Marketplace dental plan can only be purchased together with a health plan. Many families choose a separate dental plan for broader adult and child benefits. Ask whether your medical plan already includes pediatric dental so you don’t pay for it twice.
The family glitch fix: still in place
The 2022 IRS rule that fixed the “family glitch” is still in effect. The IRS premium tax credit Q&A says affordability for family members is based on what the employee pays to cover the whole family, not just the employee’s self-only premium. For 2027 the affordability threshold is 10.22% of household income. If one spouse’s employer family coverage costs more than that, the other spouse and the children may qualify for Marketplace tax credits. For high-income households, there’s a catch: those credits still stop at 400% FPL. A family of four earning $125,000 might benefit. A family earning $250,000 won’t.
On-exchange vs. off-exchange
Above 400% FPL you won’t get a subsidy anywhere, so the choice comes down to plans and networks. Off-exchange ACA plans carry the same protections, including coverage for pre-existing conditions. Some carriers sell PPO networks or plan designs only off-exchange. Florida Blue, for example, says some of its plans aren’t on HealthCare.gov and are sold only through agents. If your income could fall below 400% FPL during the year, staying on-exchange keeps the door open to tax credits. Our on-exchange vs. off-exchange comparison for high earners goes deeper.
Private, medically underwritten plans can sometimes cost less for a very healthy family. They may exclude pre-existing conditions and lack ACA protections, so look at them carefully and only next to ACA quotes.
A hypothetical example
Hypothetical, for illustration only. Picture a DeLand family of four (parents 44 and 42, kids 12 and 9) with household income of $300,000. That’s well above the $132,000 cliff, so they pay full price. They compare two 2027 options:
- Option A, PPO: lower deductible and out-of-network benefits. Assume premiums run $5,000 a year more than Option B.
- Option B, HSA-qualified HDHP: family out-of-pocket max no higher than $17,400. The family contributes the full $9,000 to an HSA. At an assumed 24% federal marginal rate, that saves about $2,160 in federal income tax.
In a low-use year, Option B comes out roughly $7,000 ahead ($5,000 in premium plus about $2,160 in tax savings), and the HSA keeps growing. In a high-use year, the out-of-network benefit and lower deductible on Option A may matter more, especially if a child needs a specialist outside the HDHP’s network. These numbers are hypothetical. Real premiums depend on carrier, county, and ages.
Frequently Asked Questions
What is the family out-of-pocket maximum for 2027?
ACA plans can’t charge more than $24,000 in in-network out-of-pocket costs for a family in 2027, up from $21,200 in 2026. An HSA-qualified HDHP has a lower cap of $17,400 for family coverage in 2027. Premiums and out-of-network care don’t count toward either limit.
Does the family glitch fix still apply in 2027?
Yes. Under current IRS rules, a family member’s employer coverage is judged by what the employee would pay for family coverage, not just the employee’s own premium. If that cost is unaffordable (above 10.22% of household income for 2027), family members may qualify for Marketplace tax credits, as long as household income is at or below 400% FPL.
Do I have to buy pediatric dental coverage?
Pediatric dental is an essential health benefit, so it must be offered, either built into the health plan or as a separate dental plan. HealthCare.gov notes that you don’t have to buy it, and that a Marketplace dental plan has to be purchased along with a health plan.
Is off-exchange coverage less protective than HealthCare.gov plans?
No. Off-exchange ACA plans carry the same ACA protections, including coverage for pre-existing conditions. The difference is that subsidies aren’t available off-exchange, and some carriers offer networks or plans you can only get off-exchange.
Compare family PPO and HSA options for 2027
Open Enrollment runs Nov. 1, 2026 to Jan. 15, 2027. Enroll by Dec. 15 for a Jan. 1 start. We’ll check your family’s doctors and hospitals against on- and off-exchange plans and show you the total cost of each. Michael McAllister, owner of Choice Health Insurance Brokers in DeLand, is a licensed health insurance broker (NPN 18229135) with 10 years in business. He is appointed with 200 carriers and quotes on- and off-exchange, public and private plans. Call or text 321-230-9536 or visit choice.healthcare to get a side-by-side quote. For HSA tax questions, talk with your CPA.