PhysEmp Insights

The benefits portal is open on your phone between pages, the enrollment deadline is close, and the screen wants three answers: which medical tier, whether to fund an HSA, and whether to add anything beyond the program’s group disability plan. It is easy to click through in four minutes and keep last year’s choices. On a resident stipend, those clicks are some of the biggest money decisions you make all year, which is why benefits sit next to pay in our guide to surviving residency. This post takes the three choices in the order you will meet them. It is general education, not tax, insurance or financial advice.

A PGY-1 who is the only earner for a family of four described this exact problem on Reddit recently: the program’s family plan costs several hundred dollars a month, and they wanted to know what cheaper options exist. Before you accept that number, collect three figures: your monthly premium for each tier, the deductible, and the out-of-pocket maximum. Then check the alternatives that are open right now.

Open enrollment for 2027 Marketplace coverage started November 1 in most states, and the subsidy rules have changed. According to KFF’s 2027 open enrollment preview, the enhanced premium tax credits expired in 2026, and households above 400% of the federal poverty level no longer qualify for any premium tax credit. A large single-income household on a resident salary may still fall under that line, so enter your real household size and income on your state’s marketplace site instead of assuming you’re priced out.

Then ask the benefits office two questions in writing: “Does the program’s plan count as affordable coverage for my spouse and children under ACA rules?” and “Is there a lower-premium tier or a high-deductible option for dependents only?” If your children might qualify for your state’s CHIP program, ask the state Medicaid office directly. The answers decide whether you’re comparing one plan or three.

If you pick a high-deductible plan, the IRS limits are already set. The 2026 and 2027 figures are $4,400 self-only and $8,750 family for 2026, rising to $4,500 and $9,000 for 2027. To qualify, the plan’s deductible must be at least $1,700 self-only or $3,400 family in 2026, and $1,750 or $3,500 in 2027.