Where pilots get coverage
The 2027 premium tax credit ends at 400% of the poverty level: $63,840 for one person, $86,560 for a couple and $132,000 for a family of four. Captains and senior first officers earn well above it, so most pilots who buy their own plan pay full price.
| How you fly | Typical coverage | Watch for |
|---|---|---|
| Airline (union contract) | Group plan negotiated in the contract | What happens on furlough, leave or a change of base |
| Corporate flight department | Employer group plan | Networks near your home, not just the hangar |
| Contract or charter pilot (1099) | Individual plan plus the self-employed deduction | Coverage while on multi-day trips away from home |
| Furloughed or between airlines | COBRA; individual plan; spouse's plan | The 60-day enrollment windows |
| Retired before 65 | Retiree plan if offered; individual plan; COBRA | Bridging to Medicare and managing income |
Medical certificates and health insurance are separate
Your FAA medical certificate and your health insurance are unrelated: no health plan protects your certificate, and choosing a plan does not report anything to the FAA. What you disclose on your medical application is governed by FAA rules. If you have questions about how seeking care interacts with certification, talk to an aviation medical examiner or your union's aeromedical resources.
Income protection is also separate. Loss-of-license insurance pays if you lose your medical certificate, and disability insurance replaces income if you cannot work. Health insurance pays medical bills only.
Two examples
Illustrative examples using 2027 averages, not quotes.
Furloughed first officer in Atlanta. A 50-year-old with a 48-year-old spouse and two children loses airline coverage in April. Their 2027 income will still be above the $132,000 family cutoff, so they compare COBRA with a full-price individual plan. Benchmark Silver for this household averages $2,840/month in Georgia. If the deductible is already mostly met on the airline plan, COBRA can win for the rest of the year; otherwise the individual plan usually costs less.
Contract jet pilot in Colorado Springs. A 44-year-old flies on 1099 contracts and buys an HSA-eligible plan at roughly $672/month (Colorado 2027 average benchmark, age 44). Premiums are deductible against contract income, and a $4,500 HSA contribution covers routine costs between trips.
What 2027 coverage costs by state
| State | Benchmark Silver, two adults age 50 + 2 children | Per year | Where you enroll |
|---|---|---|---|
| Texas | $2,855/mo | $34,260 | HealthCare.gov |
| Georgia | $2,840/mo | $34,080 | Georgia Access |
| Florida | $2,859/mo | $34,308 | HealthCare.gov |
| Colorado | $2,383/mo | $28,596 | Connect for Health Colorado |
| Illinois | $2,739/mo | $32,868 | Get Covered Illinois |
| North Carolina | $2,557/mo | $30,684 | HealthCare.gov |
| Nevada | $2,189/mo | $26,268 | Nevada Health Link |
| Utah | $2,774/mo | $33,288 | HealthCare.gov |
| U.S. average | $2,727/mo | $32,724 | — |
Full price before any tax credit, 2027 state averages (KFF) adjusted with the federal age curve. Your county, carrier and metal level change the real number; PPO and Gold plans usually cost more.
State notes for pilots
- Price spread: in this list, Florida has the highest 2027 average benchmark ($738/month at age 40) and Nevada the lowest ($565). Moving or splitting time between states can change your premium more than switching carriers.
- No state income tax: Texas, Florida, Nevada. The self-employed health insurance deduction only saves federal tax there, so the after-tax cost is a little higher than in states with an income tax.
- State-run marketplaces: Georgia (Georgia Access), Colorado (Connect for Health Colorado), Illinois (Get Covered Illinois), Nevada (Nevada Health Link) run their own enrollment sites and can set their own deadlines. Everywhere else in the list uses HealthCare.gov.
- Domicile versus home: individual plans follow where you live, not your crew base. Commuting pilots should check the network at home and how the plan covers urgent care on the road.
Deductions and HSAs for contract pilots
For 2027 an HSA-eligible plan must have a deductible of at least $1,750 (self-only) or $3,500 (family). You can then contribute up to $4,500 or $9,000 a year, plus $1,000 if you are 55 or older. Contributions are deductible, growth is tax-free and withdrawals for qualified medical costs are tax-free, so a healthy high earner can treat the account as a second retirement account.
Which plan type fits pilots
| Plan type | How it works | Best fit |
|---|---|---|
| PPO | In- and out-of-network coverage, no referrals; usually the highest premium | Commuting pilots who need routine care in more than one city. |
| EPO | In-network only except emergencies, usually no referrals; lower premium | Pilots whose family lives and gets care near one hospital system. |
| HSA-eligible plan | Deductible of at least $1,750 / $3,500 in 2027; unlocks an HSA | Contract pilots in good health who want the lowest premium and the HSA deduction. |
| Gold or Platinum | Higher premium, lower deductible and coinsurance | Families with ongoing specialist care or a planned procedure. |
The label matters less than the specific network. Two PPOs from different carriers can include very different hospitals, so check your doctors by name for the 2027 plan year.
What pilots should check in a plan
- Care away from home: many individual plans are EPOs that cover only emergencies out of area.
- Sleep, cardiology and eye care: make sure the specialists you would use are in network.
- Mental health access: confirm in-network therapists who are actually taking patients.
- Prescription formulary: check each medication and any prior-authorization rules.
2027 enrollment dates
For 2027 coverage, Open Enrollment runs November 1, 2026 to January 15, 2027 on HealthCare.gov. Enroll by December 15 for coverage starting January 1; enrollments from December 16 to January 15 start February 1. State-run marketplaces can set different deadlines. Outside Open Enrollment you need a qualifying event, such as losing other coverage, moving, marriage or a new child, which opens a 60-day Special Enrollment Period. Plans bought directly from an insurer off the marketplace follow the same windows. Renewing? Compare again: networks, formularies and prices change every year, and staying put is rarely the cheapest choice.
Frequently Asked Questions
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Sources: IRS Rev. Proc. 2026-26 (2027 premium tax credit table) and Rev. Proc. 2026-24 (2027 HSA limits); 2026 HHS poverty guidelines; KFF, 2027 average benchmark premiums by state. Premium figures are averages for planning, not quotes. Examples are illustrative. Tax rules depend on your situation; confirm with your tax advisor.