My health insurance company is leaving my market. What can I do?

How widespread were carrier exits for 2026?

In addition to Aetna’s exit, the following insurers left the individual market and/or Marketplace at the end of 2025 in the following states:

• Illinois: Health Alliance and Quartz⁵
• Kentucky: CareSource⁶
• Michigan: Molina⁷ and UM Health Plan/Michigan Care⁸
• Mississippi: Primewell Health Services⁹
• North Carolina: Celtic/Wellcare ¹⁰
• Ohio: AultCare¹¹
• Wisconsin: Molina⁷ and Chorus Community Health Plan¹²
• Wyoming: Mountain Health CO-OP¹³

In addition to the full market exits described above, Blue Cross Blue Shield of Arizona terminated Marketplace PPOs at the end of 2025.¹⁴ BCBSAZ continues to offer HMOs, but PPO enrollees had to select new plans.

And as is always the case, there were also some Marketplace insurers that changed their coverage areas for 2026. So while a carrier might continue to offer plans in a given state, some enrollees have to select new coverage because the insurer stops offering plans in a particular area. This is the case, for example, with Cigna in Illinois for 2026: Cigna is still offering Marketplace plans, but not in Cook County.¹⁵ So Cook County residents with Cigna Marketplace plans in 2025 had to select new coverage for 2026.

My health insurance company is leaving the market in my area. What do I need to do?

If you have an individual/family plan and your insurer leaves the market in your area, you need to select a new health plan. The termination of your old plan will trigger a special enrollment period that will allow you to sign up for a new individual/family plan. The special enrollment period will allow you to have uninterrupted coverage as long as you pick a new plan no later than the last day that your old plan is in effect (assuming the old plan ends on the final day of a month).

Your special enrollment period will also continue for 60 days after the old plan ends. But if you enroll during that window, you'll have a gap in coverage, as the new plan will not be retroactively effective. Coverage will take effect as early as the first of the month following your enrollment.

Note: If you have Marketplace (exchange) coverage that's terminating at the end of the year, the Marketplace will likely auto-enroll you into a replacement plan if you don't select your own new plan. You'll still have a 60-day special enrollment period that starts on January 1, during which you can pick a new plan. If you use that opportunity, the policy you choose will take effect on the first day of the month after you select it. So for example, if the Marketplace auto-enrolls you into a new policy and you then pick your own new policy on February 5, you'll have the auto-selected coverage for January and February, and then the policy you picked will take effect on March 1.

(If an employer-sponsored health plan is available to you, the loss of your individual/family plan would trigger a special enrollment period for the employer-sponsored plan. The rules are different for SEPs for employer-sponsored health plans.)

How do I choose a new exchange plan?

If your insurer is leaving the market, you'll need to pick a new health plan. Here are some tips for picking the plan that will best fit your needs and budget. If you're undergoing treatment for a health condition, you'll want to make sure that the new plan includes your doctors in its network and your prescriptions in its formulary.

In most cases – including the Aetna/CVS exit and all of the other end-of-2025 carrier exits listed above – carriers exit the market at the end of the year. So you'd have been starting over with a new deductible and out-of-pocket maximum on January 1, even if your plan had been able to renew. (All ACA-compliant individual/family health plans follow the calendar year.)

If your carrier is leaving the market mid-year, you'll need to prepare yourself for the fact that you'll likely be starting over at $0 in out-of-pocket spending when your new plan takes effect. But mid-year carrier exits have been very uncommon in the ACA-compliant individual market.

When can I enroll in a new plan if my carrier is exiting the market?

Your special enrollment period starts 60 days before your plan ends and continues for 60 days after it ends. In most cases, this is centered around the end/start of the new calendar year. But if your carrier is exiting the market mid-year, your special enrollment period will depend on when your plan ends.

Regardless of whether the carrier exits the market at year-end or mid-year, you need to enroll in a new plan before your old plan ends, to have uninterrupted coverage. If you enroll during the 60 days after your plan ends, you'll have a gap in coverage, as the new plan will not have a retroactive effective date. As noted above, if you don't pick a new plan before the end of the year and the Marketplace automatically enrolls you into a replacement policy, you won't have a gap in coverage. But if you subsequently pick a new plan in the first 60 days of the year, it won't take effect until the first of the month after you choose it.

Will I still receive a premium subsidy if my carrier exits the market?

If you choose a new plan through the Marketplace, you may be required to prove your ongoing eligibility for a subsidy during the process of updating your enrollment application. You should remain eligible for a subsidy if none of your circumstances have changed (income, dependents, employment benefits, etc.) However, the amount you pay each month will likely change, depending on the cost of the new plan you select.

And if the new plan takes effect on January 1, the amount of your subsidy will also change if the price of the benchmark plan in your area has changed for the new year. Here's how the premium subsidy math works, and here's a subsidy calculator you can use.

Do I still need to pay my premium if my carrier is exiting the market?

Yes, you need to continue to pay premiums when they're due in order to keep your coverage. In most cases, carrier exits happen at the end of the year, so you'll pay your premiums through December 31. (If you stop paying your premiums, your policy will terminate once your grace period ends.)

Should I let my exchange auto-enroll me in a new health plan if my carrier is exiting the market?

In general, no. If your carrier is exiting the market at the end of the year, it's generally an option to let the exchange automatically select a new plan for you that will start on January 1. But it may not be in your best interest to rely on the exchange's algorithm. Instead, you may be better served by selecting your own replacement plan that most closely meets your needs.

If your insurer is leaving the market mid-year, the exchange might not have a mechanism for automatic re-enrollment mid-year. Therefore, it is important to understand the options available to avoid becoming uninsured. Again, this scenario has been quite rare in the ACA-compliant individual market, but it has happened a few times, including the closure of some CO-OPs and Friday Health Plans.¹⁶

If your carrier exits the market on December 31, here's how the automatic re-enrollment process works if you don't select your own replacement plan by December 31:

• If you bought your existing coverage through the Marketplace in your state, the exchange will select a new plan for you if you don't take any action. The protocol that’s used in most states essentially moves people to the lowest-cost plan that has the same metal level , product type (HMO, EPO, PPO, or POS), and provider network as the plan that’s terminating.
• If you obtained your existing coverage outside the exchange, there is no entity that can automatically select a new plan for you if your insurer is leaving the market. If you don’t pick your own replacement plan, you’ll be uninsured on January 1. If your carrier has been bought by another carrier, the new carrier may transition you to one of their plans.

But again, even if you have a plan that you obtained through the exchange, you may not want to rely on the exchange to pick a new plan for you using an automatic algorithm. They won’t be able to prioritize the coverage aspects that are most important for you, which might include having an HSA-eligible plan (note that this includes all Bronze and Catastrophic Marketplace plans as of 2026) or a certain out-of-pocket structure.