Kansas health insurance Marketplace guide

You must meet certain criteria to qualify for health coverage through the Marketplace in Kansas. Generally, you’re eligible to apply if you:³

• Live in Kansas and are lawfully present in the U.S.
• Are not incarcerated
• Are not enrolled in Medicare

By those standards, most Kansas residents can use the Marketplace. But eligibility for financial assistance is also an important factor. To be eligible for income-based subsidies, you must:

• Not be eligible for affordable, comprehensive employer-sponsored health insurance
• Not be eligible for KanCare (Medicaid/CHIP)
• Not be eligible for premium-free Medicare Part A.⁴
• If married, file a joint tax return.⁵
• Not be able to be claimed by someone else as a tax dependent.⁵

To buy an ACA-compliant individual or family health insurance in Kansas, sign up between November 1 and January 15 during open enrollment. 

Enroll by December 15 for your coverage to become effective on January 1. But if you enroll from December 16 to January 15, your coverage will start on February 1.⁶

The open enrollment period will be shorter, however, starting in the fall of 2026. From that point on, the enrollment window will end on December 15, and all plans selected during open enrollment will take effect on January 1.

Outside of open enrollment, you can get coverage through the Marketplace if you have a qualifying life event that triggers a special enrollment period (SEP).⁷

Examples of qualifying life events include loss of health coverage, getting married, or permanent relocation (marriage and a permanent move will only trigger a special enrollment period if you already had coverage in place before the life event; for marriage, at least one spouse must have already had coverage). Learn more about special enrollment periods.

American Indians and Alaska Natives can enroll in an ACA exchange plan year-round.

If you’re eligible for an ACA Marketplace plan, there are a few ways to enroll, with or without free assistance: 

• Online through HealthCare.gov
• By phone at (800) 318-2596
• With the help of an agent/broker, navigator, or certified application counselor (help is available online, over the phone, or in person)
• Via an approved enhanced direct enrollment entity.⁸

In Kansas, you can find affordable individual and family health insurance through HealthCare.gov – the ACA Marketplace. 

Of the roughly 200,000 people who enrolled in coverage through the Kansas Marketplace for 2025, more than 187,000 were eligible for premium subsidies (advance premium tax credits, or APTC) that averaged $580/month. After the subsidies were applied, the average subsidy-eligible Kansas Marketplace enrollee was paying about $73/month for their coverage.⁹

In addition to APTC, if your household income isn’t more than 250% of the federal poverty level, you may also be eligible for cost-sharing reductions (CSR), as long as you select a Silver-level plan in the Marketplace.¹⁰ CSRs help reduce deductibles and out-of-pocket expenses. 

Source: CMS.gov⁹

You may also find affordable coverage through Medicaid (KanCare) if you’re eligible.

Kansas has not yet implemented the ACA’s expansion of Medicaid for low-income adults. However, children may be eligible for Medicaid or CHIP even if their parents aren’t. For certain families, enrolling children in Medicaid or CHIP while parents get coverage through the Marketplace can be an affordable way to obtain family coverage.  

Kansas had been considering changes to its essential health benefits (EHB) benchmark plan starting with the 2025 plan year (recommendations included coverage of hearing aids, bariatric surgery, and applied behavior analysis for autism).¹¹ But appropriations legislation enacted in 2023¹² prohibited the state from using any funds to make changes to the EHB benchmark plan. As a result, the state halted the process of changing its EHB benchmark plan.¹³

For 2026, six insurers offer plans through the Kansas health insurance Marketplace:²

• Ambetter from Sunflower Health Plan/Celtic
• Blue Cross and Blue Shield of Kansas City
• Blue Cross and Blue Shield of Kansas
• Medica Insurance Company
• Oscar Insurance Company
• UnitedHealthcare

This is down from seven in 2025, with the exit of Aetna at the end of 2025. Aetna is exiting the individual market in all states where it offers that coverage. Kansas residents with individual Aetna coverage will need to select a plan from a different carrier during the open enrollment period that begins November 1, 2025.

For 2026, the following average rate changes have been proposed by the insurers that offer coverage in the Kansas Marketplace,² amounting to a weighted average proposed increase of 30.5%, before subsidies are applied:¹⁴

Source: Federal Rate Review Summary¹⁵ 

Rate changes apply to full-price premiums. Since most people using the Kansas exchange receive premium tax credits, they don’t pay the full premium amount.¹⁶ If you qualify for subsidies, your actual rate change will depend on how your plan’s premium changes, but also how your subsidy amount changes.

For 2026, subsidies will shrink and be available to fewer people unless Congress takes action to extend the federal subsidy enhancements that have been in effect since 2021. If Congress doesn’t do anything, the subsidy enhancements will expire at the end of 2025, resulting in substantial increases in the amount that people have to pay for their Marketplace coverage.

If the cost of your current plan increases, you can explore other health plans in the exchange that may be more affordable and offer comparable benefits.

For perspective, here’s a summary of how overall average premiums have changed over the years for the individual/family market in Kansas, before any subsidies were applied:

• 2015: Average increase of 4%¹⁷
• 2016: Average increase of 23%¹⁸ (carrier with largest rate increase ultimately left the market)
• 2017: Average increase of 36.6%¹⁹
• 2018: Average increase of 29%²⁰ (BCBSKS rate change wasn’t counted because their plans (HMOs) were terminated and replaced with EPOs) 
• 2019: Average increase of 5.3%²¹
• 2020: Average increase of 0.3%²²
• 2021: Average increase of 7.8%²³ (unweighted average)
• 2022: Average increase of 6%²⁴ (unweighted average)
• 2023: Average increase of 7.2%²⁵
• 2024: Average increase of 7.3%²⁶  
• 2025: Average increase of 8.9%²⁷

During the open enrollment period for 2025 coverage, a significant new record high enrollment was reached in Kansas, with 200,046 people signing up for private plans through the Kansas Marketplace.²⁸

As with many states, Kansas has seen substantial growth in Marketplace enrollment over the last several years (see the graph below that shows year-by-year enrollment).

The recent increase in enrollment is due in large part to the American Rescue Plan (ARP). Under the ARP, ACA’s premium subsidies are larger and more widely available. ARP has been extended through 2025 by the Inflation Reduction Act.²⁹ But as noted above, the subsidy enhancements will expire at the end of 2025 unless Congress takes action to extend them.

The enrollment growth in 2024 and 2025 was also partially due to the Medicaid disenrollments that resumed in 2023, after being paused for three years during the pandemic. CMS reported that more than 31,000 Kansas residents transitioned from Medicaid to Marketplace coverage during the Medicaid continuous coverage “unwinding” period that began in the spring of 2023.³⁰

Source: 2014,³¹ 2015,³² 2016,³³ 2017,³⁴ 2018,³⁵ 2019,³⁶ 2020,³⁷ 2021,³⁸ 2022,³⁹ 2023,⁴⁰ 2024,⁴¹ 2025²⁸

Healthcare.gov: This is the ACA Marketplace where you can enroll in a health insurance plan online. You may also get help by calling (800) 318-2596. 

Kansas Insurance Department: Call the Consumer Assistance Hotline at (800) 432-2484 in Kansas or (785) 296-7829 if out of state. 

Senior Health Insurance Counseling for Kansas (SHICK): SHICK offers help with questions about Medicare.  

Medicaid (KanCare): Though Kansas has not expanded Medicaid, certain people who meet the income limits may qualify.