See your Iowa health insurance coverage options now.

Anyone who meets the following criteria can buy Marketplace health coverage in Iowa:

• You must live in Iowa
• You must be a U.S. citizen, national, or lawfully present
• You must not be incarcerated
• You must not be enrolled in Medicare
  

Eligibility for financial assistance (premium subsidies and cost-sharing reductions) is based on your income. Moreover, to qualify for financial assistance with your Marketplace plan, you must:

• Not have access to affordable health coverage through an employer. If your employer offers coverage, but you feel it’s too expensive, use our Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies in the Marketplace. 
• Not qualify for Medicaid or CHIP.
• Not be eligible for premium-free Medicare Part A.⁶

You can sign up for an ACA-compliant individual or family health insurance in Iowa between November 1 and January 15 during open enrollment.⁷ 

Here are some key dates to remember: 

• If you enroll by December 15, your coverage starts on January 1. 
• If you enroll between December 16 and January 15, your coverage begins on February 1. 

If you miss open enrollment, you may still get coverage through the Marketplace if you have a qualifying life event. Examples of qualifying life events include loss of health coverage, gaining a dependent, or permanent relocation (assuming you already had coverage prior to the move). 

Some people can enroll in ACA Marketplace plans year-round without a specific qualifying event, including:

• Native Americans⁸
• People eligible for subsidies with income up to 150% of the poverty level.⁹ This year-round enrollment opportunity in states that use HealthCare.gov is currently available until the end of 2025, but the federal government has proposed making it permanent.¹⁰

People who lose Medicaid/CHIP between March 31, 2023 and July 31, 2024 can enroll in a Marketplace plan at any point during that time, and are not limited to the normal 60-day deadline to sign up for new coverage.¹¹

You can enroll in an Iowa health insurance Marketplace plan by:

• Visiting HealthCare.gov
• Calling 1-800-318-2596 (TTY: 1-855-889-4325). The call center is available 24 hours a day, seven days a week, but it’s closed on holidays.
  

You can also find local help from local insurance agents, brokers, certified application counselors or an approved enhanced direct enrollment entity.¹² They can review options and help you pick a plan to fit your needs. Find local help at localhelp.HealthCare.gov

You can find affordable health plans in Iowa on the ACA Marketplace (HealthCare.gov).

During the 2023 open enrollment period:

• Nearly 8 in 10 eligible enrollees qualified for premium subsidies.¹³
• Premium subsidies (called Advance Premium Tax Credits or APTC) saved Iowans about $568/month on average in 2023.¹³
• Those with subsidies paid an average premium of $105 per month.¹³
  

Source: CMS.gov¹³

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).¹⁴ CSRs help reduce deductibles and out-of-pocket expenses. Note that you must select a Silver-level plan in order to take advantage of CSR benefits.

You may also qualify for affordable Medicaid if eligible. Short-term plans are a low-cost option for people not eligible for Medicaid, Medicare, or subsidies.

As of 2022, there were more than 35,000 people in Iowa who were enrolled in individual grandfathered or grandmothered health plans.¹⁵ These plans do not have to comply with various aspects of the ACA and people enrolled in these plans cannot get the financial assistance that’s available via the Iowa Health Insurance Marketplace. If you’re enrolled in a pre-2014 health plan, it’s important to double-check your options in the Iowa Marketplace during open enrollment, to see if a newer plan might provide better coverage and/or lower premiums.

In Iowa, three companies sell plans through the exchange. Residents in most counties have access to plans from all three insurers, but there are some counties where only two of the insurers offer plans.¹

Iowa’s individual market insurers have implemented the following average rate changes for 2024,¹⁶ amounting to an overall average rate decrease of about 5.5% (before any subsidies are applied):¹⁷ 

Source: Iowa Rate Review Submissions¹⁸

Rate changes apply to full-price premiums. Since nearly 90% of eligible people using the Iowa exchange receive premium tax credits, they generally don’t pay the full premium amount.¹⁹ If you qualify for subsidies, your actual rate change will depend on your plan and the subsidy amounts. Your age can also affect your premium too. 

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

For perspective, here’s a summary of how full-price (unsubsidized) average premiums have changed in Iowa’s individual/family health insurance market over the years:

• 2015: Average increase of 11%.²⁰
• 2016: Average increase of 22.3%.²¹
• 2017: Average increase of 28.8%.²²
• 2018: Average increase of 51%.²³
• 2019: Average decrease of 7.9%.²⁴
• 2020: Average decrease of 10.8%.²⁵
• 2021: Average decrease of 0.2%.²⁶
• 2022: Average increase of 6.6%.²⁷
• 2023: Average increase of 2.3%.²⁸

During the open enrollment period for 2023 coverage, a record high for Iowa’s exchange was reached, with over 80,000 people signing up for private individual market plans.¹³

This increase in enrollment is likely due to the American Rescue Plan (ARP). Under the ARP, the ACA’s premium subsidies are more significant and widely available.²⁹ These subsidy enhancements have been extended through 2025 by the Inflation Reduction Act.

Source: 2014,³⁰ 2015,³¹ 2016,³² 2017,³³ 2018,³⁴ 2019,³⁵ 2020,³⁶ 2021,³⁷ 2022,³⁸ 2023²⁹

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. 

Iowa Insurance Division
Get information about insurance and other products regulated by the Iowa Insurance Division (IID). You can also file complaints about insurance with the IID.

Iowa Comprehensive Health Association (HIPIOWA)
If you have been denied coverage, the HIPIOWA may offer you access to health insurance. 

Iowa Senior Health Insurance Information Program (SHIIP)
Helps answer questions and provide help to Medicare beneficiaries.