Utah health insurance Marketplace guide

Most people in Utah can buy health insurance through the exchange. Marketplace health coverage is available if you meet the following criteria:⁴

• You must be a resident of Utah.
• You must be lawfully present in the U.S.
• You can’t be incarcerated.
• You must not be enrolled in Medicare.

Whether or not you qualify for financial assistance with your premium, deductible, or out-of-pocket costs depends on your income and how it compares with the cost of the second-lowest-cost Silver plan in your area. 

Additionally, to qualify for financial assistance, you must: 

• Not have access to affordable health coverage through an employer. If you think your employer-sponsored health plan is too expensive, use our Employer Health Plan Affordability Calculator to check if you qualify for premium subsidies in the Marketplace. 
• Not be eligible for Medicaid or CHIP in Utah, or for premium-free Medicare Part A.⁵ 
• If married, file a joint tax return.⁶
• Not be able to be claimed by someone else as a tax dependent.⁶

In Utah, the open enrollment window to sign up for ACA Marketplace individual and family health plans runs from November 1 to January 15.⁷

For coverage to start on January 1, enroll by December 15. Enrolling between December 16 and January 15 will push your coverage start date to February 1.

But starting in the fall of 2026, due to a federal regulation finalized in 2025, the open enrollment period will be shorter. In Utah, the open enrollment window will run from November 1 to December 15, and all plans selected during open enrollment will take effect January 1.

Outside of open enrollment, you can only sign up for coverage (through the exchange or directly through an insurance company) if you have a special enrollment period (SEP). In most cases, this means you need to have a qualifying life event. But American Indians and Alaska Natives can enroll at any time.

You have a few ways to enroll in a Marketplace health plan in Utah:

• Online: Go to HealthCare.gov. This is the federal Marketplace website that also lets you shop around for plans. You can also enroll in a Utah Marketplace plan via an EDE entity approved to offer coverage in Utah.⁸
  
• By Phone: Call 1-800-318-2596 (TTY: 1-855-889-4325) to talk to a representative over the phone. The call center is available 24 hours a day, seven days a week, except holidays.
  
• In-person: Get help from a licensed insurance agent, navigator, or certified application counselor in your area. Look for assistance at localhelp.HealthCare.gov. Call 2-1-1 or visit takecareutah.org.

No matter which of the above methods you use, you’ll still purchase your health plan through HealthCare.gov (or an approved EDE) since Utah uses the federally-facilitated Marketplace. The website will walk you through the application process and determine your eligibility for financial assistance.

People in Utah who enroll in a Marketplace plan (accessed at HealthCare.gov) can be eligible for two different types of financial assistance, depending on their household income:

• Premium tax credits (premium subsidies): If you sign up on HealthCare.gov, you may qualify for financial assistance called Advance Premium Tax Credits (APTC) to lower your monthly premiums. Of the people who enrolled through the Utah Marketplace during the open enrollment period for 2025 coverage, nearly 96% qualified for APTC. The average APTC amount was $463/month. For subsidy-eligible enrollees, this reduced the average net premium to just $52/month.⁹
• Cost-sharing reductions (CSR): If your household income is no more than 250% of the federal poverty level, you can also receive cost-sharing reductions (CSR) assistance, as long as you select a Silver-level plan. CSRs reduce your deductible and out-of-pocket expenses, which means you can get the care you need at an affordable cost. 

Source: CMS.gov⁹

Medicaid: Check if you’re eligible for Medicaid by going online to HealthCare.gov or through medicaid.utah.gov.¹⁰

For 2026, six insurers will offer Marketplace coverage in Utah, with varying coverage areas:²

• BridgeSpan Health Company
• Regence BlueCross BlueShield of Utah
• SelectHealth
• University of Utah Health Plans
• Imperial Health Plan of the Southwest
• Molina Healthcare of Utah

This is down from seven in 2025,¹¹ as Aetna is exiting the individual market (nationwide) at the end of 2025. In addition, Molina is exiting most of the counties where it offers coverage in Utah in 2025, and will only continue to offer coverage in two southwest Utah counties.¹²

Utah Marketplace enrollees whose carrier is exiting the market in their area will need to select a plan from a different insurer during the open enrollment period for 2026 coverage.

The following average rate changes have been proposed for 2026 by Utah’s Marketplace insurers,¹³ amounting to a weighted average premium increase of 14.2%¹⁴ (calculated before subsidies are applied).

Source: Federal Rate Review Database¹³ and Utah Insurance Department¹⁵

Although the weighted average proposed premium increase is about 14% for 2026,¹⁴ it’s important to understand that only applies to full-price premiums. Most enrollees qualify for premium subsidies, and thus don’t pay full price. But if Congress doesn’t extend the federal subsidy enhancements that have been in effect since 2021, they will expire at the end of 2025. If that happens, after-subsidy premiums will increase significantly in 2026, and some people will lose their subsidies altogether. 

For perspective, here’s how average full-price premiums have changed in Utah’s individual/family market in previous years:

• 2015: Average increase of 5%¹⁶
• 2016: Average increase of 25%¹⁷
• 2017: Average increase of 31.7%¹⁸
• 2018: Average increase of 39.5%¹⁹
• 2019: Average increase of 0.5%²⁰
• 2020: Average decrease of 2.3%%²¹
• 2021: Average rate changes ranged from -7% to +3%²²
• 2022: Average increase of 1%²³
• 2023: Average increase of 6%²⁴
• 2024: Average increase of 11.4%²⁵
• 2025: Average increase of 10.4%²⁶

During the open enrollment period for 2025 coverage, 421,890 people enrolled in private plans through Utah’s health insurance Marketplace.²⁷

This was a new record high, on the heels of several consecutive years of record high enrollment. The graph below shows enrollment over time in Utah’s exchange. The sharp increase in enrollment in recent years has been driven in large part by the subsidy enhancements under the American Rescue Plan and Inflation Reduction Act, which made Marketplace plans more affordable. The enrollment increases for 2024 and 2025 were also partially driven by Medicaid disenrollments, which resumed in 2023. Some people who are no longer eligible for Medicaid have obtained coverage in the Marketplace instead.

Source: 2014,²⁸ 2015,²⁹ 2016,³⁰ 2017,³¹ 2018,³² 2019,³³ 2020,³⁴ 2021,³⁵ 2022,³⁶ 2023,³⁷ 2024,³⁸ 2025²⁷

HealthCare.gov
The official federal website where you can sign up for health insurance plans through the ACA Marketplace. 

Utah Insurance Department
Oversees and licenses health insurance companies, brokers, and agents, offering information and help for various health insurance concerns. 

Utah Health Insurance Transparency; Latest Rate Changes
Shows rate and plan filings that insurers have submitted for review by state regulators.

Utah Senior Services
Supports Medicare beneficiaries by providing assistance, information, and valuable resources.

Take Care Utah
An initiative aimed at helping Utah residents understand and access health insurance options, including the ACA Marketplace and Medicaid.