Six insurers, including Bankers Reserve, are offering ACA Marketplace plans in Iowa for 2027. Residents must select a plan by December 15 for coverage starting January 1.
Updated November 11, 2026.
Iowa’s 2027 health insurance open enrollment period is underway. Residents can enroll in or change individual coverage through the Affordable Care Act (ACA) Marketplace until January 15, 2027.
The enrollment season brings changes to participating insurers, premiums and federal financial assistance. Medica is leaving Iowa’s individual health insurance market, while Bankers Reserve joins five other insurers offering Marketplace coverage for 2027.
Iowa uses the federally operated Health Insurance Marketplace at HealthCare.gov. It serves eligible residents who purchase their own insurance, including self-employed workers, people without employer-sponsored coverage and some households whose workplace insurance is considered unaffordable under federal rules.
2027 enrollment deadlines: December 15 and January 15
The federal Marketplace enrollment calendar establishes two important deadlines: December 15 for coverage beginning January 1 and January 15 for coverage generally beginning February 1.
| Date | Enrollment deadline or change |
|---|---|
| November 1, 2026 | Open enrollment began. Applications, renewals and plan changes became available. |
| December 15, 2026 | Deadline to select or change a plan for coverage beginning January 1, 2027. |
| January 1, 2027 | Coverage begins for people who enrolled by December 15 and paid their first required premium. |
| January 15, 2027 | Final day of Marketplace open enrollment for 2027 coverage. |
| February 1, 2027 | Coverage generally begins for people who selected a plan between December 16 and January 15 and paid their first required premium. |
After January 15, most applicants need a qualifying life event, such as losing health coverage, getting married, moving to a new coverage area or having a baby, to enroll in or change a Marketplace plan.
The Iowa Insurance Division also reports that the year-round special enrollment option previously available to certain households with incomes at or below 150% of the federal poverty level has been removed for plan year 2027.
Medicaid and the Children’s Health Insurance Program (CHIP) follow different enrollment rules and generally accept applications throughout the year.
Iowa insurers requested premium increases for 2027
Insurance companies offering ACA-compliant individual plans in Iowa submitted rate filings for 2027. The Iowa Insurance Division’s rate hearing records list proposed average increases ranging from 4.4% to 16.84% among five participating insurers.
These figures are the average increases included in the rate filings subject to public hearings. They are not necessarily the final approved increases or the amount an individual customer will pay.
| Insurance company | Proposed average increase |
|---|---|
| Wellmark Health Plan of Iowa | 4.4% |
| UnitedHealthcare Plan of the River Valley | 10.35% |
| Oscar Insurance Company | 11.94% |
| Avera Health Plans | 14.4% |
| Iowa Total Care / Ambetter | 16.84% |
Bankers Reserve does not appear in this rate hearing summary. Its absence from that table does not mean the company is excluded from the 2027 Marketplace: state regulators separately identify Bankers Reserve as a participating insurer.
After regulators reviewed the filings, an October 12 analysis by ACA Signups, using final approved data from the federal SERFF regulatory database, estimated a statewide weighted average increase of approximately 5.7% for the individual insurance market before subsidies.
That 5.7% figure is an independent calculation, not an official statewide rate published by the Iowa Insurance Division. It also does not predict what a particular household will pay. Final costs depend on the selected plan, age, location, household members and financial assistance.
Monthly premiums are only one part of insurance expenses. Deductibles, copayments, coinsurance, prescription coverage and annual out-of-pocket limits may also change between plans.
Six insurers offer Iowa Marketplace plans as Medica exits
Medica is withdrawing from Iowa’s individual health insurance market effective January 1, 2027. The decision affects approximately 4,000 Iowa members, according to company information reported by Becker’s Payer Issues.
Current Medica policyholders seeking individual Marketplace coverage for 2027 should review available replacement plans. Their new coverage may have different provider networks, prescription drug formularies, deductibles and premiums.
According to the Iowa Insurance Division’s November 6 announcement, six insurers are offering individual Marketplace plans for 2027:
- Avera Health Plans: Available in Clay, Dickinson, Emmet, Lyon, O’Brien, Osceola and Sioux counties.
- Bankers Reserve: Available in Adair, Dallas, Jasper, Madison, Marion, Polk and Warren counties.
- Iowa Total Care / Ambetter: Available in numerous Iowa counties, with availability determined by location.
- Oscar Insurance Company: Available in numerous Iowa counties, with availability determined by location.
- UnitedHealthcare Plan of the River Valley: Available in 17 Iowa counties.
- Wellmark Health Plan of Iowa: Available in all 99 Iowa counties.
Not every insurer is available in every county. Residents should enter their ZIP code at HealthCare.gov’s plan comparison tool to see the plans and estimated prices available at their address.
Current customers should also review their Marketplace and insurer renewal notices. Automatic enrollment may occur in some cases, but it is not guaranteed. Even when a replacement plan is assigned, its coverage and costs may differ from the previous policy.
Premium tax credits and eligibility rules change in 2027
Eligible Marketplace customers may receive federal premium tax credits that reduce the monthly cost of their health insurance. Financial assistance generally depends on factors including expected household income, household size and the cost of qualifying coverage in the applicant’s area.
The enhanced federal premium tax credits introduced during the COVID-19 pandemic expired on December 31, 2025. Regular premium tax credits remain available to eligible applicants, although some households now receive less assistance than they did when the enhanced subsidies were in effect.
A separate eligibility change affects some immigrants in 2027. Starting January 1, 2027, HealthCare.gov states that, among lawfully present noncitizens, only lawful permanent residents (green card holders), Cuban or Haitian entrants, and Compact of Free Association (COFA) migrants qualify for Marketplace premium tax credits or cost-sharing reductions.
People with certain other lawful immigration statuses may still qualify to purchase Marketplace coverage but may no longer qualify for those savings. Eligibility to obtain insurance and eligibility to receive financial assistance are different questions. Applicants can review the federal Marketplace’s immigration status rules before choosing a plan.
For 2027 coverage, the Marketplace calculates assistance using the applicant’s expected income for that year. A household’s monthly payment can change even when the insurer’s average base rate increase is relatively small.
Applicants should update their income and household information when renewing coverage. A new job, changes in self-employment earnings or a different household size may affect eligibility for financial assistance.
Deductibles, networks and prescriptions affect total costs
Marketplace plans are divided into metal categories, including Bronze, Silver and Gold. These categories describe how insurers and customers share covered medical expenses; they do not measure the quality of care.
Bronze plans generally have lower monthly premiums but higher expenses when medical services are needed. Gold plans typically have higher premiums and lower cost-sharing. Eligible customers who select Silver plans may qualify for additional reductions in deductibles, copayments and coinsurance.
When comparing coverage, residents should examine:
- Monthly premium: The amount paid to keep insurance active, after any applicable premium tax credit.
- Deductible: The amount paid for certain covered services before the insurer begins paying its share.
- Out-of-pocket maximum: The annual limit on covered in-network expenses, excluding premiums.
- Provider network: The doctors, specialists, clinics and hospitals covered under the specific plan.
- Prescription coverage: Which medications are covered and how much the customer pays.
- Copayments and coinsurance: Fixed amounts or percentages charged for covered services.
Provider networks are especially important when comparing plans in Des Moines, Cedar Rapids, Iowa City, Davenport and smaller Iowa communities. A physician or hospital included in one plan may be outside the network of another plan sold by the same company.
Residents who qualify for cost-sharing reductions generally must select an eligible Silver plan to receive those additional savings on medical expenses.
Documents needed for a 2027 Marketplace application
Marketplace applications require information about the people seeking coverage and their expected household income for 2027.
Useful documents and details include:
- Current home and mailing addresses.
- Social Security numbers or other applicable identity and immigration information for household members applying for coverage.
- Estimated household income for 2027.
- Recent pay stubs, tax information or self-employment income records.
- Information about health insurance offered through an employer, when applicable.
- Current insurance documents and renewal notices.
Some applicants may need to submit additional documentation if the Marketplace cannot verify information included in their application.
HealthCare.gov accepts applications online, by telephone, through approved enrollment partners and with assistance from trained counselors. The federal website explains the available application and enrollment methods.
Free Marketplace enrollment help is available in Iowa
Residents who need assistance comparing plans or completing an application can contact trained Marketplace enrollment counselors.
The federal local assistance directory helps applicants find certified counselors and participating insurance agents by ZIP code.
Iowa Navigator is another free resource. Its trained navigators provide confidential, one-on-one assistance with Marketplace coverage, Medicaid and CHIP.
Spanish-language assistance is available through the federal Marketplace. The HealthCare.gov Call Center can be reached at 1-800-318-2596 (TTY: 1-855-889-4325), 24 hours a day, seven days a week, except holidays.
Residents should use the official federal Marketplace or an approved enrollment partner to apply for premium tax credits. The Iowa Insurance Division also cautions consumers to watch for misleading insurance marketing and websites that impersonate the Marketplace.
Medicare and Medicaid have separate enrollment rules
Marketplace open enrollment is different from Medicare’s annual enrollment period, which runs from October 15 through December 7, 2026 for changes to Medicare Advantage and Medicare prescription drug plans for 2027.
Medicare coverage is not purchased through HealthCare.gov. Iowa’s Senior Health Insurance Information Program (SHIIP) offers free Medicare counseling to beneficiaries and their families.
Related: Medicare 2027 in Iowa: Open Enrollment Starts Oct. 15
Iowa Medicaid and Hawki, the state’s Children’s Health Insurance Program, generally accept applications year-round from eligible individuals and families. Applications and eligibility information are available through the Iowa Department of Health and Human Services.
People insured through an employer must follow their employer’s enrollment procedures and deadlines rather than the federal Marketplace schedule.
For Iowans buying individual insurance through the ACA Marketplace, the immediate step is to compare available 2027 plans, confirm whether their preferred doctors and prescriptions are covered, and review the final monthly cost after any eligible financial assistance.
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