Iowa residents can enroll in or change their 2027 health insurance plans through the Affordable Care Act Marketplace beginning November 1, 2026.
Open enrollment continues through January 15, 2027, but December 15 is the deadline to select a plan that starts January 1.
The enrollment season brings changes to insurance premiums, federal financial assistance and the companies offering individual coverage in Iowa. Medica is leaving the state’s individual health insurance market, while five other insurers are expected to offer Marketplace plans for 2027.
Iowa uses the federally operated Health Insurance Marketplace at HealthCare.gov. The program serves eligible residents who purchase their own coverage, including self-employed workers, people without employer-sponsored insurance and some families whose workplace coverage is considered unaffordable under federal rules.
2027 Marketplace enrollment begins November 1 and ends January 15
HealthCare.gov has established the following enrollment schedule for coverage in 2027:
| Date | Enrollment deadline or change |
|---|---|
| November 1, 2026 | Open enrollment begins. Applications, plan renewals and changes become 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. Plans selected between December 16 and January 15 generally begin February 1. |
After January 15, enrollment or plan changes generally require a qualifying life event, such as losing other coverage, getting married, moving to a new coverage area or having a baby.
Medicaid and the Children’s Health Insurance Program have different enrollment rules and generally accept applications throughout the year.
Iowa insurers requested premium increases for 2027
Insurance companies offering Affordable Care Act-compliant individual plans in Iowa submitted rate increase requests for 2027. The Iowa Insurance Division’s published rate filing data shows proposed average increases ranging from 4.4% to 16.84%, depending on the insurer.
The figures below are the average increases originally requested by insurers. They are not necessarily the final approved increases or the additional 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% |
Since the original requests were submitted, regulators have completed additional rate reviews. An October 12 analysis of the final approved filings in the federal SERFF regulatory database calculated a statewide weighted average increase of approximately 5.7% for the individual insurance market before subsidies.
That statewide figure is different from the insurer-specific proposals above. It also does not predict the premium for a particular household. The final amount depends on the approved plan, age, location, household members and any financial assistance available.
Monthly premiums are only one part of health insurance costs. Deductibles, copayments, coinsurance, prescription coverage and annual out-of-pocket limits can also change between plans.
Medica will no longer offer individual plans in Iowa in 2027
Medica is withdrawing from Iowa’s individual health insurance market effective January 1, 2027. The company confirmed that the decision affects approximately 4,000 members in Iowa.
Current Medica policyholders who need coverage for 2027 will have to review their replacement options. A different plan may have a different provider network, prescription drug formulary, deductible or monthly premium.
Five insurers are expected to participate in Iowa’s individual Marketplace for 2027:
- Avera Health Plans
- Ambetter / Iowa Total Care
- Oscar Insurance Company
- UnitedHealthcare
- Wellmark Health Plan of Iowa
Plan availability varies by county and ZIP code. Not every insurer or plan is available to every Iowa resident.
Marketplace renewal notices can identify whether an existing plan will continue, change or become unavailable. Anyone assigned a replacement plan should compare the coverage rather than assume that the new policy matches the previous one.
Financial assistance may change monthly insurance costs
Eligible Marketplace customers may receive a federal premium tax credit that reduces the monthly cost of health insurance. The amount generally depends on expected annual household income, household size and the cost of qualifying coverage in the 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, but some households receive less assistance than they did before the enhanced subsidies ended.
The Marketplace will calculate assistance for 2027 using the applicant’s expected income for that coverage year. A household’s actual monthly premium may change even when the insurer’s average base rate increase is relatively small.
Before November 1, HealthCare.gov’s savings estimates may still reflect 2026 information. The Marketplace plan comparison tool will allow users to review available 2027 plans and estimated prices as the new enrollment season begins.
Applicants should update their income and household information when renewing coverage. A new job, changes in self-employment earnings or changes in household size can affect eligibility for financial assistance.
Comparing premiums alone may overlook higher medical costs
Marketplace plans are divided into metal categories, including Bronze, Silver and Gold. These categories describe how insurers and customers share covered medical costs; they do not measure the quality of medical care.
Bronze plans generally offer lower monthly premiums but higher expenses when medical services are needed. Gold plans typically have higher premiums and lower cost-sharing. Silver plans may provide additional reductions in deductibles, copayments and coinsurance to eligible customers.
When comparing plans, several details can affect the total cost of coverage:
- Monthly premium: The amount paid to maintain insurance, after any applicable premium tax credit.
- Deductible: The amount paid for certain covered services before the insurance plan 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 included and what the customer pays for them.
- Copayments and coinsurance: Fixed amounts or percentages charged for covered services.
Provider networks can be particularly important when comparing plans in Des Moines, Cedar Rapids, Iowa City, Davenport and smaller Iowa communities. A hospital or physician covered by one plan may be outside the network of another plan offered 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.
Applications use household, income and insurance information
Marketplace applications require information about the people seeking coverage and their expected household income for 2027.
Useful documents and information include:
- Current home and mailing addresses.
- Social Security numbers or other applicable identity 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 be asked to provide additional documents if the Marketplace cannot verify information submitted with the application.
The HealthCare.gov enrollment process allows applications online, by telephone, through certified enrollment partners or with assistance from trained counselors.
Free enrollment assistance is available throughout Iowa
HealthCare.gov offers free enrollment assistance through trained Marketplace counselors. Its local assistance directory identifies counselors and participating agents by ZIP code.
In Iowa, Iowa Navigator also provides Marketplace enrollment assistance, helping residents understand coverage options and the application process.
Help is available in Spanish and other languages 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.
Medicare and Medicaid follow different enrollment schedules
The Marketplace enrollment period should not be confused with Medicare’s annual enrollment season, which runs from October 15 through December 7, 2026 for changes to Medicare Advantage and Medicare prescription drug plans for 2027.
Medicare plans are not purchased through HealthCare.gov. Iowa’s Senior Health Insurance Information Program (SHIIP) provides 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 covered through an employer must follow their employer’s enrollment deadlines. State of Iowa employee benefits, for example, have a separate enrollment period ending November 5, 2026.
For individual Marketplace insurance in Iowa, the 2027 enrollment period begins November 1, 2026. Coverage selected by December 15 can begin January 1 once the first premium is paid, while the final open enrollment deadline is January 15, 2027.
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