Quick answer
Iowa’s benchmark silver plan for a 40-year-old averaged $501 a month in 2026 before subsidies, about $124 below the U.S. average of $625. By age, that’s roughly $392 a month at 21 and $1,176 at 64. About 76% of Iowa enrollees got financial help, and the average enrollee paid $235 a month after it. Insurers have proposed 2027 increases averaging about 6.7%, less than half the roughly 15% median that insurers proposed nationwide, but the rates weren’t final as of late September 2026.
Key takeaways
- A 40-year-old in Iowa faced a 2026 benchmark premium of about $501 a month before subsidies, roughly 20% below the national average.
- Iowans made 123,304 plan selections for 2026, down about 10% from 2025, and about 76% got a premium tax credit or cost-sharing help, compared with about 87% nationwide.
- Proposed 2027 increases average about 6.7%, and Wellmark, which covers about 80,000 people in its individual filing, asked for less than 5%, with final rates still pending as of late September 2026.
- Medica is leaving Iowa’s individual market at the end of 2026, so about 4,000 enrollees need a new plan, and five insurers remain.
- Iowa starts Medicaid work requirements early: by December 1, 2026, Iowa Health and Wellness Plan members who aren’t exempt must meet monthly activity rules to keep coverage.
On this page
What an Iowa Marketplace plan costs before subsidies
| Age | Benchmark silver plan, per month (2026 estimate) |
|---|---|
| 21 | $392 |
| 30 | $445 |
| 40 | $501 |
| 50 | $700 |
| 60 | $1,064 |
| 64 | $1,176 |
| Child under 15 | $300 |
Iowa follows the federal age curve, so a 64-year-old pays three times what a 21-year-old pays for the same plan. Two 40-year-old parents with two young children would pay about $1,602 a month for benchmark coverage before any tax credit.
What you’d pay after a tax credit
A single 40-year-old earning $40,000 would owe about $287 a month for Iowa’s benchmark plan in 2026, and a premium tax credit would cover the remaining $214 or so. The credit is tied to income, and it’s available when your household earns between 100% and 400% of the federal poverty level. For 2027, that same person’s share would be about $289 a month. Past 400% of the poverty level, which is $62,600 for one person for 2026 coverage and $63,840 for 2027, the credit stops.
Iowa enrollees are less likely than Marketplace shoppers nationally to get help. About 76% of 2026 enrollees got a tax credit or cost-sharing reductions, and the average enrollee paid $235 a month after subsidies, above the national average of $178. Those who did get a subsidy paid $134 a month on average, and 14% of all Iowa enrollees paid less than $10. The income limits for subsidies explain where the cutoffs fall for larger households.
Costs beyond the premium
Most plans have you pay toward a deductible before they start sharing costs, and after that you pay copays or coinsurance. Those charges stop at the out-of-pocket maximum, which can’t be more than $10,600 for one person in 2026 or $12,000 in 2027. If your income is under 250% of the poverty level, a silver plan comes with cost-sharing reductions that lower those amounts.
Iowa Marketplace facts
- Marketplace: HealthCare.gov. Iowa doesn’t run its own exchange.
- Enrollment: Iowa had 123,304 plan selections for 2026 and 136,833 for 2025. Enrollees who got a premium tax credit received $499 a month on average.
- Insurers: Six insurers sold 2026 plans: Wellmark Health Plan of Iowa, Oscar, Iowa Total Care (Ambetter), UnitedHealthcare, Avera Health Plans and Medica. Medica is leaving after 2026, and its roughly 4,000 Iowa members will have to pick a new plan; see what to do if your insurance company leaves the Marketplace. Cigna isn’t part of Iowa’s Marketplace.
- 2027 prices: Still proposed as of late September 2026. ACA Signups and healthinsurance.org put the weighted average at about 6.7%, based on the filings insurers submitted in the summer. The Iowa Insurance Division held a public hearing on August 20, and its rate page, updated September 23, lists requests from 4.4% (Wellmark) to 16.84% (Iowa Total Care), with Oscar at 11.94%. Compare other states in premium increases by state.
- State help: Iowa has no premium subsidy of its own, no reinsurance program, no public option and no individual mandate, so the federal tax credit is the main help with premiums.
- Medicaid: Iowa expanded Medicaid through the Iowa Health and Wellness Plan, which covers adults up to 138% of the poverty level. Children can get hawk-i, Iowa’s CHIP, with family income up to 307% of the poverty level. By December 1, 2026, Iowa Health and Wellness Plan members who aren’t exempt must log at least 80 hours a month of work, job training, school or volunteering, or earn at least $580 a month. People who are pregnant or had a baby in the last 12 months, caregivers of children under 14 and people who are medically frail are among those exempt. See Medicaid work requirements.
When to enroll
Iowa uses the HealthCare.gov calendar. Open enrollment for 2027 coverage runs from November 1, 2026 to January 15, 2027, and you need to choose a plan by December 15 for it to start January 1. If you’re a Medica member, this is the window to switch. For ways to bring your premium down, see how to lower your Marketplace premium.
Other options in Iowa
- Job-based coverage, which usually costs you less when an employer offers it.
- The Iowa Health and Wellness Plan for adults up to 138% of the poverty level, and hawk-i for children; see health insurance for children.
- Medicare at 65.
Health insurance costs in nearby states: Minnesota, Wisconsin, Illinois, Missouri and Nebraska. You can also compare health insurance costs in every state.
Find out what 2027 plans cost where you live in Iowa: compare quotes by ZIP code.
Frequently asked questions
How much is health insurance in Iowa per month?
Before subsidies, the 2026 benchmark silver plan averaged $501 a month for a 40-year-old and about $392 for a 21-year-old. After tax credits, the average Iowa enrollee paid $235 a month in 2026.
How much will Iowa premiums go up in 2027?
Insurers proposed increases averaging about 6.7% before subsidies, and Wellmark, the largest, asked for less than 5%. The rates were still proposed as of late September 2026.
Is Medica leaving Iowa?
Yes. Medica stops selling individual plans in Iowa at the end of 2026, which affects about 4,000 people. Wellmark, Oscar, Iowa Total Care, UnitedHealthcare and Avera remain for 2027.
When do Iowa’s Medicaid work requirements start?
By December 1, 2026, a month ahead of the federal January 2027 start. Iowa Health and Wellness Plan adults who aren’t exempt will need 80 hours a month of work, school, training or volunteering, or $580 a month in earnings, unless they’re exempt.
Sources
- healthinsurance.org: Iowa Health Insurance Marketplace
- Iowa Insurance Division: Health Insurance Rate Increase Data
- Iowa HHS: IHAWP Community Engagement Requirements
- Scott County Health Department: Be Ready for Upcoming Iowa Medicaid Changes
- ACA Signups: 2027 Rate Changes – Iowa
- KFF: Marketplace Average Benchmark Premiums
This article is general information, not insurance or tax advice. Iowa premiums depend on your county, age, income and insurer, and 2027 rates were still proposed when this was written. Last reviewed September 2026.