ACA Marketplace Plans
Major changes are coming for 2026. We’ll help you make sense of it all.
Why Marketplace plans?
ACA Marketplace (Affordable Care Act) health plans provide comprehensive coverage for individuals and families who don’t have access to employer insurance or Medicare. Plans are divided into four tiers — Bronze, Silver, Gold, and Platinum — each balancing monthly premiums against out-of-pocket costs.
With Marketplace plans, you get:
Coverage for essential health benefits like preventive care, prescriptions, maternity, and mental health
Subsidies and tax credits (though changing in 2026) that may reduce monthly costs
Multiple plan tiers — Bronze, Silver, and Gold — to match your budget and health needs
Guaranteed coverage for pre-existing conditions
What’s changing for 2026?
Big shifts are coming that could affect both your costs and your coverage:
Loss of Enhanced Subsidies: Unless extended by Congress, premium tax credits will shrink back to pre-2021 levels, raising net costs for many by 75% or more.
Premium Increases: Insurers are requesting rate hikes averaging 18% nationwide.
Higher Out-of-Pocket Maximums: $10,600 for individuals / $21,200 for families.
Benchmark Silver Plans Less Generous: Subsidy amounts tied to these plans will stretch less.
Aetna Leaving the Marketplace: Coverage options will shrink in states where Aetna previously operated.
Stricter Enrollment Verification: More documentation required for subsidies and special enrollments.
End of $0 Auto-Renewal Plans: Households on zero-premium coverage must actively renew to avoid new $5 monthly minimum premiums.
Enrollment windows matter
The ACA Marketplace has strict deadlines each year. Missing them could mean waiting until the next cycle or losing access to subsidies. Here’s what you need to know for 2026 coverage:
Special Enrollment Periods (SEPs) apply year-round for qualifying events such as a move, job change, marriage, or birth. ⚠️ Starting in late 2026, the Open Enrollment period will shorten — ending December 15 in many states. Missing these deadlines could mean going uninsured until the next cycle.
Who can enroll
You may qualify if you:
Live in the U.S. (50 states or D.C.)
Are a U.S. citizen, U.S. national, or lawfully present immigrant
Marketplace coverage is not available for:
People with employer coverage, Medicaid, or Medicare
Individuals who are currently incarcerated
How CIS helps you navigate the changes
With so many rules shifting, working with an experienced guide matters more than ever. CIS helps you:
Compare carriers and plans side-by-side
Maximize subsidies and tax credits where available
Match doctors, hospitals, and prescriptions to the right network
Track deadlines and ensure compliance
Explore supplemental options (like indemnity or STM coverage) to offset rising costs
Provide ongoing support all year at no cost to you
Preparing for enrollment
Start early to avoid last-minute stress:
Gather household info (SSNs, income docs, prior year tax return)
Estimate your 2026 household income for subsidy eligibility
Make a list of doctors, hospitals, and prescriptions to check against networks
Think about upcoming procedures or ongoing health needs
Plan for potential premium increases and higher out-of-pocket limits
Get started today
2026 is shaping up to be the most complex Marketplace year in recent memory. Don’t go it alone. Schedule your free consultation with CIS today. We’ll help you compare options, maximize savings, and prepare for the year ahead.