Marketplace (ACA) plans are how millions without job-based coverage get insured — and 2026 is a pricier year, with premiums up about 26% on average and the enhanced pandemic-era subsidies now expired. The smart moves: shop on HealthCare.gov (or your state’s exchange) during open enrollment (Nov 1–Jan 15), check whether you still qualify for a premium tax credit (incomes roughly $16k–$64k), and pick a Silver plan if you want extra cost-sharing help.
What the plans cost
| Metal tier | Avg monthly* | Good for |
|---|---|---|
| Catastrophic | ~$278 | Under-30 / hardship only |
| Bronze | ~$405 | Lowest premium, high deductible |
| Silver | ~$540 | Subsidies + cost-sharing help |
| Gold | ~$718 | Higher premium, lower out-of-pocket |
| Platinum | ~$1,384 | Most coverage, highest premium |
*Source: MoneyGeek, 2026 average monthly rates for a 40-year-old non-smoker before any subsidy. After premium tax credits, CMS projects the lowest-cost plan averages around $50/month. Your real cost depends heavily on income, age and location.
Major marketplace insurers
The metal tier is only half the decision — the company behind the plan decides your network and how smoothly claims go. These are the names you’ll see most often on the exchange:
| Insurer | Known for |
|---|---|
| Kaiser Permanente | Top member satisfaction (where available) |
| Blue Cross Blue Shield | Widest availability and networks |
| UnitedHealthcare | Large national footprint |
| Aetna (CVS Health) | Broad plans, CVS/MinuteClinic ties |
| Cigna | Good drug coverage options |
| Ambetter (Centene) | Low-premium Silver plans |
| Molina Healthcare | Budget-focused, Medicaid crossover |
Availability varies by county — not every insurer sells in every area. Always confirm which carriers are on your local exchange.
How the tiers and subsidies work
The metal tiers aren’t about quality of care — they’re about how you and the plan split costs. Bronze has the lowest premium but you pay more when you need care; Gold and Platinum flip that. Premium tax credits lower your monthly cost based on income, and cost-sharing reductions — which shrink your deductible and copays — are only available on Silver plans. For 2026, note that the enhanced COVID-era subsidies expired at the end of 2025, so many buyers will pay more than last year; standard credits still apply. This is a developing area, so always confirm your exact numbers on HealthCare.gov.
The 4 numbers that matter more than the premium
People fixate on the monthly premium and ignore the numbers that actually decide what they pay. Before you enroll, compare these across plans: the deductible (what you pay before the plan kicks in), the out-of-pocket maximum (your worst-case yearly total), whether your doctors and hospitals are in-network, and whether your prescriptions are on the plan’s formulary. A “cheaper” plan with a $9,000 deductible and your doctor out-of-network can cost far more than a pricier one that covers your care.
How it varies by state
This is where the marketplace gets genuinely different depending on where you live:
- Your exchange may not be HealthCare.gov. States like California (Covered California), New York, Colorado, Pennsylvania (Pennie) and about a dozen others run their own sites with their own plans and help.
- Medicaid expansion changes the bottom rung. In expansion states, if your income is very low you’re routed to Medicaid instead. In non-expansion states (such as Texas and Florida), some low-income adults fall into a “coverage gap” with no subsidy and no Medicaid.
- Prices swing by county, not just state. The benchmark Silver premium can differ by hundreds of dollars between two neighboring regions, because it depends on the local insurers and hospitals.
The practical takeaway: start at HealthCare.gov, and if it redirects you to a state exchange, that’s normal — follow it.
How to pick the right plan
Match it to you
- Rarely see a doctor → Bronze
- Qualify for subsidies → Silver (unlocks CSR)
- Frequent care or meds → Gold
- Always check your doctors are in-network
Before you enroll
- Estimate your income accurately — it sets your subsidy
- Compare total cost, not just the premium
- Re-shop every year; the cheapest plan changes
- Enroll by Dec 15 for Jan 1 coverage
Real examples
If you’re self-employed earning about $40,000: you’re squarely in subsidy territory. Run a Silver plan first — at that income you likely qualify for cost-sharing reductions that quietly lower your deductible, something a Bronze plan can’t give you. (More in our self-employed guide.)
If you’re 26 and aging off a parent’s plan: losing that coverage is a qualifying life event, so you get a special enrollment window — you don’t have to wait for January. A Bronze or catastrophic plan may be plenty if you’re healthy.
If you take a regular prescription: check the drug formulary before anything else. The same medication can be a $10 copay on one plan and hundreds out-of-pocket on another, which matters far more than a $30 difference in premium.
The bottom line
Shop HealthCare.gov (or your state exchange) during open enrollment, enter your income accurately to capture your subsidy, and compare a Silver plan (for cost-sharing help) against a cheaper Bronze. Budget for higher 2026 prices — but many people still qualify for standard premium tax credits.
The ACA marketplace can feel confusing on purpose, but the system really rewards two habits: shopping every single year and getting your income estimate right, because that number sets your subsidy. Auto-renewing last year’s plan is how people quietly overpay.
For 2026 specifically, brace yourself a little — prices jumped and the beefed-up pandemic subsidies went away, so your renewal quote may sting. If your income lands in the subsidy range, run the numbers on a Silver plan first: the cost-sharing help it unlocks is the best-kept secret in the marketplace, and most people skip right past it.
FAQs
What are the metal tiers?
Do I qualify for a subsidy?
Why did my 2026 premium go up?
What if I miss open enrollment?
Can I keep my own doctor?
When is open enrollment?
Sources: MoneyGeek (2026 marketplace rates); KFF and CMS (2026 premium changes and projected after-subsidy costs); HealthCare.gov; KFF.