Iowa Health Insurance for Self-Employed People, Farmers and Families
Looking for health insurance in Iowa? We help self-employed people, farmers, 1099 workers, families and small business owners compare Marketplace and private health insurance options based on their budget, doctors, prescriptions and coverage needs.
Iowa also has some unique health coverage choices, including the Iowa Farm Bureau Health Benefit Plan and the Iowa Health and Wellness Plan. Understanding how these choices differ can help you avoid comparing plans based on price alone.
1099 Health Insurance is licensed to help clients in Iowa. Most consultations are completed by phone and screen-share, so we can review your options together wherever you live in the state.
Iowa Health Insurance at a Glance for 2027
| Iowa Health Insurance Marketplace | HealthCare.gov |
|---|---|
| 2027 Open Enrollment | November 1, 2026 – January 15, 2027 |
| January 1 coverage deadline | Enroll or change plans by December 15, 2026 |
| Current 2027 individual-market filings | Wellmark Health Plan of Iowa, Oscar, Iowa Total Care/Ambetter, Avera Health Plans and UnitedHealthcare Plan of the River Valley |
| Leaving for 2027 | Medica has announced its exit from Iowa's ACA individual Marketplace for 2027. |
| Filed 2027 rate changes | Current average filings range from approximately +4.4% to +16.84%, depending on the insurance company. These filings were still subject to Iowa's rate-review process when this page was updated. |
| Medicaid expansion | Iowa expanded Medicaid through the Iowa Health and Wellness Plan for eligible adults. |
| New Medicaid rules | Community-engagement requirements begin December 1, 2026 for certain new applicants, with existing members affected at applicable renewals beginning in 2027. |
| Farm Bureau Health Benefit Plan | Available to eligible Iowa Farm Bureau members. It uses medical-history questions and is not required to follow certain federal and state health-insurance market requirements that apply to ACA coverage. |
| Private health insurance | Other private coverage outside the Marketplace may also be available depending on the type of coverage and applicant eligibility. |
What's Changing for Iowa Health Insurance in 2027?
Medica is leaving Iowa's individual Marketplace
Medica has announced that it will leave Iowa's ACA individual health insurance market for 2027.
If you currently have a Medica individual plan, you'll need replacement coverage for 2027.
When comparing replacements, check your doctors, hospitals, prescriptions, deductible and maximum out-of-pocket costs before selecting a new plan.
Iowa's 2027 rate filings vary significantly
The Iowa Insurance Division has published the following average 2027 individual-market rate filings.
| Insurance Company | Filed Average 2027 Change | Approximate Enrollment in Filing |
|---|---|---|
| Wellmark Health Plan of Iowa | +4.4% | Approximately 80,000 |
| UnitedHealthcare Plan of the River Valley | +10.35% | 546 |
| Oscar Insurance Company | +11.94% | 11,971 |
| Avera Health Plans | +14.4% | 393 |
| Iowa Total Care / Ambetter | +16.84% | 6,982 |
| Medica | Announced exit from Iowa's individual ACA market for 2027 | |
These are average rate filings and do not predict your personal premium change.
Your actual cost depends on your age, county, plan selection, household information and eligibility for Marketplace financial assistance.
Because Wellmark represents a large share of the lives included in Iowa's current filings, its rate change has a substantial effect on the statewide picture.
Some Iowans still have older pre-ACA coverage
The Iowa Insurance Division's 2027 filings also include approximately 17,700 members in older Wellmark pre-ACA individual coverage.
That filing shows an average proposed increase of approximately 8.5%.
If you still have a grandfathered or other older individual plan, don't cancel it without first comparing benefits, provider networks, prescription coverage, premium and replacement eligibility.
Marketplace Financial Assistance in Iowa
Eligible Iowa residents can receive federal Premium Tax Credits when enrolling in qualified Marketplace coverage through HealthCare.gov.
Under current rules, Premium Tax Credits generally apply to otherwise eligible households with income between 100% and 400% of the federal poverty level.
The amount you receive depends on your household, estimated annual income and other Marketplace eligibility rules.
Income can be complicated for farmers and self-employed people
Marketplace savings are based on your expected household income for the coverage year, not simply your gross business or farm revenue.
Farmers and other self-employed people can have income that changes significantly from year to year because of expenses, commodity prices, equipment purchases, seasonal income and other business factors.
If your income changes materially during the year, update your Marketplace application.
For questions about business deductions, retirement contributions, HSAs or your taxable income, speak with a qualified tax professional.
Iowa Farm Bureau Health Benefit Plans
Iowa has a state-specific option that many people shopping for their own coverage encounter: the Iowa Farm Bureau Health Benefit Plan.
These plans are available to eligible Iowa residents who are members of the Iowa Farm Bureau Federation.
They are different from ACA Marketplace plans, so it's important to understand those differences before applying.
Medical history matters
Applicants are required to answer questions about their medical history. Approval is based on the plan's underwriting criteria.
By comparison, ACA Marketplace plans cannot deny you or charge you more because of your health history.
You can apply year-round
Iowa Farm Bureau Health Benefit Plans accept applications throughout the year rather than limiting applications to the federal Marketplace Open Enrollment period.
Farm Bureau membership is required
You must be an Iowa resident and a member of the Iowa Farm Bureau Federation to apply.
They do not receive Marketplace subsidies
Federal Marketplace Premium Tax Credits cannot be applied to a Farm Bureau Health Benefit Plan.
These plans follow different rules than Marketplace coverage
The Farm Bureau Health Benefit Plan's own disclosures state that the coverage is not required to comply with certain federal or state health-insurance market requirements, including certain Affordable Care Act requirements.
That means you should carefully review eligibility, exclusions, coverage limits, provider access and other plan terms before comparing it with ACA Marketplace or other private coverage.
Iowa Health and Wellness Plan Changes for 2027
Iowa expanded Medicaid through the Iowa Health and Wellness Plan, or IHAWP.
The program generally provides Medicaid coverage to eligible Iowa adults ages 19 through 64 with household income that does not exceed 133% of the federal poverty level.
New requirements begin December 1, 2026
Beginning December 1, 2026, certain people applying for IHAWP must meet new monthly community-engagement requirements to qualify and maintain coverage.
Current IHAWP members scheduled for renewal beginning in February 2027 may also become subject to these rules at their applicable renewal.
How the requirement can be met
Depending on your situation, the requirement can generally be satisfied by:
- Working at least 80 hours per month
- Earning at least $580 per month
- Participating in qualifying job training or a work program for at least 80 hours per month
- Attending a qualifying education program at least half-time
- Completing at least 80 hours per month of qualifying community service
- Combining qualifying activities to reach the monthly requirement
Seasonal workers have special rules
Iowa HHS says income for seasonal workers can be averaged over six months when determining whether the earnings requirement is met.
This may be particularly relevant to some agricultural and seasonal workers in Iowa.
Many people are excluded from the requirement
Exclusions include certain:
- American Indians and Alaska Natives
- People who are medically frail, disabled or have certain serious medical conditions
- Pregnant individuals and certain people receiving postpartum Medicaid
- Caregivers of children under age 14 or people with disabilities
- People participating in qualifying drug or alcohol treatment
- Certain veterans with a total disability rating
- Certain people who are currently or recently incarcerated
What if you lose Iowa Medicaid?
Losing Medicaid can create a Special Enrollment Period that allows you to enroll in Marketplace health insurance outside normal Open Enrollment.
If your Iowa Medicaid eligibility changes, we can help compare the Marketplace and other coverage options available to you.
Health Insurance for Self-Employed Iowans and Farm Families
Buying your own health insurance can be especially complicated when you're a farmer, business owner, freelancer or independent contractor with income that changes throughout the year.
We can help you compare:
- Monthly premiums
- Deductibles and maximum out-of-pocket costs
- Doctor and hospital networks
- Prescription coverage
- Marketplace Premium Tax Credit eligibility
- Iowa Health and Wellness Plan eligibility
- Farm Bureau Health Benefit Plans
- Marketplace versus private health insurance options
We regularly help:
Iowa Health Insurance Options
Marketplace Health Insurance
Iowa uses HealthCare.gov for individual and family Marketplace coverage.
Marketplace plans cover pre-existing conditions and include the essential health benefits and consumer protections required under federal law.
HealthCare.gov is also where eligible consumers can receive federal Premium Tax Credits.
Private Health Insurance
Some Iowa residents may also have private health insurance options outside the Marketplace.
Depending on the product, private plans may use medical underwriting and can have different provider networks, benefits, exclusions, deductibles and eligibility requirements than Marketplace plans.
Marketplace Premium Tax Credits cannot be used to pay for coverage purchased outside HealthCare.gov.
We can compare Marketplace and private options with you so you understand the differences before applying.
Iowa Farm Bureau Health Benefit Plan
Eligible Iowa Farm Bureau members may apply for Farm Bureau Health Benefit Plan coverage throughout the year.
Applicants answer medical-history questions, and the coverage operates under different market rules than ACA Marketplace plans.
Review the benefits, exclusions and eligibility requirements carefully before comparing it with other coverage.
Iowa Health and Wellness Plan
IHAWP is Iowa's Medicaid expansion program for eligible low-income adults ages 19 through 64.
Applications are available throughout the year, although new community-engagement requirements begin taking effect in late 2026 and 2027.
Short-Term Health Insurance
Short-term health insurance may be available in Iowa for temporary coverage needs.
Current Iowa rules allow authorized carriers to offer an initial short-term policy term of up to 12 months, with renewals that may extend total coverage for up to 36 months.
Short-term plans can use medical underwriting and may not provide all of the benefits or protections required of ACA-compliant Marketplace coverage.
Health Sharing Programs
Health sharing memberships may be available, but they are not health insurance.
Payment of medical expenses is not guaranteed in the same way covered claims are paid under an insurance contract.
Small Business Health Insurance
Iowa employers may have access to traditional small-group insurance and other employer health benefit arrangements.
Dental, Vision and Supplemental Coverage
Dental, vision, accident, critical illness and other supplemental products may be available alongside medical coverage.
Individual and Family Coverage
Whether you're purchasing coverage for yourself, a spouse or your family, we can compare options using your Iowa ZIP code, doctors and prescriptions.
Check Your Iowa Doctors and Hospitals Before Enrolling
Provider networks vary by insurance company, plan and county.
This is particularly important if you're replacing Medica coverage or comparing a Marketplace plan with another type of health coverage.
Depending on where you live, provider systems you may want to check include:
- UnityPoint Health
- MercyOne
- University of Iowa Health Care
- Broadlawns Medical Center
- Avera Health in northwest Iowa
Don't assume a doctor or hospital participates simply because it accepts another plan from the same insurance company.
During a phone or screen-share consultation, we can help check your doctors, hospitals and prescriptions while comparing your coverage options.
Serving All 99 Iowa Counties
We help Iowa residents by phone and screen-share, so you can compare health insurance without traveling to an insurance office.
We work with clients in Des Moines, West Des Moines, Ankeny, Cedar Rapids, Iowa City, Davenport, Sioux City, Waterloo, Ames, Council Bluffs, Dubuque and communities throughout Iowa.
We also help self-employed people and farm families in rural Iowa, where insurance-company and provider-network choices can differ significantly from larger metro areas.
Your ZIP code is the starting point for determining which plans are actually available to you.
Convenient Iowa Health Insurance Consultations
Most consultations are completed by phone. When it helps to compare plans together, we can use screen-sharing so you can see premiums, deductibles, benefits and provider networks while we discuss your options.
How It Works
Schedule a Call
Pick a convenient time for a phone consultation. If helpful, we can use screen-sharing to review coverage together.
Compare Your Options
We compare plans available in your area, Marketplace financial assistance, doctors, prescriptions and other coverage options that may apply to your situation.
Choose and Apply
If you find an option that works for you, we help with the application and remain available when you have questions after enrollment.
Iowa Health Insurance FAQ
When is Iowa health insurance Open Enrollment for 2027?
Iowa uses HealthCare.gov. Open Enrollment for 2027 Marketplace coverage runs from November 1, 2026 through January 15, 2027.
Enroll or change plans by December 15 for coverage beginning January 1. Open Enrollment continues through January 15.
My Medica plan is ending. What should I do?
Medica has announced that it is leaving Iowa's individual ACA market for 2027.
Compare replacement plans during Open Enrollment and check your doctors, hospitals, prescriptions and out-of-pocket costs before selecting new coverage.
Which companies have filed for Iowa individual coverage in 2027?
Current Iowa Insurance Division filings include Wellmark Health Plan of Iowa, Oscar, Iowa Total Care/Ambetter, Avera Health Plans and UnitedHealthcare Plan of the River Valley.
Availability varies by county and final participation should be confirmed when 2027 plans are available.
How much are Iowa health insurance rates changing for 2027?
Current average individual-market filings range from approximately 4.4% for Wellmark to 16.84% for Iowa Total Care/Ambetter.
These are average filings rather than your individual premium change, and they were still subject to Iowa's rate-review process when this page was updated.
What is the Iowa Farm Bureau Health Benefit Plan?
It is an Iowa-specific health benefit option available to eligible Iowa Farm Bureau Federation members.
Applicants answer medical-history questions, and the plan is not required to comply with certain federal and state health-insurance market requirements that apply to ACA Marketplace plans.
Do I have to be a farmer to apply for an Iowa Farm Bureau Health Benefit Plan?
The plan's eligibility information requires Iowa residency and Iowa Farm Bureau Federation membership. Farm Bureau membership is not limited only to people who make their living as farmers.
Can I apply for a Farm Bureau Health Benefit Plan year-round?
Yes. The Farm Bureau Health Benefit Plan accepts applications throughout the year, subject to eligibility and underwriting requirements.
Can self-employed people in Iowa get a Marketplace subsidy?
Yes, if they meet the eligibility requirements. Under current rules, Premium Tax Credits generally apply to otherwise eligible households with income between 100% and 400% of the federal poverty level.
Marketplace assistance is based on expected annual household income.
Can I choose private health insurance instead of the Marketplace?
Some Iowa residents may have private coverage options outside HealthCare.gov depending on the type of product and eligibility requirements.
Private plans can have different underwriting, benefits, exclusions and provider networks. Marketplace Premium Tax Credits cannot be used outside the Marketplace.
Did Iowa expand Medicaid?
Yes. Iowa expanded Medicaid through the Iowa Health and Wellness Plan, which generally covers eligible adults ages 19 through 64 with income that does not exceed 133% of the federal poverty level.
When do Iowa Medicaid work requirements begin?
Iowa's new community-engagement requirements begin December 1, 2026 for people applying for the Iowa Health and Wellness Plan on or after that date.
Existing members with renewals beginning in February 2027 may also become subject to the requirement at their applicable renewal.
What counts toward the Iowa Medicaid requirement?
Depending on the member's situation, the requirement may be satisfied by working 80 hours per month, earning at least $580 per month, qualifying education, job training, community service or a combination of qualifying activities.
Numerous exclusions apply.
Can I buy short-term health insurance in Iowa?
Yes, Iowa currently allows authorized insurers to offer short-term limited-duration coverage.
Current Iowa rules allow an initial term of up to 12 months with renewals that may extend total coverage to as much as 36 months.
These plans can use medical underwriting and may provide different protections and benefits than ACA-compliant Marketplace coverage.
Can I get Iowa health insurance outside Open Enrollment?
Marketplace coverage generally requires Open Enrollment or a Special Enrollment Period after a qualifying event such as losing other coverage, marriage, having a baby or certain moves.
Iowa Medicaid applications are available year-round. Some other private coverage options may also have different application periods.
Can you help check my doctors and prescriptions?
Yes. Have the names of your doctors, specialists, preferred hospitals and medications available during your consultation. We can help check them while comparing your coverage options.
How do consultations work?
Most consultations are completed by phone. When it is useful to compare plans together, we can use screen-sharing so you can see the coverage information while we discuss it.
Get Help Comparing Iowa Health Insurance
Whether you're a farmer, freelancer, business owner, leaving Medica coverage or comparing a Marketplace plan with other Iowa coverage options, we'll help you understand the differences before you choose.
We can help you compare Marketplace and private health insurance options by phone or screen-share.
Iowa Health Insurance Sources
- Iowa Insurance Division — 2027 individual-market rate filings
- Iowa Insurance Division — individual health insurance and short-term limited-duration coverage information
- HealthCare.gov — 2027 Open Enrollment dates and Marketplace financial-assistance information
- Iowa Department of Health and Human Services — Iowa Health and Wellness Plan eligibility
- Iowa Department of Health and Human Services — 2026-2027 IHAWP community-engagement requirements
- Iowa Farm Bureau Health Benefit Plan — eligibility, underwriting and coverage disclosures
