Health Plan Choices: What Are Your Options for Buying Your Own Health Insurance in 2026?

ByIris

If you’re under 65 and buying your own coverage, your main options are an ACA Marketplace plan, a Catastrophic plan, short-term health insurance, a health share, or staying uninsured, and for most people who don’t get help from an employer, an ACA Marketplace plan with a premium tax credit is the only option that includes guaranteed coverage for pre-existing conditions and a federal subsidy.

That answer is more complicated than it used to be. The enhanced premium tax credits that lowered ACA premiums for millions of people expired on January 1, 2026, and Marketplace insurers raised their rates by an average of 26% for the year on top of that increase. This guide walks through what’s actually changed, what each option costs right now, and how to figure out which one fits your situation.

What changed with ACA premiums in 2026?

ACA Marketplace premium payments rose sharply in 2026 because two things happened at once: insurers raised their base rates by an average of 26%, and the enhanced premium tax credits that had been in place since 2021 expired on January 1, 2026. According to KFF, enrollees who keep the same plan they had in 2025 are seeing their net premium payments increase by an average of 114%, rising from about $888 a year to roughly $1,904 a year after subsidies are applied.

The increase isn’t uniform. People with incomes just above the poverty line are largely protected, since federal law still caps what the lowest-income enrollees pay at around 2% of household income for a benchmark plan. The people facing the steepest increases are those with incomes above 400% of the federal poverty level, who lost access to subsidies entirely once the enhanced credits expired. For a single adult, the 2026 federal poverty level used for ACA subsidy calculations is $15,650, which puts the 400% cutoff at roughly $62,600 in annual income.

How much does an ACA Marketplace plan actually cost in 2026?

The average gross monthly premium for a benchmark (second-lowest-cost) Silver plan is $625, and the average lowest-cost Bronze plan runs about $456 a month, according to the Peterson-KFF Health System Tracker. Those are the prices before any subsidy is applied. What you actually pay depends entirely on your income relative to the federal poverty level, since the premium tax credit is calculated on a sliding scale.

The same KFF analysis notes that the average Marketplace deductible grew by about $1,000 per person in 2026, as more enrollees shifted into higher-deductible Bronze and Catastrophic plans to keep their monthly payment manageable after losing subsidy eligibility. That trade-off, a lower monthly bill in exchange for a much higher amount you’d owe if you actually need care, is the central decision most people are weighing this year.

What are the ACA plan tiers, and which one should I pick?

ACA Marketplace plans come in four metal tiers, Bronze, Silver, Gold, and Platinum, plus a separate Catastrophic option, and all of them cover the same ten essential health benefits required under federal law. The tiers differ only in how the cost is split between your monthly premium and what you pay when you actually use care:

  • Bronze: Lowest premium, highest deductible. A reasonable fit if you’re healthy and mainly want protection against a major medical event.
  • Silver: Moderate premium and deductible. The only tier eligible for Cost-Sharing Reductions (CSRs), which lower your deductible and out-of-pocket costs if your income qualifies.
  • Gold: Higher premium, lower deductible. Usually the better deal if you expect to need regular care or have ongoing prescriptions.
  • Platinum: Highest premium, lowest deductible. Available in fewer states and from fewer insurers than the other tiers.
  • Catastrophic: Very low premium, very high deductible (around $10,600 for an individual in 2026). Previously limited to people under 30 or those with a hardship exemption, but KFF reports that CMS is expanding access to Catastrophic plans in 2026 for anyone who doesn’t qualify for premium tax credits or cost-sharing help, through a streamlined hardship exemption.

If your income qualifies you for Cost-Sharing Reductions, a Silver plan is almost always worth the extra premium, since CSRs are only available on Silver-tier plans and can meaningfully lower your deductible.

What is the income limit for ACA subsidies in 2026?

For 2026 coverage, premium tax credits are generally available to households with income between 100% and 400% of the federal poverty level, which is $15,650 to roughly $62,600 for a single individual, based on the prior year’s poverty guidelines used in subsidy calculations. This is sometimes called the “subsidy cliff,” because under current law there is a hard cutoff at 400% FPL rather than a gradual phase-out. From 2021 through 2025, the American Rescue Plan and the Inflation Reduction Act temporarily removed that cliff, but it returned for the 2026 plan year once those enhanced provisions expired, according to HealthCare.gov’s federal poverty level glossary.

If your income falls above that threshold, you can still buy an ACA Marketplace plan, but you’ll pay the full, unsubsidized premium. Several bills to extend the enhanced credits have been introduced in Congress, but as of this writing none have passed both chambers.

What are the alternatives to an ACA Marketplace plan?

If you don’t qualify for a subsidy, or you’ve decided a Marketplace plan isn’t the right fit, the realistic alternatives fall into three categories, each with a different trade-off between cost and protection:

Short-term health insurance offers lower premiums than ACA plans but is medically underwritten, meaning it can deny coverage or exclude conditions based on your health history. It doesn’t have to cover the ten essential health benefits and is not required to cover maternity care, mental health, or prescriptions the way ACA plans are.

Health sharing ministries are membership-based cost-sharing arrangements, not insurance. Members pay a monthly contribution, and the community pays eligible medical bills according to the organization’s own guidelines rather than a regulated insurance contract. They are exempt from ACA requirements, which means they can exclude pre-existing conditions, cap how much they’ll pay toward a given need, and are not required to cover the same essential health benefits.

Direct Primary Care (DPC), often paired with either a Catastrophic ACA plan or a health share, covers routine primary care through a flat monthly membership fee rather than insurance billing. It does not cover hospitalization, surgery, or specialist care on its own.

None of these alternatives include a federal subsidy, and none are required to guarantee coverage for a pre-existing condition the way an ACA plan is by law.

How do I know if I should switch from a Silver or Gold plan to a Bronze plan?

You should consider switching to a lower tier only if you’re confident you won’t need much care beyond preventive visits, since the trade-off is a significantly higher deductible in exchange for a lower monthly bill. KFF’s open enrollment guidance for 2026 specifically flags this as the central decision facing enrollees this year: many people are moving from Silver or Gold plans into Bronze or Catastrophic plans to manage the premium increase, but that shift means a much larger bill if a major medical event happens.

Before switching tiers, run the math on your actual expected use. If you take regular prescriptions, see a specialist routinely, or are planning a pregnancy, the lower premium on a Bronze plan can be outweighed quickly by a higher deductible once you start using care. If you’re generally healthy and mainly want protection against a worst-case scenario, the lower premium may be the better trade.

Frequently Asked Questions

When is open enrollment for 2026 ACA coverage? Open enrollment for 2026 coverage ran from November 1, 2025, through January 15, 2026, in most states, with a December 15, 2025 deadline for coverage starting January 1. A handful of state-based marketplaces, including California, New York, New Jersey, and Massachusetts, had later cutoff dates into late January. Outside of this window, you generally need a qualifying life event, like losing a job or getting married, to enroll through a Special Enrollment Period.

Are health sharing ministries the same as health insurance? No. Health sharing ministries are membership organizations that pool member funds to pay medical bills, not insurance companies, and they are exempt from ACA consumer protections. That means they can exclude pre-existing conditions, are not required to cover the ten essential health benefits, and have no legal obligation to pay a given medical bill the way an insurer does under a regulated policy.

What is the ACA subsidy cliff, and is it still in effect for 2026? Yes, the subsidy cliff is back for 2026. It refers to the hard income cutoff at 400% of the federal poverty level, above which a household receives no premium tax credit at all, rather than a gradual phase-out. The enhanced credits that eliminated this cliff from 2021 through 2025 expired on January 1, 2026, and current law reinstates the traditional 100%–400% FPL eligibility range.

Can I get an ACA plan if I have a pre-existing condition? Yes. Every ACA Marketplace plan is legally required to cover pre-existing conditions with no waiting period and no extra charge based on your health history. This protection does not apply to short-term health insurance or health sharing ministries, both of which can exclude or limit coverage for a pre-existing condition at their own discretion.

What’s the difference between a Bronze plan and a Catastrophic plan? Both have low monthly premiums and high deductibles, but a Catastrophic plan has an even higher deductible, around $10,600 for an individual in 2026, in exchange for an even lower premium. Catastrophic plans were previously limited to people under 30 or those with a financial hardship exemption, but CMS is expanding eligibility in 2026 to include anyone who doesn’t qualify for premium tax credits or cost-sharing reductions.

How much does the average person pay for an ACA Marketplace plan after subsidies? It depends heavily on income, since the subsidy is calculated on a sliding scale up to 400% of the federal poverty level. KFF reports that the average subsidized enrollee who keeps the same plan from 2025 is paying about $1,904 a year in 2026, up from roughly $888 in 2025, an increase driven by the expiration of the enhanced premium tax credits combined with rising base premiums.

This article is for general informational purposes only and is not insurance, legal, or financial advice. Premiums, subsidies, and eligibility rules referenced here reflect publicly available data from KFF.org and CMS.gov as of 2026 and are subject to change. Always confirm current figures directly at HealthCare.gov or with your state’s Marketplace before making a coverage decision.

By the Modern Healthcare Works team