Skip to main content

By state

State-specific information.

Health insurance is regulated state by state. Pick yours to see which marketplace serves it, and what that means for your deadlines and your application.

Every state has an insurance department that licenses insurers and reviews rates, its own Medicaid program with its own income limits, and its own decision about whether to run a health insurance marketplace. Most states leave the marketplace to the federal government and send residents to HealthCare.gov. Twenty one, counting the District of Columbia, run their own.

States that run their own marketplace

In these states you shop, apply, and claim any premium tax credit on the state site rather than on HealthCare.gov. Deadlines, extra state subsidies, and plan designs are set locally, so check the state site even if you know the federal rules.

What actually differs by state

Enrollment deadlines

Federal Open Enrollment runs November 1 through January 15. Several state-run marketplaces extend past that date, and a few start earlier. Missing the deadline means waiting for a qualifying life event, so confirm the date where you live rather than assuming the federal one.

Which plans are sold in your county

Insurers file plans county by county, not statewide. Two neighboring counties can have different carriers, different networks, and different prices for the same metal tier. This is why every quote starts with a ZIP code.

Medicaid eligibility

Income limits, whether the state expanded coverage to adults, and how the program is administered are all state decisions. Medicaid and CHIP accept applications year round.

State coverage requirements

There has been no federal penalty for going without coverage since 2019, but California, Massachusetts, New Jersey, Rhode Island, and the District of Columbia impose their own, and Vermont asks residents to report coverage on their state return.

Consumer protections beyond the federal floor

Some states go further than federal law on surprise billing, ground ambulance charges, network adequacy, short-term plans, and external review. Your state department of insurance publishes what applies and handles complaints.

How marketplace plans workCheck Medicaid eligibility

Plans in your county

Insurers file plans county by county. Enter your ZIP code to see what is actually sold where you live.

The landscape

How coverage is split across the country.

marketplaces run by a state or DC
21
state marketplaces using the federal platform
2
states including DC that expanded Medicaid
41
insurance departments regulating your policy
51

Good to know

Common questions about state differences.

Why does it matter which marketplace my state uses?
Because the application, the plan list, and sometimes the deadline all live there. States that run their own marketplace set their own Open Enrollment window, and several of them run later than the federal January 15 date. They also make their own decisions about extra state subsidies, standardized plan designs, and how they handle special enrollment periods. Applying on the wrong site is the most common way people miss a deadline.
Do premium tax credits work the same in every state?
The federal premium tax credit is set by federal law and works the same way whichever marketplace you use, as long as you buy a qualified health plan through the marketplace rather than directly from an insurer. Some states add their own subsidy on top of the federal credit for certain income ranges, which is one more reason to apply through the state marketplace where one exists.
How does Medicaid differ by state?
Substantially. Each state sets its own income limits within federal rules, decides whether to cover adults under the Affordable Care Act expansion, and runs its own application. There is no enrollment window for Medicaid or CHIP, so you can apply in any month. If you apply through the marketplace and look eligible for Medicaid, your application is routed to the state agency.
What else varies from state to state?
Which insurers sell in your county and what their networks look like, whether the state has its own coverage requirement and penalty, how the state handles short-term plans, how surprise bills and ground ambulance charges are handled beyond the federal floor, and how appeals and external review are administered. Your state department of insurance is the authority on all of it.
Can I use a licensed agent instead of applying myself?
Yes, in every state. A licensed agent can enroll you in marketplace and off-marketplace coverage, and the premium is the same either way because agent commissions are already built into the rates insurers file with regulators. If you would rather talk it through, enter your ZIP code or call us.

Wherever you live

See the plans sold in your county.

Enter your ZIP code and a licensed agent can walk you through the options and the deadlines that apply in your state.

Compare plans available in your area in minutes.