If you live in Indiana and need health insurance, the Affordable Care Act (ACA) Marketplace gives you access to subsidized coverage based on your income and household size. Whether you are shopping for a plan during Open Enrollment or looking into options after a qualifying life event, understanding the eligibility rules for 2026 can save you hundreds of dollars each month.
Indiana residents have two main paths to affordable health coverage under the ACA: Marketplace plans with premium tax credits and the Healthy Indiana Plan (HIP), which is the state's Medicaid expansion program for adults. This guide breaks down who qualifies for each, what the income limits look like, which insurance companies offer plans in Indiana, and exactly how to apply.
How ACA Eligibility Works in Indiana
The ACA Marketplace is open to U.S. citizens and lawfully present residents who live in Indiana and are not incarcerated. To enroll, you must not be eligible for Medicare or have access to qualifying employer coverage that meets affordability standards.
Your eligibility for financial help depends on your Modified Adjusted Gross Income (MAGI) and household size. In Indiana, the system works on a sliding scale:
- Below 138% of the Federal Poverty Level (FPL): You likely qualify for the Healthy Indiana Plan (HIP), Indiana's Medicaid program for adults. This is the first option the system checks.
- Between 100% and 400% FPL: You qualify for premium tax credits that lower your monthly insurance bill on the Marketplace.
- Above 400% FPL: Under the standard ACA rules, premium subsidies phase out at 400% FPL. Enhanced subsidies introduced by the American Rescue Plan removed this cap through 2025. Check Healthcare.gov for the latest information on whether enhanced subsidies remain available for 2026 coverage.
Because Indiana expanded Medicaid through the Healthy Indiana Plan, there is no coverage gap. Adults with incomes below 138% FPL have a clear path to coverage through HIP, while those above that threshold can access Marketplace subsidies.
2026 Federal Poverty Level Guidelines
The Department of Health and Human Services updates poverty guidelines each year. These are the 2026 FPL amounts used to determine ACA and Medicaid eligibility:
| Household Size | 100% FPL (Annual) | 138% FPL (Medicaid Cutoff) | 400% FPL (Subsidy Ceiling) |
|---|---|---|---|
| 1 | $15,960 | $22,025 | $63,840 |
| 2 | $21,640 | $29,863 | $86,560 |
| 3 | $27,320 | $37,702 | $109,280 |
| 4 | $33,000 | $45,540 | $132,000 |
| 5 | $38,680 | $53,378 | $154,720 |
| 6 | $44,360 | $61,217 | $177,440 |
For each additional person beyond six, add $5,680 to the 100% FPL figure.
How to read this table: If your household income falls between the 138% FPL column and the 400% FPL column, you likely qualify for Marketplace premium tax credits. If your income is at or below the 138% FPL column, you may qualify for the Healthy Indiana Plan instead.
Healthy Indiana Plan (HIP) Income Limits
Indiana's Medicaid expansion program, the Healthy Indiana Plan, covers adults aged 19 and older with incomes up to 138% FPL. The following monthly income limits are effective as of March 1, 2026, according to the Indiana Family and Social Services Administration:
| Household Size | Monthly Income Limit |
|---|---|
| 1 | $1,835.50 |
| 2 | $2,489.20 |
| 3 | $3,141.85 |
| 4 | $3,795.50 |
| 5 | $4,449.20 |
HIP members are required to make a monthly contribution of 2% of household income into a Personal Wellness and Responsibility (POWER) account to receive HIP Plus benefits. Those who do not make contributions receive HIP Basic, which has more limited benefits and includes copayments.
For children, Indiana's Hoosier Healthwise program covers kids through age 18 at higher income thresholds (approximately 261% FPL). Monthly income limits for children effective March 1, 2026 are:
| Household Size | Monthly Income Limit |
|---|---|
| 1 | $3,391.50 |
| 2 | $4,599.20 |
| 3 | $5,805.85 |
| 4 | $7,012.50 |
| 5 | $8,220.20 |
ACA Marketplace Subsidies: What You Can Save
Premium tax credits work by capping the percentage of income you spend on the benchmark Silver plan. The less you earn relative to the poverty level, the lower your expected contribution. Here is a general breakdown of how premium costs scale:
- 100% to 150% FPL: You may pay close to $0 per month for a benchmark Silver plan, and many Bronze plans are available at no premium cost.
- 150% to 200% FPL: Expected contribution is roughly 2% to 4% of income toward premiums.
- 200% to 250% FPL: Expected contribution is roughly 4% to 6% of income.
- 250% to 300% FPL: Expected contribution is roughly 6% to 8% of income.
- 300% to 400% FPL: Expected contribution increases gradually up to approximately 8.5% of income.
In addition to premium tax credits, households earning between 100% and 250% FPL may also qualify for cost-sharing reductions (CSRs). These lower your deductibles, copays, and out-of-pocket maximums when you select a Silver-level plan.
Important note: The exact dollar amounts of your premium tax credit depend on the cost of plans available in your area. Use the Healthcare.gov income calculator or our free screener to get a personalized estimate.
Insurance Companies Offering Marketplace Plans in Indiana (2026)
Five insurance carriers are approved to sell individual Marketplace plans in Indiana for 2026:
| Carrier | Counties Covered | Plan Levels Available |
|---|---|---|
| Anthem Insurance Companies, Inc. | 85 | Catastrophic, Bronze, Silver, Gold |
| CareSource Indiana Inc. | 92 | Bronze, Silver, Gold, Platinum |
| Cigna Health and Life Insurance Company | 15 | Bronze, Silver, Gold |
| Coordinated Care Corporation | 92 | Silver, Gold |
| United Healthcare Insurance Company | 50 | Bronze, Silver, Gold |
The number of plan options and which carriers are available varies by county. Check the Indiana Marketplace County Coverage Map to see which carriers serve your area.
Open Enrollment and Special Enrollment Periods
Open Enrollment for 2026 Coverage
The Open Enrollment period for 2026 Indiana Marketplace plans was November 1, 2025 through January 15, 2026. If you enrolled and paid your first premium by December 15, 2025, your coverage began on January 1, 2026.
If Open Enrollment has already closed, you may still be able to enroll through a Special Enrollment Period.
Special Enrollment Period (SEP) Qualifying Events
You can enroll outside of Open Enrollment if you experience a qualifying life event, including:
- Losing existing health coverage (job loss, aging off a parent's plan, losing Medicaid)
- Getting married or divorced
- Having or adopting a baby
- Moving to a new state or county
- Turning 26 and losing coverage under a parent's plan
- Changes in household income that affect Medicaid or subsidy eligibility
You generally have 60 days from the qualifying event to enroll in a Marketplace plan.
How to Apply: Step by Step
For ACA Marketplace Plans
- Gather your information. You will need Social Security numbers, income documents (pay stubs, W-2s, or tax returns), and information about any employer coverage available to your household.
- Go to Healthcare.gov. Indiana uses the federal Marketplace. Create an account or log in to your existing one.
- Complete your application. Enter your household size, income, and other details. The system will determine your eligibility for premium tax credits and cost-sharing reductions.
- Compare plans. Review the available Bronze, Silver, Gold, and Platinum plans in your county. Pay attention to monthly premiums, deductibles, and provider networks.
- Select a plan and enroll. Choose the plan that fits your needs and budget.
- Pay your first premium. Your coverage does not start until you pay. Set up autopay to avoid missing future payments.
Need help? Certified Indiana Navigators offer free assistance with the enrollment process. You can also call the Marketplace at 1-800-318-2596.
For the Healthy Indiana Plan (HIP/Medicaid)
- Apply online through the FSSA Benefits Portal.
- Apply by phone by calling 800-403-0864.
- Apply in person at your local Division of Family Resources (DFR) office.
Medicaid applications are processed year-round. There is no limited enrollment period.
Other Benefits You May Qualify For
Many Indiana residents who qualify for ACA coverage or Medicaid also qualify for additional assistance programs. These include:
- SNAP (food assistance): Income limits for a family of four are approximately $3,483 per month gross income.
- LIHEAP (energy assistance): Helps pay heating and electric bills for households at or below 60% of State Median Income. The application period runs October 1, 2025 through April 20, 2026.
- WIC: Provides nutrition assistance for pregnant women, new mothers, and children under 5 at incomes up to 185% FPL.
- EITC: Indiana offers a state Earned Income Tax Credit worth 9% of the federal EITC for working families.
Use our free benefits screener to check your eligibility for all available programs in just a few minutes. You can also visit our Indiana Benefits Overview for a complete look at programs available in the state.
Frequently Asked Questions
What is the income limit for ACA subsidies in Indiana for 2026?
Under the standard ACA rules, premium tax credits are available for households earning between 100% and 400% of the Federal Poverty Level. For a single person, that means an annual income between $15,960 and $63,840. For a family of four, the range is $33,000 to $132,000. Check Healthcare.gov for the latest subsidy rules, as enhanced subsidies that removed the 400% income cap may or may not have been extended beyond 2025.
Can I get Medicaid instead of a Marketplace plan?
Yes. Indiana expanded Medicaid through the Healthy Indiana Plan (HIP). If your income is at or below 138% FPL (about $1,835.50 per month for a single person), you likely qualify for HIP. Medicaid applications are accepted year-round, so you do not have to wait for Open Enrollment.
What happens if my income changes during the year?
You should report income changes to the Marketplace as soon as possible. If your income drops below 138% FPL, you may become eligible for HIP. If your income increases, your premium tax credit amount may change. Failing to report changes can result in owing money back at tax time.
I missed Open Enrollment. Can I still get coverage?
You may qualify for a Special Enrollment Period if you experienced a qualifying life event such as losing other coverage, getting married, having a baby, or moving. You can also apply for Medicaid or the Healthy Indiana Plan at any time of the year.
Do I have to pay anything for HIP?
HIP requires monthly contributions of 2% of household income into a POWER account to receive HIP Plus benefits. If you do not make contributions, you receive HIP Basic, which has higher copays and does not include vision or dental benefits.
What if I earn too much for subsidies but cannot afford insurance?
If your income is above 400% FPL and you do not qualify for premium tax credits, you can still purchase a Marketplace plan at full price. You may also want to consider a Bronze or Catastrophic plan (if you are under 30 or qualify for a hardship exemption), which tend to have lower monthly premiums.
Where can I get free help with enrollment?
Certified Indiana Navigators provide free, confidential help with Marketplace enrollment. Find one near you through the Indiana Department of Insurance navigator search. You can also call the Marketplace help line at 1-800-318-2596.
Next Steps
The best way to find out what you qualify for is to check your eligibility. Use our free screener to see your estimated savings across ACA subsidies, Medicaid, and other benefit programs in under five minutes. For a broader view of all Indiana assistance programs, visit our Indiana Benefits Overview.
