Alaska Health Insurance Consumer Guide

Here are the eligibility requirements for health coverage through the Marketplace in Alaska:⁴

• You must live in Alaska.
• You must be lawfully present in the U.S.
• You must not be incarcerated.
• You must not be enrolled in Medicare.

Although most Alaska residents are thus eligible to use the Marketplace, eligibility for financial assistance (premium subsidies and cost-sharing reductions) has stricter rules. It depends on your income and how it compares with the cost of the second-lowest-cost Silver plan in your area – which depends on your age and location. In addition, to qualify for Marketplace financial assistance you must:

• Not have access to affordable health coverage offered by an employer. If your employer offers coverage but you feel it’s too expensive, you can use our Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies in the Marketplace.
• Not be eligible for Medicaid or CHIP.
• Not be eligible for premium-free Medicare Part A.⁵
• If you’re married, you must file a joint tax return with your spouse.⁶ (with very limited exceptions)⁷
• Not be able to be claimed by someone else as a tax dependent.⁸

The open enrollment window in Alaska runs from November 1 to January 15. This is when you can sign up for ACA-compliant individual and family health plans.

For your coverage to start on January 1, you must sign up by December 15. If you enroll between December 16 and January 15, your coverage will begin on February 1.⁹

You can still make plan changes or enroll in the Marketplace beyond the open enrollment window. However, you must qualify for a special enrollment period (SEP). SEPs generally require a qualifying life event, such as losing your health coverage involuntarily or gaining a dependent.

If you miss the open enrollment deadline and don’t have a qualifying life event, you may still be able to apply if you meet one of the following criteria:

• Your income is below 150% of the poverty level, and you qualify for premium tax credits. In this case, you can enroll anytime until at least 2025. 
• You’re a Native American or Alaska Native.¹⁰
• You lose Medicaid or CHIP coverage between March 31, 2023 and July 31, 2024. In this case, you can enroll through an extended special enrollment period.¹¹

To enroll in an Alaska Marketplace health plan, you can:

• Go to HealthCare.gov online – the ACA exchange website.
• Dial the Marketplace Call Center at (800) 318-2596.
• Contact an agent/broker, navigator, or certified application counselor.
• Enroll via an approved enhanced direct enrollment entity.¹²

Go to localhelp.HealthCare.gov to find a navigator, certified application counselor, or agent in your area. 

You can find affordable health insurance in Alaska by shopping on the ACA Marketplace/exchange (HealthCare.gov).

Depending on your income and circumstances, you may qualify for income-based subsidies called Advance Premium Tax Credits (APTC) under the ACA. These credits will reduce the amount you have to pay in premiums each month.

As of early 2024, 85% of Alaska Marketplace enrollees were receiving premium subsidies. The average subsidy amount was $732/month, reducing the average enrollee’s net premium to $215/month.¹³

(Note that the numbers above are based on effectuated enrollment in early 2024, which is different from the numbers and metrics reported at the end of open enrollment and reflected in the graphic below.)

Source: CMS.gov¹⁴

Another way to save money while using the Alaska exchange is cost-sharing reductions (CSR).¹⁵ You can qualify for CSR if your income is no more than 250% of the federal poverty level and you enroll in a Silver-level plan.¹⁶

Alaska Natives and American Indians qualify for a special version of CSR — with no out-of-pocket costs — if their household income isn’t more than 300% of the federal poverty level. Unlike regular CSR, which is only available on Silver-level plans, the CSR for Alaska Natives and American Indians is available on any metal-level plan.

If you’re not eligible for Marketplace subsidies, other ways to obtain affordable coverage include:

• Apply for Medicaid if you’re eligible: You can begin the enrollment process through HealthCare.gov (you’ll be directed to the state Medicaid program if it appears you’re eligible) or my.alaska.gov. Our Medicaid eligibility guide walks you through the details of Medicaid eligibility in Alaska.
  
• Look into short-term health insurance: If you’re looking for a more budget-friendly option, at least one insurer in Alaska offers short-term health insurance plans. However, these plans are not regulated by the ACA and subsidies are not available to offset their cost. If you’re eligible for financial assistance in the Marketplace, a Marketplace plan is likely to be a better option. And starting in September 2024, new short-term health plans will be subject to strict federal duration limits. 

Two insurance companies offer plans in Alaska’s health insurance Marketplace.¹⁷

One of them (Premera Blue Cross Blue Shield of Alaska) offers coverage statewide, but the other (Moda Assurance) only offers plans in the Anchorage and Fairbanks areas.¹⁸

Both carriers have filed rates and plans for 2025.¹⁹

Alaska’s Marketplace insurers have proposed the following average rate increases for 2025:

Source: RateReview.HealthCare.gov¹⁹

When looking at overall average rate changes, it’s important to understand:

• The averages only apply to full-price premiums. Few people pay full price since 85% of Alaska’s exchange enrollees receive subsidies.²⁰ Their net rate change depends on their plan rate and subsidy amount changes.
• Averages don’t account for premiums increasing with age. Even if an insurer doesn’t change rates, you’ll likely pay more each year as you get older. Subsidies may offset this rate change for eligible enrollees.

For perspective, here’s a look at how average pre-subsidy premiums have changed in Alaska’s individual/family market over the years:

• 2015: Average increase of 31% (largest in the nation)²¹
• 2016: Average increase of 39%²²
• 2017: Average increase of 7.3% (and Moda exited the market)²³
• 2018: Average decrease of 22%²⁴ (reinsurance program took effect)
• 2019: Average decrease of 3.9%²⁵
• 2020: Average rates unchanged²⁶ (Moda rejoined the market).
• 2021: Average unweighted decrease of 2%²⁷
• 2022: Average decrease of 3.7%²⁸
• 2023: Average increase of 19.1%²⁹
• 2024: Average increase of 16.4%³⁰

During open enrollment for 2024 health coverage, 27,464 people signed up for private health plans through Alaska’s exchange.³¹ This was a record high; you can see previous year enrollments in the chart below.

Alaska’s Marketplace enrollment initially peaked in 2016, then declined each year until 2020. But it has been steadily increasing since 2021. This growth is due in part to American Rescue Plan subsidies, which continue through 2025 thanks to the Inflation Reduction Act.³² 

The enrollment growth in 2024 is also partly due to the “unwinding” of the pandemic-era Medicaid continuous coverage rule. By April 2024, more than 6,000 Alaska residents had transitioned from Medicaid to a Marketplace plan during the unwinding period.³³

Source: 2014,³⁴ 2015, ³⁵ 2016,³⁶ 2017,³⁷ 2018,³⁸ 2019,³⁹ 2020,⁴⁰ 2021,⁴¹ 2022,⁴² 2023,⁴³ 2024⁴⁴

HealthCare.gov
The official federal website where you can sign up for health insurance plans through the ACA Marketplace. 

Denali KidCare
Alaska’s children’s health insurance program. 

United Way of Anchorage
Federally funded Navigator organization to assist with Medicaid and exchange enrollment in Alaska. 

Alaska State Health Insurance Counseling and Assistance Programs (SHIP)
Enrollment counseling and advice to Medicare beneficiaries and their caregivers.

Medicare Rights Center
A national service for Medicare-related questions.

Alaska Comprehensive Health Insurance Association
Created by the Alaska State Legislature to provide coverage for residents unable to obtain individual health insurance.