Health Plans API

The Opelyx Health Plans API provides structured access to ACA marketplace health insurance plan data covering all 50 states plus Washington, DC.

Coverage

• 30 FFM states — Federally Facilitated Marketplace (CMS PUF data)
• 21 SBM states — State-Based Marketplace (state exchange data)
• ~22,000 plans and ~1.4 million rate records for plan year 2026

Capabilities

Plan Search

Search by ZIP code, age, metal level, plan type, and more. Results include premiums calculated for the requested age.

Plan Comparison

Compare 2-4 plans side-by-side on premiums, deductibles, out-of-pocket maximums, and cost-sharing details.

Cost Estimation

Estimate out-of-pocket costs for common healthcare scenarios (low, moderate, high utilization).

APTC Calculator

Calculate Advanced Premium Tax Credit subsidies based on income and household size.

API Design

• HAL format — Responses use Hypertext Application Language with _links and _embedded
• RFC 9457 errors — All errors are application/problem+json Problem Details
• Cursor pagination — Keyset-based pagination for consistent, performant page traversal
• RFC 8288 Link headers — Pagination and resource discovery via standard Link headers
• Conditional requests — ETag and If-None-Match for cache validation

Endpoints

Endpoint	Description	Tier
GET /v1/health/plans	Search plans by ZIP + age	Free
GET /v1/health/plans/:id	Plan detail with rates and cost-sharing	Free
GET /v1/health/plans/compare	Compare 2-4 plans side-by-side	Pro
GET /v1/health/plans/:id/oop-estimate	Out-of-pocket cost estimation	Free
GET /v1/health/plans/aptc-estimate	APTC subsidy calculation	Pro
GET /v1/health/zip/:zip	ZIP to state/county/rating area	Free
GET /v1/health/years	Available plan years	Free

Next Steps

Concepts Learn how ACA plans, rates, and rating areas work

Guides Step-by-step workflows with code examples

API Reference Auto-generated endpoint documentation