Individual Health Insurance Customized for You

Three Ways to Buy Individual Coverage

If your employer doesn't offer a plan, you're not limited to one option. Three distinct paths lead to individual health insurance, and they're built differently under the law.

ACA Marketplace

Bought through HealthCare.gov or your state exchange. The only path that can carry income-based premium tax credits.

Best fit when: your income qualifies for a subsidy, or you have a health condition that needs guaranteed-issue protection.

Off-Exchange ACA-Compliant

Same required benefits and guaranteed-issue protections as Marketplace plans, sold directly by a carrier instead. No subsidies available this way.

Best fit when: your income is too high for a subsidy and you'd rather work directly with a carrier.

Private, Medically Underwritten

Priced and approved based on your health history. Can be less expensive for healthy applicants, but isn't guaranteed-issue and may exclude pre-existing conditions.

Best fit when: you're healthy, don't qualify for a subsidy, and want a lower premium while you're between other coverage.

Enrollment Timing

ACA Marketplace and off-exchange plans are only available to enroll in during specific windows:

• Open Enrollment: Generally November 1 through January 15 nationally, though a few state-run exchanges extend this window.
• Special Enrollment Period (SEP): A 60-day window triggered by a qualifying life event, such as losing other coverage, moving, marriage, or a new baby.

Private medically underwritten plans don't follow the same calendar; you can typically apply any time, subject to underwriting approval.

Pre-Existing Conditions

ACA Marketplace and off-exchange plans must accept you regardless of health history and cannot charge more because of a condition. Private medically underwritten plans can decline coverage or exclude a condition based on your health history, which is the main tradeoff for their typically lower premiums.