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Buying Insurance Outside Of The Marketplace

Yes, you can buy health insurance outside the marketplace. Most insurance companies that offer health plans through the marketplace also offer policies outside the exchange. Even if you purchase a health plan outside the marketplace, the cost of the insurance plan will remain the same as it is for people purchasing health plans on exchange.

buying insurance outside of the marketplace

One of the main objectives of the health insurance marketplace is to make health plans more affordable and accessible to people. However, health plans purchased outside the marketplace may also offer the same benefits.

Some health insurance companies have opted not to participate in the ACA marketplace. If you prefer these companies for your health coverage, you will have to buy plans from them outside the marketplace.

Not necessarily. There are some health plans sold outside the health insurance marketplace that are required to provide the same basic set of benefits as plans sold inside the marketplace, are not allowed to exclude coverage of a pre-existing condition, and are also required to provide a minimum level of financial protection to their consumers. Specifically, these plans must cover at least 60 percent of what the average person would spend on covered benefits and there is a cap on the maximum amount you will pay out of pocket ($9,100 for an individual and $18,200 for a family in 2023).

However, it is important to note that you may only obtain premium tax credits and cost-sharing reductions if you purchase a plan through the health insurance marketplace. There is no income limit on eligibility for premium tax credits, so most people will do better to buy coverage through the health insurance marketplace.

While plans sold through the health insurance marketplace must be certified by the marketplace as meeting minimum coverage and quality standards, plans sold outside the marketplace need not be certified.

A good place to start looking for coverage is the Health Insurance Marketplace created in 2014 by the ACA. On the marketplace for your state, you can look through the details of private health insurance plans and compare the cost and benefits of each. If your state does not have its own marketplace, use

On-exchangehealth insurance plans are available on or a state-based exchange, also known as a marketplace. Financial help, or subsidies, are only available when you enroll in an on-exchange health plan. Subsidies include premium tax credits and cost-sharing reductions. If you qualify for financial help to lower the cost of health coverage, an on-exchange plan is your best option.

Carrier options also vary on and off government exchanges. Some health insurance companies may be licensed to sell plans in your state, but only on a private website. Other carriers may only sell exchange-based health insurance (which can still be listed on private websites, for the same price). And a few companies may offer health insurance plans on an exchange as well as in the private marketplace.

Our mission is to provide information that will help everyday people make better decisions about buying and keeping their health coverage. Our editorial staff is comprised of industry professionals and experts on the ACA, private health insurance markets, and government policy. Learn more about our content.

This is a set period of time every year when you can buy health coverage from private insurance companies or on the marketplace at You don't have to meet any special circumstances. Exact dates may vary from year to year.

Connect for Health Colorado is Colorado's insurance marketplace. Financial assistance is available for people who make 400% or less of the Federal Poverty Level if they buy their insurance plan through Connect for Health. You can apply for financial assistance and choose an insurance plan on Connect for Health's website,, or by calling them at 855-752-6749.

New insurance plans can only be chosen during open enrollment. Open enrollment for Colorado for 2023 runs from November 1, 2022 through January 15, 2023. You can sign up for or change your coverage outside of open enrollment if you have a qualifying life event, such as a marriage, a birth, a death, or a change in insurance offered through your job. If you miss the open enrollment window and do not have a qualifying life event, you will not be able to get insurance until the next open enrollment period.

Health insurance marketplaces, or health insurance exchanges, serve as online markets where individuals can compare policies and buy insurance. Some states, like Massachusetts, have their own state-based marketplaces, while others are using the federally managed marketplace.

Regardless of how your state's health insurance marketplace is managed, you may begin by visiting From there, you'll be directed to the correct marketplace for your state of residency.

You may be eligible for a subsidy if you enroll in a plan through the health insurance marketplace. This subsidy calculator, created by the Henry J. Kaiser Family Foundation, can help you estimate your subsidy amount. But be careful when estimating your income; if you underestimate your income when purchasing a plan, you may be required to pay back any subsidies you receive. We strongly suggest discussing your situation with a licensed tax professional before assuming you are eligible for a subsidy.

An Individual/Family Policy is insurance you buy outside of an employer or association. The policy is issued to the individual who applies for it and their family. More information about shopping for health insurance is available. Once you have an individual/family policy, you can add other family members and dependents in some cases.

As part of the Affordable Care Act, California created a health insurance marketplace called Covered California. Through Covered California, individuals, families, and small businesses can purchase insurance products sold by private insurers. Covered California also helps individuals and families determine if they qualify for the Medi-Cal program and subsidies from the federal government toward purchase of a private insurance plan. Visit Covered California for more information about getting coverage.

Health insurance plans for individuals and small employers must meet similar requirements inside and outside the Marketplace. These requirements include the coverage of essential health benefits, coverage of preexisting conditions, new rating requirements, and guaranteed availability and renewal.

If you're buying an individual/family major medical health insurance policy, it will be fully compliant with the ACA, regardless of whether it's an on-exchange or off-exchange plan. The same is true of small group health insurance plans.

No. The cost-sharing charges for the silver plan are automatically reduced for someone who is eligible for a cost-sharing reduction. For example, consider the situation of Jane, a single woman buying her own health insurance. If Jane is not eligible for CSR and enrolls in the standard silver plan shown in Table 1, she would have a $7,150 annual deductible, with a 30% coinsurance for many services after meeting that deductible, and a $70 co-payment for each physician visit (that would apply before the deductible is met). She could be charged no more than $9,100 in out-of-pocket charges (deductibles, co-payments, and coinsurance) for in-network covered benefits for the year. However, if Jane has income equal to 200 percent of the federal poverty line, she would face lower cost-sharing charges, as shown in the column of Table 1 for the plan with an 87 percent actuarial value. For example, she would have a $650 deductible instead of the $7,150 deductible under the standard silver plan. She would pay $10 for each doctor visit instead of $70.

Open enrollment for 2023 coverage has ended. You may still be eligible to enroll in coverage or change your current coverage outside of the annual Open Enrollment period if you have experienced a qualifying life event -- like losing the insurance you get through your job, getting married or divorced, or having a baby. These events would qualify you for a Special Enrollment Period, which means you may be eligible to enroll in a plan outside of the annual Open Enrollment period.

The ACA Health Insurance Marketplace is also known as the Health Insurance Exchange. The ACA Marketplace/Exchange is an online "marketplace" where individuals, families, and small business owners can compare plans and shop for health insurance that best fits their needs. Health plans sold on the ACA Marketplace/Exchange meet the requirements of the Affordable Care Act.

Minnesotans can enroll in health insurance coverage outside of MNsure, but doing this prevents access to financial help such as premium tax credits, low-cost or no-cost coverage. Only by enrolling through MNsure can consumers get access to financial help.

Those who have experienced a qualifying life event such as marriage, divorce, childbirth or adoption may qualify to buy insurance outside of open enrollment. If you are new to Connect for health visit the New Customers page of the Connect for Health Colorado website for more information. If you've already purchased health insurance through Connect for health Colorado and have experienced a qualifying life event, visit the Current Customers page to report your change and ensure you have the right coverage.

Connect for Health Colorado is a marketplace that helps individuals, families and small employers across Colorado purchase health insurance and apply for new federal financial assistance to reduce costs. connect for Health Colorado is the only place where Coloradans can apply for advance premium tax credits ad cost-sharing reductions to help pay for commercial insurance coverage. The next open enrollment period stats November 1st, 2020 for coverage that will begin January 2021. 041b061a72


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