Quick answer
You can buy an ACA plan directly from an insurer or through a licensed agent or broker instead of HealthCare.gov or your state’s marketplace. These off-exchange plans follow the same rules: they cover pre-existing conditions and essential benefits, and you can only enroll during open enrollment or after a qualifying event. The big difference is money: premium tax credits and cost-sharing reductions are only available on marketplace plans. If your employer offers an ICHRA, buying off the marketplace may let you pay your share with pre-tax payroll deductions; see what is an ICHRA.
Key takeaways
- Off-exchange ACA plans cover the same essential benefits and pre-existing conditions as marketplace plans.
- You can’t get a premium tax credit or cost-sharing reductions on a plan bought outside the marketplace.
- If you don’t qualify for a subsidy, an off-exchange plan can sometimes cost less, especially silver plans in some states.
- Agents and brokers are usually paid by insurers, so their help is typically free to you.
- Short-term plans and other non-ACA products are also sold off the exchange, but they don’t have to follow ACA rules.
On this page
Ways to buy off the exchange
- Directly from an insurer, on its website or by phone. You’ll only see that company’s plans.
- Through an insurance agent, who represents one insurer.
- Through a broker, who can show you plans from several insurers.
- Through an online quote site, which compares plans from multiple companies.
Some broker websites can also enroll you in marketplace plans with subsidies through a direct connection to HealthCare.gov. That counts as buying on the exchange. If you might qualify for help, make sure the site you use can apply your tax credit.
Same rules as the marketplace
Off-exchange ACA plans must follow the Affordable Care Act: they can’t reject you or charge more for your health, they must cover the essential health benefits, and they cap out-of-pocket costs. The same open enrollment dates apply, which for 2027 coverage run November 1, 2026, to January 15, 2027, on HealthCare.gov, and outside that window you need a qualifying life event.
When an insurer sells the same plan both on and off the exchange, it has to charge the same premium for it.
The main trade-off: no subsidies
Premium tax credits and cost-sharing reductions only apply to plans bought through the marketplace. For 2026 coverage, credits go to households with income between 100% and 400% of the federal poverty level ($15,650 to $62,600 for one person, or $15,960 to $63,840 for 2027 coverage). If you might qualify, apply through the marketplace first. See how health insurance subsidies work.
If you buy off the exchange and later find you’d have qualified, you generally can’t claim the credit for those months at tax time.
When buying off the exchange can make sense
- You earn too much for a subsidy. Since the larger subsidies expired after 2025, people above 400% of the poverty level pay full price either way.
- Cheaper silver plans. In many states, insurers raise marketplace silver premiums to cover the cost of cost-sharing reductions. Some offer off-exchange silver plans without that extra charge, which can save money if you get no subsidy.
- Different plan options. Some insurers sell plans or networks, such as PPOs, only off the exchange.
Even with no subsidy, it can be worth applying on the marketplace first, because your income could change during the year and you’d need to be enrolled there to get help.
Coverage that isn’t ACA insurance
Off-exchange sellers may also offer products that don’t follow ACA rules: short-term plans, fixed indemnity plans, discount plans and health care sharing ministries. They can refuse to cover pre-existing conditions and may skip benefits like maternity or mental health care. Health insurance coverage types explains the differences, and how much coverage health insurance actually offers helps you judge a plan.
Tips before you buy
- Confirm the plan is ACA-compliant; look for a metal level like bronze or silver.
- Compare several plans, including the same insurer’s marketplace versions. Our guides to picking a health plan and comparing health insurance rates can help.
- If you’re leaving a plan you already have, see how to switch health insurance companies.
- Self-employed people can often deduct premiums whether or not the plan came from the marketplace. See is health insurance tax deductible.
Want to see on-exchange and off-exchange prices? Compare quotes by ZIP code.
Frequently asked questions
Are off-exchange plans cheaper?
Only for people who don’t qualify for subsidies, and not always. The same plan costs the same on and off the exchange. The savings usually come from off-exchange silver plans or plans only sold outside the marketplace.
Can I switch from an off-exchange plan to a marketplace plan mid-year?
Usually not without a qualifying life event. You can switch during open enrollment.
Do off-exchange plans cover pre-existing conditions?
Yes, if they’re ACA plans. Short-term and other non-ACA plans may not.
Do I pay a broker for help?
Usually not. Brokers and agents are typically paid a commission by the insurer.
Sources
This article is general information, not insurance advice. Plan options vary by state and insurer, so compare current plans on HealthCare.gov, your state’s marketplace or with a licensed agent. Last reviewed September 2026.