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Landon Mitchell
Landon Mitchell

Can I Buy Health Insurance Without Going Through The Marketplace

While we have made every effort to provide accurate information in these FAQs, people should contact the health insurance Marketplace or Medicaid agency in their state for guidance on their specific circumstances.

can i buy health insurance without going through the marketplace


The Affordable Care Act (ACA) provides individuals and families greater access to affordable health insurance options including medical, dental, vision, and other types of health insurance that may not otherwise be available. Under the ACA:

Visit to apply for benefits through the ACA Health Insurance Marketplace or you'll be directed to your state's health insurance marketplace website. Marketplaces, prices, subsidies, programs, and plans vary by state.

Most health insurance plans and Medicare severely limit or exclude long-term care. If you want coverage, you may need a separate long-term care insurance policy. These questions can help you evaluate long-term care insurance policies.

Medicare provides medical health insurance to people under 65 with certain disabilities and any age with end-stage renal disease (permanent kidney failure requiring dialysis or a kidney transplant). Learn about eligibility, how to apply and coverage.

Open enrollment is the period within the year that people can enroll in a health insurance plan. Open enrollment for the Health Insurance Marketplace runs annually from early November to mid-December, with coverage starting in the New Year. In 2021, You can enroll in Marketplace health coverage February 15 through May 15 due to the coronavirus disease 2019 (COVID-19) emergency.

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.

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.

Another reason to shop for your health insurance off-exchange is the network of healthcare providers included in the plan. In some cases, health insurance companies control their costs by limiting the provider networks for exchange plans.

So, you might have trouble finding a preferred provider organization (PPO) plan on the marketplace. Instead, you might be limited to health maintenance organization (HMO) and exclusive provider organization (EPO) plans, which have restricted provider networks.

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.

Employer-sponsored group health insurance is a health plan chosen and primarily paid for by your employer. These plans are also offered to or can include your dependents (usually spouses and children). Your employer chooses which plan options are available to you and picks up the bulk of the cost of health insurance premiums. Employees also typically pay premiums, which are taken out of your check on a pre-tax basis, which lowers your taxable income.

The health insurance marketplace at provides insurance plans to individuals, families and small businesses. Through this online resource, you can learn more about health insurance, compare plans, enroll in a plan and figure out how much you can save through premium tax credits and subsidies.

To buy a policy through the marketplace, you must apply during open enrollment or special enrollment. Open enrollment for 2023 coverage begins Nov. 1, 2022, for the federal marketplace and runs until Jan. 15, 2023, in most states. To have your coverage start by Jan. 1, 2023, enroll in your plan by Dec. 15, 2022.

The best time to sign up for health insurance is before you need it. Open enrollment for private health insurance through the federal marketplace (and many state marketplaces) begins on Nov. 1 every year and runs until Jan. 15.

During open enrollment, callers impersonate representatives of the insurance marketplace, offering special rates or encouraging you to join an association or union to get covered. Government representatives will never call to try and sell you insurance, nor will they push you with high-pressure sales pitches.

You can sign up for Original Medicare from the government or get Medicare Advantage, which is offered by private health insurance companies that contract with the government. If you have Original Medicare, you can get prescription drug benefits through Medicare Part D.

You can also get coverage through the ACA marketplace. Depending on your household income, you may get a subsidized ACA plan that may provide premium tax credits and cost-sharing subsidies that reduce out-of-pocket costs.

Insurance you get through your job or an association is called group insurance. You must be a member of the group to get coverage. Most people get health insurance through their job, but not all employers offer it.

Tax credits are amounts taken off what you owe in taxes. You can use this savings to pay your health insurance premiums. To get a tax credit, you must buy through the federal marketplace. Your income must be between 100% and 400% of the federal poverty level.

These types of health insurance provide only limited coverage. Companies selling them can deny you coverage or charge you more if you have a preexisting condition. They also usually limit the amount they will pay for your care.

Guaranty associations pay claims for licensed insurance companies that go broke. There are separate guaranty associations for different lines of insurance. The Texas Life and Health Insurance Guaranty Association pays claims for health insurance. It will pay claims up to a dollar limit set by law.

Your COBRA coverage will be the same as the coverage you had with your employer's plan. If you continue HMO coverage and move out of the service area, the HMO will pay only for emergency care. COBRA coverage will end if your employer stops offering health insurance.

Under the federal Affordable Care Act (ACA), companies with 50 or more employees will be assessed a penalty starting in 2015 if they do not offer group health insurance to fulltime workers. Companies with fewer than 50 employees are exempt from the penalty.

For those without affordable group insurance, another option might be one of the health care plans offered by the Minnesota Department of Human Services. These plans have very low, if any, enrollee cost sharing and in Minnesota will cover low income adults as well as children. An individual looking for insurance on MNsure will be screened for eligibility for the Minnesota health care plans. Those deemed eligible will be directed to DHS. Go to Minnesota Department of Human Services to learn more about the Minnesota Health Care Programs available to eligible Minnesotans.

Help shopping and choosing a health plan is available via navigators, in-person assisters, certified application counselor and licensed insurance agents/brokers, and via the MNsure customer call line at 1-855-366-7873. For more details about MNsure, go to MNsure.

Individual and small group health insurance called Qualified Health Plans (QHPs) will be sold on MNsure. For those with lower incomes but not eligible for Minnesota health care programs, MNsure will determine if they quality for a subsidy to help pay for the insurance. Subsidies are only available for shoppers using the MNsure website. A subsidy will be used to discount your insurance premium.

Medicare coverage is not subject to these market reforms. Go to Minnesota Board on Aging or Minnesota Department of Commerce - Insurance or for more information about Medicare health plans and Medicare supplemental insurance.

To help make health insurance more affordable, the federal government offers financial help, also called subsidies, to individuals and families who qualify based on their income and household size. There are two types of subsidies available: Advanced Premium Tax Credit (APTC) and Cost Sharing Reductions (CSRs).

This website is operated by Blue Cross and Blue Shield of North Carolina and is not the Health Insurance Marketplace website. This website does not display all QHPs available through the Health Insurance Marketplace website. To see all available QHP options, go to the Health Insurance Marketplace website at All information discussed on this page pertains to Blue Cross NC individual-market, medical health insurance plans that are eligible for sale in 2023 and meet ACA guidelines. The information contained does not apply to plans that are transitional, group, dental-only or other plan types. All details regarding plan benefits and design contained herein are for informational purposes only. Please see the product benefit booklet for all terms and conditions that apply.

Your coverage will automatically renew. Your coverage may be canceled by Blue Cross NC for fraud or intentional misrepresentation of material fact on your application or for nonpayment of premiums. Coverage for dependent children ends at the end of the month they become age 26. Members will be notified 30 days in advance of any change in coverage. To be eligible for a catastrophic health plan, you must be under 30 years of age when the plan begins or qualify for a hardship exemption through the federal government.

Blue Cross NC has collaborated with Novant Health to bring you Blue Home with Novant Health. Blue Home with Novant Health is a health insurance plan offered by Blue Cross NC that provides access to a limited network of providers. Novant Health is an independent company that is solely responsible for the physicians and medical facilities it owns and operates. Novant Health does not offer Blue Cross or Blue Shield products or services. 041b061a72


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