Shopping “OFF the Marketplace”
WHO should buy a health plan OFF the Marketplace? Many consumers believe the only way to buy private health insurance in today’s market, is ON the Marketplace through the ACA / “Obamacare” website at healthcare.gov. This is not true. What is true, is that, it is the ONLY platform to receive financial assistance if eligible.
So, who wouldn’t want to buy through the Marketplace? Many clients bypass the government website altogether and buy directly from the carrier for one reason or another. Examples of consumers who seek coverage OFF the Marketplace include those with Modified Adjusted Gross Income (MAGI) that is too high (Above 400% FPL) to qualify for any financial assistance through Advanced Premium Tax Credits (APTC). Others find cheaper alternatives compared to what’s being offered by their employer, especially when comparing child only plans and premiums. Other consumer who are snowbirds or have college students away from home, MAY need a plan with a PPO network that covers them in both places. Sometimes, these plans with larger PPO networks are only available OFF the Marketplace.
If any of the above describes you, then you have the option to buy a ACA compliant health insurance plan directly from a carrier (with or without an agent) during the Open Enrollment Period (OEP), or Special Enrollment Period (SEP).
Of course, it’s always best to call an agent to assess your situation and suitability for an OFF Marketplace plan.