Can I buy health insurance outside of the Marketplace that meets all ACA consumer protection standards?

Yes. Many insurers that offer plans through the ACA Marketplace also offer identical plans outside of the Marketplace that meet all ACA standards, although premium tax credits and cost-sharing subsidies are not available for plans sold outside of the Marketplace. Some people prefer to buy health insurance outside of the Marketplace when they are sure they won’t qualify for financial assistance.

Like health insurance plans sold on the Marketplace, “ACA-compliant” plans sold outside of the Marketplace cover essential health benefits, and they won’t turn you down, charge you more, or limit coverage if you have a pre-existing health condition.

ACA-compliant plans are sold only during the annual Open Enrollment period, or at other times during the year for people who are eligible for a special enrollment period (such as losing other coverage or having a baby).

Many types of health plans that are not ACA-compliant, such as short-term limited-duration plans and hospital indemnity plans, are also sold outside of the Marketplace, though comparison-shopping may be more difficult. Plans that are not ACA-compliant may have lower premiums because they can exclude people with pre-existing conditions and offer more limited benefits.

Some signs that a health plan is not ACA-compliant include:

• The plan brochure states that it is “NOT comprehensive health coverage.”
• The application asks questions about your health status or medical history
• The plan doesn’t cover essential health benefits, such as maternity care or prescription drugs
• The plan has annual or lifetime dollar limits on how much the plan will pay for covered benefits
• The plan is for sale outside of Open Enrollment, regardless of whether the person is eligible for a special enrollment period

If you are shopping outside of the Marketplace and you want an ACA-compliant plan, be sure to specify that to the insurer or broker you’re working with.

Finally, even if you think you won’t qualify for financial assistance for a Marketplace plan, it still might be worthwhile to shop for coverage on the Marketplace. All plans offered through the Marketplace will meet ACA standards; no non-ACA-compliant plans are sold there.