Yes, and this is one of the most common reasons people call us. Premium tax credits phase
out as income rises, and plenty of self-employed people and higher earners land just past the
cutoff, where a full-price Marketplace plan stops making sense.
When that happens there are two directions. The first is an off-exchange ACA plan —
same consumer protections, same guaranteed coverage of pre-existing conditions, just purchased
directly from the carrier instead of through the Marketplace. Pricing is sometimes better and
the networks can differ.
The second is private, non-ACA coverage: short-term medical, hospital indemnity, accident
and critical illness plans, or coverage through a professional association or group. These can
cost considerably less month to month.
You should know the trade-off before anyone sells you one. Private plans are typically
medically underwritten, which means you can be declined or have a pre-existing condition
excluded, and they aren't required to cover the ten essential health benefits an ACA plan must
cover. For a healthy person who mainly needs protection against a catastrophe, that can be a
sound deal. For someone managing an ongoing condition, it usually isn't. We'll tell you plainly
which one you are and price both side by side.