Home › Guides › Private plans
Guide · Outside the MarketplacePrivate health insurance outside the Marketplace.
HealthCare.gov is one door, not the only one. If your income is too high for a subsidy, or you want a wider network, here is every kind of coverage sold outside the Marketplace in Florida, explained without a sales pitch.
Most people only hear about two choices: an employer plan or HealthCare.gov. In reality there are five kinds of coverage you can buy in Florida, and the right one depends on three things: your income, your health and the doctors you want to keep.
1. Off-Marketplace ACA plans
Insurers sell many of the same ACA-compliant plans directly or through agents, and some sell plans that are not on HealthCare.gov at all. These plans follow every ACA rule: no health questions, pre-existing conditions covered, essential health benefits included and an out-of-pocket maximum. In Broward County, for example, thirteen insurers sell individual plans off the exchange for 2026, against eleven on it.
The catch: no premium tax credit. If your income is under 400% of the poverty level, buy through the Marketplace instead so you keep your subsidy.
Good fit for: people over the subsidy cliff who want ACA protections, or who want a plan or network that is not on the Marketplace.
2. Underwritten private plans
Some insurers sell major medical plans that ask about your health and price you individually. They are not ACA plans. Many are built on national PPO networks, which can matter if you travel or split the year between Florida and another state.
The catch: the insurer can decline you, charge more, or exclude a condition. Benefits are defined by the policy, not by the ACA, so maternity, mental health or prescriptions may be limited. Read the exclusions and the maximum benefits line by line.
Good fit for: healthy people over the subsidy cliff who want a broad network and a lower premium, and who understand what is excluded.
3. Short-term plans
Short-term health insurance is designed for gaps, such as the months before a new job's plan starts. Florida law allows initial terms under 12 months and up to 36 months in total. A 2024 federal rule cut that to four months, but in August 2025 federal agencies said they would not prioritize enforcing it, so longer Florida plans are available again. That could change.
The catch: short-term plans usually exclude pre-existing conditions, often skip maternity, mental health and prescriptions, and can cap what they pay. They are not a long-term plan.
Good fit for: a known, short gap for a healthy person who missed open enrollment and has no special enrollment period.
4. Fixed indemnity and supplemental plans
These pay a set amount per event, for example a fixed sum per hospital day or per doctor visit, regardless of the actual bill. Accident, critical illness and hospital indemnity plans fall here.
The catch: they are not major medical insurance. A serious illness can cost far more than the fixed amounts pay. Use them alongside real coverage, never instead of it.
5. Health-sharing programs
Health-care sharing ministries are faith-based nonprofits whose members share medical costs. Florida law is explicit that they are not insurance, are not protected by the Florida Insurance Code, and that members remain responsible for their own bills. To qualify under Florida law, they cannot be sold through licensed insurance agents, which is why an agent cannot enroll you in one.
The catch: nothing guarantees a bill will be shared. Pre-existing conditions and some kinds of care are often limited.
How to choose
- Under 400% of the poverty level? Start with the Marketplace. A subsidy usually beats anything else. Check yours with the ACA subsidy calculator.
- Over the cliff and healthy? Compare off-Marketplace ACA plans with underwritten private plans side by side, including the exclusions.
- Over the cliff with ongoing conditions? Stay with ACA-compliant coverage, on or off the Marketplace, so those conditions are covered.
- Self-employed? The self-employed calculator shows what any plan really costs after your tax deduction.
As an independent agency we compare these side by side, including what each one leaves out. Get a free comparison and we will send real options for your ZIP code within 24 hours.
Common questions
Can I buy health insurance outside the Marketplace?
Yes. Many insurers sell ACA-compliant plans directly or through licensed agents, and Florida also allows underwritten private plans, short-term plans and supplemental coverage. Only Marketplace plans can carry a premium tax credit.
Are plans outside the Marketplace cheaper?
Sometimes. An off-exchange ACA plan costs the same as the matching Marketplace plan, without a subsidy. Medically underwritten plans can cost less for healthy people because the insurer prices your health, but they can exclude conditions or decline you.
Do private plans cover pre-existing conditions?
ACA-compliant plans, on or off the Marketplace, must. Underwritten private plans and short-term plans usually do not have to, so read the exclusions before you buy.
Is a health-sharing ministry insurance?
No. Florida law says these programs are not insurance and are not protected by the Florida Insurance Code. Members share costs voluntarily and stay responsible for their own bills.
