Is an off-exchange ACA plan right for me?

Off-exchange plans might be a good fit if you’re: A high earner: If your income disqualifies you from Marketplace subsidies, off-exchange plans could offer comparable coverage (without the subsidy factored in) at a potentially lower premium. Eligible for employer reimbursement: Your employer may offer a reimbursement arrangement, like ICHRA or QSEHRA, where they reimburse you for some or all of the premiums you pay for health insurance you purchase on your own. If you’re offered an ICHRA or QSEHRA, you typically won’t qualify for subsidies and will likely need to shop off-exchange plans. Seeking specific plans: Shopping off-exchange plans can offer a wider variety of options if you’re looking for different plans. Just be sure to consider factors like network coverage, premiums, deductibles and out-of-pocket costs.

Enroll today in an ACA plan that fits your budget

Q: What’s the difference between on-exchange vs. off-exchange ACA plans?

On-exchange plans are plans you purchase through the health insurance Marketplace (also called the Exchange), which is run by the federal government. These plans are ACA-compliant, meaning they must cover 10 essential health benefits for consumers. If you’re shopping on-exchange plans, you may be eligible for financial help in the form of monthly premium subsidies and cost-sharing reductions. Off-exchange plans are health insurance plans you buy directly from an insurance company or broker, outside of the health insurance Marketplace. Off-exchange plans are still ACA-compliant, providing minimum coverage and essential health benefits, but may offer more flexibility in coverage options. One of the biggest differences with an off-exchange plan is that you won't be eligible for the premium subsidies and cost-sharing reductions available on the Exchange.

Shopping for an off-exchange ACA Marketplace plan? UnitedHealthcare Individual & Family plans offer options that may meet your needs and budget. Enter your ZIP code and answer a few questions to find a plan for 2026 coverage. When you see the financial assistance question, select “No, show me off-exchange plans.”

ZIP code

Questions? Talk with a licensed insurance agent at:
1-855-537-9523, TTY 711

Looking for plans that offer subsidies?

Shop ACA plans with subsidies

Off-exchange plans may be a good fit if you …

Earn a high income

If you don’t qualify for Marketplace subsidies, off-exchange plans might offer similar coverage at a lower premium.

Get employer reimbursement

If your employer offers a reimbursement arrangement like ICHRA or QSEHRA, you likely won’t qualify for subsidies and may need to shop off-exchange.

Want more options

Off-exchange plans can provide a wider variety of options. Just make sure to review network coverage, premiums, deductibles and out-of-pocket costs.

Benefits made to support your needs

Our ACA Marketplace plans offer a variety of plans with the right coverage and price point for you. Here’s a look at some of the benefits you could get with one of our Individual & Family plans.

Shop our ACA Marketplace plans

Compare ACA plan costs and coverage

Plan name	Monthly premiums	Annual deductible	Metal levels
Essential	$	$$$$	Bronze
Value	$$	$$	All metal levels
Advantage	$$$	$	Silver and Gold
Copay Focus	$$$$	$0 medical deductible	All metal levels

Learn more about off-exchange ACA Marketplace plans

Let’s cover a few basics and get answers to common questions.

On-exchange plans are plans you purchase through the health insurance Marketplace (also called the Exchange), which is run by the federal government. These plans are ACA-compliant, meaning they must cover 10 essential health benefits for consumers. If you’re shopping on-exchange plans, you may be eligible for financial help in the form of monthly premium subsidies and cost-sharing reductions.

Off-exchange plans are health insurance plans you buy directly from an insurance company or broker, outside of the health insurance Marketplace. Off-exchange plans are still ACA-compliant, providing minimum coverage and essential health benefits, but may offer more flexibility in coverage options. One of the biggest differences with an off-exchange plan is that you won't be eligible for the premium subsidies and cost-sharing reductions available on the Exchange.  

Some employers offer reimbursement arrangements for employees to purchase coverage on their own through the ACA Marketplace, instead of offering employer group health insurance benefits. There are 2 types of reimbursements — Individual Coverage Health Reimbursement Arrangement (ICHRA) and Qualified Small Employer Health Reimbursement Arrangement (QSEHRA).

Employers reimburse some or all of the premiums employees pay for health insurance they purchase on their own. Typically, if you get an ACA Marketplace health plan with a reimbursement arrangement like ICHRA or QSEHRA, you won’t qualify for subsidies. This means you’ll need to shop for an off-exchange plan.

Off-exchange plans might be a good fit if you’re:

A high earner: If your income disqualifies you from Marketplace subsidies, off-exchange plans could offer comparable coverage (without the subsidy factored in) at a potentially lower premium.   
Eligible for employer reimbursement: Your employer may offer a reimbursement arrangement, like ICHRA or QSEHRA, where they reimburse you for some or all of the premiums you pay for health insurance you purchase on your own. If you’re offered an ICHRA or QSEHRA, you typically won’t qualify for subsidies and will likely need to shop off-exchange plans.    
Seeking specific plans: Shopping off-exchange plans can offer a wider variety of options if you’re looking for different plans. Just be sure to consider factors like network coverage, premiums, deductibles and out-of-pocket costs.

Looking for a plan?

Enter your ZIP code to see plans in your area.

ZIP code

Talk with a licensed insurance agent at:
1-800-806-0451, TTY 711

8 a.m. – 9 p.m. ET, Monday – Thursday
8 a.m. – 8 p.m. ET, Friday
9 a.m. – 5:30 p.m. ET, Saturday
Closed: Sunday

Already a member?

Call our Member Services team at:
1-877-265-9199, TTY 711

24/7 Member Services + Care Support or sign in to our member site.

Sign up for updates

Get helpful tips and information to help you better understand your options.⁷

Disclaimers

The benefits described may not be offered on all plans or in all states. Some plans may require copayments, deductibles and/or coinsurance for these benefits. The policy has exclusions, limitations, reduction of benefits, and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, review the plan coverage documents, or call or write your insurance agent/broker or the company, whichever is applicable. By responding to this offer or communication, you agree that a representative may contact you.

UnitedHealthcare Individual & Family plans medical plan coverage offered by: UnitedHealthcare of Arizona, Inc.; Rocky Mountain Health Maintenance Organization Incorporated in CO; UnitedHealthcare of Florida, Inc.; UnitedHealthcare of Georgia, Inc; UnitedHealthcare of Illinois, Inc.; UnitedHealthcare Insurance Company in AL, IN, KS, LA, MA, MO, NE, NJ, TN, and WY; Optimum Choice, Inc. in MD and VA; UnitedHealthcare Community Plan, Inc. in MI; UnitedHealthcare of Mississippi, Inc.; UnitedHealthcare of New Mexico, Inc.; UnitedHealthcare of New York, Inc.; UnitedHealthcare of North Carolina, Inc.; UnitedHealthcare of Ohio, Inc.; UnitedHealthcare of Oklahoma, Inc.; UnitedHealthcare of South Carolina, Inc.; UnitedHealthcare Benefits of Texas, Inc; UnitedHealthcare of Texas, Inc.; UnitedHealthcare of Oregon, Inc. in WA; UnitedHealthcare of Wisconsin, Inc., and UnitedHealthcare Plan of the River Valley, Inc. in Iowa. Administrative services provided by United HealthCare Services, Inc. or their affiliates.

Footnotes

Preventive care services are covered as required by the Affordable Care Act (ACA).
$0 cost-share for network periodic oral evaluation 2 times per consecutive 12 months. Adult dental benefit coverage is limited to a $1,000 benefit maximum per plan year. Coverage for routine vision exam and eyewear is limited to once every 12 months. If you opt to receive vision care services or vision care materials that are not covered benefits under this plan, a participating vision care provider may charge you their normal fee for such services or materials. Coverage may not be available on all plans or in all states. For costs and complete details of coverage, contact your insurance agent or the company, as applicable.
Pay $10 or more for a 1-month supply of generic medications listed on the Prescription Drug List (formulary). Refer to your plan documents to determine the formulary medication tiers for your state, the tier cost shares and any deductible or out-of-pocket amounts that may be required. Only applies to in-network pharmacies. See plan documents for more information. Not available on all plans or in all states.
Walgreens discount valid until 12/31/26. Discount valid only for in-store purchases of eligible Walgreens brand health and wellness products by current members eligible for the UnitedHealthcare discount program. Discount cannot be used online. For a full list of Walgreens brand health and wellness products and exclusions, please visit www.walgreens.com/smartsavings. Not available in Washington.
Unless otherwise required, virtual care benefits are available only when services are delivered through a designated virtual network provider. Virtual visits are not intended to address emergency or life-threatening medical conditions and should not be used in those circumstances. Services may not be always available, or in all locations, or for all members. Check your benefit plan to determine if these services are available. Data rates may apply. Certain prescriptions may not be available and other restrictions may apply.
Members age 18 and over can earn up to a $250 reward on a prepaid Visa® card upon completion of eligible activities. To earn $50, complete the following activities: set up a UnitedHealthcare member account on myuhc.com/exchange, opt-in to all types of text messages, sign up for all paperless plan communications, and the subscriber of the plan signs up for Autopay of premiums on behalf of all members enrolled on the plan (not available in New Jersey). To earn $50, complete the health risk assessment available on myuhc.com/exchange (excludes members in a Copay Focus plan in partnership with Kelsey-Seybold Clinic in Texas). To earn $150, complete a primary care provider (PCP) visit. The PCP reward is earned after claim is processed and can take 6-8 weeks. Limit one reward per eligible member. Eligible members who are unable to participate in an available program may be permitted to earn the same reward by completing a reasonable alternative. Call the number on the back of your health plan ID card to learn more. If you receive access to certain reward funds with your Card, you agree to the terms and conditions available at HealthyBenefitsPlus.com/HealthPerks. Call 1-833-818-8692 for rewards balance. No Cash (except as required by law) or ATM Access. Fees and usage restrictions may apply. See cardholder terms for details. Issued by Citizens Alliance Bank, Member FDIC, pursuant to a license from Visa® U.S.A. Inc.
By providing your email address, you have agreed to receive email messages from UnitedHealthcare containing advertisements of UnitedHealthcare products. You can stop receiving emails at any time by clicking “unsubscribe” in the footer of any UnitedHealthcare email. UnitedHealthcare recommends that you provide an email address that is personal and not tied to any account that is shared or could be monitored by someone besides you. Emails may be sent to you unsecure and could be read in transmission or by anyone who has access to your account. By providing your email address, you agree to our Privacy Policy.

Enroll today in an ACA plan that fits your budget

Which county are you in? UnitedHealthcare Individual & Family ACA plans are not available in your area. But we can still help. No results found near you

Off-exchange plans may be a good fit if you …

Earn a high income

Get employer reimbursement

Want more options

Benefits made to support your needs

Compare ACA plan costs and coverage

$

$$$$

$$

$$

$$$

$

$$$$

Learn more about off-exchange ACA Marketplace plans

Looking for a plan?

Which county are you in? UnitedHealthcare Individual & Family ACA plans are not available in your area. But we can still help. No results found near you

Already a member?

Sign up for updates

Enroll today in an ACA plan that fits your budget

Off-exchange plans may be a good fit if you …

Earn a high income

Get employer reimbursement

Want more options

Benefits made to support your needs

Compare ACA plan costs and coverage

$

$$$$

$$

$$

$$$

$

$$$$

Learn more about off-exchange ACA Marketplace plans

What’s the difference between on-exchange vs. off-exchange ACA plans?

How does employer reimbursement work?

Is an off-exchange ACA plan right for me?

Looking for a plan?

Already a member?

Sign up for updates