Off-Market Health Insurance
Looking beyond the Marketplace? We offer independent guidance to help Texans explore off‑market (off‑exchange) health insurance—ACA‑compliant plans purchased directly through insurers or brokers.
Be Aware:
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Off‑market plans aren’t eligible for federal premium tax credits or cost‑sharing reductions—even if you'd otherwise qualify.
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While ACA‑compliant plans must meet specific federal requirements, they aren’t necessarily vetted or certified as Qualified Health Plans (QHPs) within the Marketplace, meaning additional protections (like standardized benefits or quality oversight) may not apply.
1
Greater variety
Access to insurers or plan types (e.g., broader networks, alternative formularies) not always available on the Marketplace.
2
Expanded plan options
These plans can include different provider networks, prescription drug formularies, or plan structures (e.g., PPOs or custom networks) that better suit your needs.
3
Customization
Flexible plan design that can offer better fit for your preferences—not confined by Marketplace requirements.
4
Same essential coverage
Plans still include all 10 ACA essential benefits, and identical plans carry the same premiums whether purchased on‑ or off‑exchange.
