The Marketplace is not your only option.

What Is Private Health Insurance?

Private Health Insurance Coverage Purchased Outside the Marketplace

Many people are surprised to learn that the Health Insurance Marketplace isn’t the only place to buy individual health insurance.

  • Earn too much to qualify for a subsidy?
  • Marketplace premium jumped again this year?
  • Your hospital or specialist is out of network?

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What Private Market Means

Coverage Bought Outside the Marketplace

Depending on your situation, you may also have access to private health insurance plans offered directly through insurance carriers. These plans are purchased outside the Marketplace and are not eligible for government premium subsidies. For individuals and families who do not qualify for financial assistance, private health insurance may be another option worth exploring.

As an independent health insurance broker, we compare both Marketplace (ACA) plans and private health insurance options. We’ll explain the differences, review your eligibility, compare provider networks, benefits, and costs, and answer your questions in plain language so you can make an informed decision based on your healthcare needs, budget, and preferences.

Our goal isn’t to recommend one type of plan over another. It’s to help you understand your options and choose the coverage that’s the best fit for your unique situation.

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Is This You

Who Private Market Coverage Is Right For

The private market is often the strongest fit for people the ACA Marketplace serves poorly. If any of these sound like you, it is worth a side-by-side comparison.

  • You earn too much to qualify for ACA subsidies
  • You do not qualify for Marketplace assistance
  • Your Marketplace premium jumped and you want better value
  • You need broader provider networks or specific hospitals
  • You want PPO access and the freedom to keep your doctors
  • You are an early retiree between 55 and 64
  • You are self-employed or an independent contractor
RJ Health Partners covering for an early retiree couple

Plan Types

Your Private Market Options

Four different structures, four different jobs. Here is what each one is actually built for.

A PPO gives you the flexibility to choose your doctors and specialists with no referral needed. You can see providers in and out of network, and you save more when you use doctors and hospitals inside the PPO network.

  • No referral needed to see a specialist
  • In-network and out-of-network care are both covered
  • Usually the broadest hospital and provider access
  • Best if you want to keep specific doctors

An HSA-eligible High-Deductible Health Plan (HDHP) typically has a lower monthly premium and a higher deductible than many traditional health plans. When paired with a Health Savings Account (HSA), it can help you set aside money for qualified medical expenses. Any unused HSA funds remain in your account and can be used for future qualified medical expenses.  An HSA-eligible plan may be a good option if you’re looking for lower monthly premiums and are comfortable with a higher deductible.

  • Typically lower monthly premiums with a higher deductible
  • Compatible with a Health Savings Account (HSA)
  • Unused HSA funds remain in your account for future qualified medical expenses
  • Best if you are generally healthy and want to build a medical fund

Catastrophic plans protect you from very high medical costs from a serious illness or injury. They cover major events like hospital stays, surgeries, and prescriptions, and are typically a lower-cost option for people who want essential protection without higher monthly premiums.

  • Lowest premiums of the private options
  • Covers hospital stays, surgeries, and prescriptions
  • Designed for worst-case protection, not routine care
  • Best if you want essential protection at the lowest monthly cost

Round out your coverage with dental and vision. Dental plans include preventive care like cleanings and exams, plus common procedures such as fillings and crowns. Vision plans help cover eye exams, glasses, and contact lenses. Standalone options are available for individuals and families.

  • Cleanings, exams, fillings, and crowns
  • Eye exams, glasses, and contact lenses
  • Available standalone, no medical plan required
  • Best added alongside any private medical plan

Why Go Private

What You Gain by Shopping Outside the Exchange

Broader Networks

More plan choices and wider provider access than many marketplace options.

Keep Your Doctors

Flexibility to stay with the specialists and hospitals you already trust.

Enroll Year-Round

Private plans can be purchased outside of ACA open enrollment in most cases.

Better Value Above the Subsidy Line

A strong fit for people who earn too much to qualify for subsidies.

Complete the Picture

Round Out Your Coverage

A medical plan is the foundation. These fill the gaps it was never designed to cover.

Dental Insurance

Preventive cleanings and exams, plus fillings, crowns, and major work.

Vision Insurance

Eye exams, glasses, and contact lenses for you and your family.

Supplemental Coverage

Accident, critical illness, and GAP plans that cover what medical leaves behind.

Common Questions

Private Market FAQs

Yes. Private PPO and EPO plans are available outside the marketplace and may offer better network access, more flexibility, or lower premiums depending on your situation. We compare options side by side for you.

If you earn above the subsidy threshold, private health plans are often more affordable and offer comparable or better coverage than marketplace plans. We help self-employed people and early retirees in exactly this situation.

An HSA is a tax-advantaged savings account for medical expenses. You must be enrolled in a qualifying high-deductible health plan to contribute. It is especially useful for the self-employed. Ask your tax professional about how it applies to you.

In-network providers have a contract with your insurer and charge lower rates. Out-of-network providers do not, so your costs are higher or, in some plans, not covered at all.

In most cases, yes. Unlike Marketplace coverage, many private plans are not restricted to Open Enrollment, so you can apply when you actually need coverage rather than waiting for a window.

No. We are paid a commission by the insurance carriers, not by you. Because we are independent, we quote both private and Marketplace plans and tell you which one genuinely wins for your situation.
Rossaue Hosein Insurance Broker

Get Started

Compare Private Plans Today

We’ll show you the best private options for your budget and your doctors. Free, no-obligation comparison.

Talk to a licensed broker

(813) 923-3133

info@rjhealthpartners.com

Tampa Bay and across Florida