What are the private health insurance options for high earners who buy off-exchange?
High earners who do not use HealthCare.gov Marketplace pricing help buy the same ACA-compliant private plan off-exchange directly from the carrier or an independent broker and pay the full-price premium out of pocket (HealthCare.gov, 2026).
Reviewed by Jason Burns, Editor & Steward · Last verified 2026-07-19
What it means
- The plans are identical policies; the only difference is that no Marketplace price adjustment is applied to your premium. Off-exchange buyers often have more plan designs to choose from, including PPOs with broader networks.
Action steps
- Get quotes for two or three carriers in your state and compare the same metal tier.
- If you have variable income, consider a HDHP + HSA to shelter pre-tax dollars for medical expenses.
Risks & deadlines
- Off-exchange enrollment still follows Open Enrollment and Special Enrollment Period deadlines.
Sources
Talk to a licensed agent
Phone consultations only — 1-866-254-9580. Private Health Insurance Direct Questions is an educational question directory for full-price, off-exchange private health insurance buyers. It is not medical, legal, tax, or benefits advice.
Source: full plain-language answer at Private Health Insurance Direct Answers. Licensed under Citation License 1.0 (terms).