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  • Open enrollment is the best time to buy health insurance on or off the Marketplace and state and exchanges
  • One can buy private plans that meet the requirements of the Individual Mandate during the Open Enrollment Period
  • Nevada requires insurance companies to offer policies year-around
  • Consumers can only get financial assistance and advance tax credits from the federal marketplace or state exchanges
  • Private sellers, agents, and brokers offer qualified health plans year-around


The annual open enrollment period for Obamacare is the best time to buy health insurance. Eligible applicants can buy on or off the exchange and get full federal premium assistance and costs reduction benefits.

Private insurance providers prepare their plans keyed to open enrollment. They can compete with the Obamacare sellers and Marketplace products by making medical costs predictions and estimates on the same body of business information.

Comparison shopping can put a sharp focus on the concerns that matter most to the customer. Enter your zip above for free health insurance quotes!

Private Policies Off the Marketplace


Policies sold outside of the open enrollment dates for Obamacare are usually not qualified health insurance within the meaning of the individual mandate. Some private policies meet the standards of the Affordable Care Act and avoid the penalty.

These qualified insurance policies get no premium or other costs assistance, and the plan’s statement of benefits must clearly declare that it is qualified health insurance. For those with incomes above 400 percent of the federal poverty lines, the lack of financial assistance may not matter.

Employer-sponsored Plans

Persons eligible for employer coverage must take it unless it is not affordable. Affordable employer coverage must cost less than nine percent of the family annual income.

Employer-sponsored plans can start at any time of the year. New hires must get coverage within 90 days of their start date.

Companies that add health insurance benefits have flexibility for offering it to employees, and they are not bound to the federal open enrollment season.

The Individual Mandate


Health insurance reform in the US requires insurance companies to accept applicants without regard to any factors except age, location, family size, and tobacco usage. They may not deny health insurance coverage.

The law requires nearly every resident to get and keep qualified health insurance. Those that fail or refuse to get coverage may have to pay the penalty. To satisfy the individual mandate, insurance plans must have the below-listed content.

  • Minimum essential content and an actuarial value of 60 percent or higher
  • Essential health benefits from the statutory listing of critical benefits including prevention and wellness at no additional expense
  • Limits on expenses, costs, and deductibles

Shopping Off the Marketplace

Many private insurance companies offer policies that they do not sell on the Obamacare Marketplace or state exchanges. These policies target a small part of the market. They are high-content policies and often come with many customization options. They are not meant for mass audiences, and most focus on upscale markets.

Buyers with high incomes must shop off marketplace to find the best policies for their needs. They will get a very little financial benefit because their incomes are at or over 400 percent of the FPL.

Their priorities may be to avoid the penalty but to get customized coverage.

Income Too High for Credits and Costs Assistance


High-income buyers cannot qualify for the premium tax credits and costs reduction assistance parts of Obamacare. High incomes do not qualify for aid; the upper limit for Marketplace assistance is 400 percent of the federal poverty line.

  • Buy from an insurance company directly for the best potential to shape an offer to meet the customer’s needs. The insurance companies have products for various markets outside of the Obamacare marketplace. With different priorities, as to costs and features, high-income individuals must look at direct insurance as part of reviewing the marketplace.
  • Buy from an agent or agency. Agents can offer knowledge and understanding of the insurance markets to help guide the decision.
  • Buy from an online seller. These forms can aggregate offers and plans from many sources. Customers can use comparison shopping techniques to find the best fit for their medical care needs and budget.
  • Buy on the Obamacare Marketplace without financial assistance. The Obamacare Marketplace offers a wide range of choices in health insurance coverage. Each will satisfy the individual mandate and avoid the shared responsibility payment. The Marketplace offer technical assistance and information that can be helpful in the election process.

Open Enrollment Period


Extensions come from either state or the federal governments. These additional days for sign up usually reflect some need to help applicants that may have been slowed by factors beyond their control.

In the past, these have included weather events like floods and storms and system events like overcrowding online during the final signup days. While many people buy outside of Obamacare, the exceptions to open enrollment includes affordability and life events.

The individual insurance must cost no more than eight percent of the family annual income.

If there are no available options at this price or lower, then the individual gains an exception from the insurance mandate. Another source of exceptions is in the life events.

Buying Health Insurance After Open Enrollment

One can buy qualified health insurance from a private seller at any time. One can get them during or outside of Open Enrollment Period. Most private plans sold outside of the open enrollment do not meet the requirements for qualified health insurance. The information on the policy must declare whether it meets the Obamacare standard.

Special Enrollment Periods


After the open enrollment period of November 1, 2016, through December 15, 2016, no one can enroll unless they have an extension or a special enrollment period. Special enrollment periods are 60-day windows for getting new health insurance through the Obamacare Marketplace.

One can qualify for premium subsidies, cost reduction assistance, and Health Savings accounts. The below-listed items are included among federal and state rules recognizing Life Events.

  • Marriage
  • Divorce
  • Childbirth
  • Moving to a new location
  • Loss of dependent coverage at age 26.

Shop Where You Want for the Same Price


Obamacare created insurance exchanges. The idea was to have vigorous and competitive markets with active state government participation to protect citizens and bring the best values and lowest prices. The regulations provide that the costs of a policy would be the same whether purchased on the exchange or outside of it.

If a customer prefers to buy insurance directly from the issuing company, then they will get the same price. Many people like dealing with an insurance broker that can bring the products of several insurance companies. The consumer will pay the same price as the policy costs on the Obamacare Marketplace or state exchange.

The method of purchase also does not affect the price. Customers can buy online, by telephone, paper forms, or in-person.

The Nevada Exception

Nevada’s insurance laws require firms to offer health insurance year-round. The State Exchange and healthcare.gov have handled applications during the open enrollment season.

The insurance law requires forms to make policies outside of the exchange enrollment when the applicant cannot get subsidies or costs assistance for which they may be qualified.

It is often a poor and wasteful purchase for these buyers that would gain so much more during the open enrollment, extension, or exception brought on by a qualifying life event.

The Best Time to Buy Private Health Insurance


Open enrollment is the best time to buy private health insurance. During the open enrollment period, it is possible for buyers with qualified incomes to get federal and state assistance with premiums and costs. One can buy qualified health plans outside of the Obamacare Marketplace and state exchanges

These policies can qualify and meet the individual mandate. They cannot get premium tax credits nor any financial assistance available under the Affordable Care Act.

Comparison shopping is a powerful tool for finding the best solution to medical care needs within a budget. Enter your zip below and explore multiple health insurance quotes from your state’s most popular providers!

[su_spoiler title=”References:” icon=”caret-square” style=”fancy” open=”yes”]

  1. https://www.healthcare.gov/quick-guide/eligibility/
  2. http://obamacarefacts.com/private-health-plans-outside-the-marketplace/
  3. http://obamacarefacts.com/affordable-employer-sponsored-coverage/
  4. http://obamacarefacts.com/obamacare-individual-mandate/
  5. http://obamacarefacts.com/benefitsofobamacare/
  6. https://www.healthcare.gov/apply-and-enroll/income-too-high-for-tax-credit/
  7. http://obamacarefacts.com/sign-ups/enrollments-outside-marketplace/
  8. https://www.healthcare.gov/private-plan-exceptions-outside-open-enrollment/
  9. https://www.healthcare.gov/glossary/special-enrollment-period/
  10. https://www.healthcare.gov/
  11. http://www.leg.state.nv.us/NRS/NRS-687B.html#NRS687BSec480
  12. http://healthcare.gov
  13. http://obamacarefacts.com/obamacare-open-enrollment-2017/