On Exchange plans offered through Healthcare.gov and private carriers.  Plans considered through Marketplace will cover any pre-existing conditions.  Affordable Care Act also require the plans to ensure they have 10 mandates for Essential Benefits. 

  • Prescription Drugs. 

  • Pediatric Services. 

  • Preventive and Wellness Services and Chronic Disease Management.

  • Emergency Services

  • Hospitalization. ...

  • Mental Health and Addiction Services. ...

  • Pregnancy, Maternity, and Newborn Care. ...

  • Ambulatory Patient Services.

These plans are for 12 months and have an Open Enrollment period to change plans every November 1 - December 15 every year.

  • No Underwritting (Guarantee Issued)

  • Premium high (if not subsidized)

  • State Specific (HMO Networks)

  • Deductibles are based upon your income.

Off Exchange plans do not require the 10 mandates but many of the plans do cover most of the mandates.  Since these plans are sold by Private Carriers and do require Health Questions to be accepted.

These plans do not have Enrollment periods so that if you need a plan you can get one today!  

These plans are not available for either 1 month up to 36 months depending on the carrier.

  • Plans are underwritten for pre-existing conditions

  • Lower premiums

  • Nationwide PPO Networks

  • Deductibles start at $1,000

Carriers:  United Healthcare, National General, Pivot