"Private health insurance" can mean a few things. Most often, people mean a plan they buy on their own, outside the Marketplace. You buy it from an insurance company, or with help from an agent.
This guide walks through what private means, the steps to apply, and when you can apply.
What "private" means
A private plan here means a plan bought outside the Marketplace. There are two main kinds:
- ACA plans sold off the Marketplace. They follow the ACA's rules. Under federal law, if you apply during Open Enrollment or a special enrollment period, they can't refuse you or leave out health problems you had before.
- Other private plans that are not ACA plans. Some are PPOs that use networks in many states. They may not follow all of the ACA's rules.
One rule is the same for both. Under current law, the premium tax credit is only for plans bought through the Marketplace. The IRS says you must enroll through the Marketplace to get it. So a private plan has no tax credit.
Step 1: Check the Marketplace first
Before you shop private, see if you could get a tax credit. If you could, a Marketplace plan may fit better. Our private PPO vs Marketplace guide compares the two.
Step 2: List your doctors and check the network
Write down your doctors, hospitals, and drugs. Then look up each one in the plan's directory. No plan lets you see any doctor. Each PPO has its own network.
Step 3: Answer the health questions
Some private plans ask about your health on the application. Some private plans ask health questions, and approval is not guaranteed. Some may not cover care for health problems you had before you enrolled. Answer each question honestly.
Step 4: Wait for a decision
The company reviews your application. It may accept you, change the plan or price, delay, or decline. Keep your current coverage until your new plan is approved and starts.
Step 5: Confirm your start date
Ask when coverage starts, and get it in writing. Pay the first bill on time. Ask if the plan starts only after the first payment.
When you can apply
Timing depends on the kind of plan.
ACA plans, on or off the Marketplace, use the same windows. Under federal law (45 CFR 147.104), insurers must let you buy during Open Enrollment.
As of October 23, 2026, under current law, Open Enrollment for 2027 coverage runs November 1, 2026, to January 15, 2027. A court case about these dates, City of Columbus v. Kennedy, is still on appeal, with argument set for October 30, 2026, so check HealthCare.gov. See every date in our Florida open enrollment guide.
Outside Open Enrollment, you need a life change, like losing other coverage, moving, or having a baby. You then generally have 60 days to pick a plan. See special enrollment in Florida.
Some private plans that are not ACA plans may let you apply any time of year. These plans may ask health questions and may not cover health problems you had before you enrolled. Ask which kind of plan it is before you apply.
When the Marketplace may fit better
- You may get a tax credit based on your income.
- You have health problems and want a plan that must cover them. Under federal law, ACA plans can't leave out health problems you had before.
- You want a plan that can't turn you down.
If you are self-employed, see our self-employed nationwide PPO page. To learn how these plans work, see nationwide PPO health insurance.