What Are My Insurance Options?

If you need health coverage, an individual Marketplace plan (possibly with a subsidy) might be the best choice — but it’s certainly not the only option. Depending on your situation, there are several paths to getting the coverage you need:

Marketplace Plans (Healthcare.gov)

If you qualify for financial assistance, purchasing a plan through the federal Marketplace can significantly lower your monthly premium and out-of-pocket costs. Most Americans are eligible for some type of subsidy.

📅 Marketplace plans are only available during the Open Enrollment Period (November 1 – January 15) or if you qualify for a Special Enrollment Period due to a life event.

Off-Exchange Plans

If you don’t qualify for a premium tax credit, you may have access to additional plan options offered outside the Marketplace. These “off-exchange” plans are ACA-compliant and often include different provider networks or plan designs.

📅 Off-exchange plans follow the same enrollment windows as Marketplace plans. You must apply during Open Enrollment or qualify for a Special Enrollment Period.

Special Enrollment Periods (SEP)

A Special Enrollment Period allows you to enroll in a Marketplace or off-exchange individual plan outside of Open Enrollment. You may qualify if you experience a major life event such as:

• Losing other health coverage

• Getting married or divorced

• Having a baby or adopting

• Moving to a new state or region

• Gaining lawful presence in the U.S.

SEPs usually provide a 60-day window to enroll from the date of your qualifying event.

Continuing Your Current Coverage

If you recently lost job-based coverage, you may be able to continue your existing plan:

• COBRA lets you stay on your former employer’s group health plan for up to 18 months (at full cost).

• Texas State Continuation offers shorter-term continuation for small group plans (typically 9 months).

Joining Other Group Coverage After Loss of Coverage

If you lose your current coverage, you may have the right to join your spouse’s or partner’s employer-sponsored health plan mid-year.
This is called a HIPAA Special Enrollment Right, and it provides a limited window (often 30–60 days) to enroll in other group coverage without waiting for that plan’s annual open enrollment.

Short-Term Health Coverage

Healthy individuals looking for temporary, lower-cost coverage may consider short-term plans. These plans are not ACA-compliant and generally don’t cover pre-existing conditions, maternity, or mental health care — but they can help bridge gaps between longer-term coverage.

Small Group Health Plans for Business Owners

If you own a small business or even a side business, you may be eligible to establish a small group health plan. Group plans can offer excellent benefits and greater flexibility — and they can start any month of the year, regardless of the individual Open Enrollment timeline.

Additional Alternatives

Other coverage paths may be available depending on your situation, including:

• Student health insurance plans (for college students)

• Supplemental or limited benefit plans (to help with unexpected costs)

• Health Care Sharing Ministries (faith-based cost-sharing arrangements that are not insurance)