Private Health Insurance for Self-Employed & High Earners

Paying Full Price for Health Insurance? Compare Private PPO Plans.

For self-employed people, owner-operators and families who make too much for help with premiums.

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Watch: real Marketplace prices

This is what full price looks like on the Marketplace

We pulled up a family quote on Nevada Health Link, the state's official exchange, with no subsidy applied. This is what people who earn too much for premium help are being asked to pay.

$1,288 to $1,925a month for Bronze and Silver plans
$11,000 to $21,200deductibles before most coverage starts
HMO networkson every plan in the clip: local doctors and referrals

Screen recording of a full-price family quote on Nevada Health Link (Bronze and Silver HMO plans from Anthem, Ambetter, CareSource, Health Plan of Nevada, Imperial and Select Health). Prices vary by state, ages, household and plan year.

See what a private plan would cost me

Why self-employed people and high earners look at private plans

If you are paying the full Marketplace price anyway, the subsidy is no longer a reason to stay. Here is what the private side can offer instead.

Nationwide PPO networks

Major carriers' PPO networks reach across the country instead of stopping at a county or state line. In many states the exchange offers mostly HMO and EPO plans.

Coverage that travels with you

If you drive across states, split time between homes, or have a kid in college out of state, a national network means routine care, not just emergencies, away from home.

Pick your own doctors

PPOs let you see in-network specialists without a referral, and many pay part of out-of-network care too. We check your doctors against the network before you apply.

Priced on health and age, not income

Your premium does not move with your income, there is no subsidy cliff to fall off, and nothing to pay back at tax time. The trade-off: the carrier asks health questions.

Making too much for a subsidy? You are who this page is for

With the enhanced premium tax credits expired, the 400% of poverty level cutoff is back for 2027. Above it there is no credit at all: roughly $63,000 for a single adult and about $130,000 for a family of four. Cross that line by a dollar and you pay the full Marketplace price.

That is the range where a healthy applicant often finds a privately underwritten plan for less, with a better network. It is also why we run your subsidy number first: if you qualify for a meaningful credit, the Marketplace usually wins and we will say so.

Worth comparing if you are

Self-employed, a 1099 contractor or an owner-operator in reasonably good health
A family earning above the subsidy cutoff and paying full price
On the road, in two states, or covering a student away at school
Outside open enrollment with no qualifying life event
Retired early and bridging to Medicare

Probably better on the Marketplace if you

Qualify for a premium tax credit of any real size
Have an ongoing condition or take a maintenance medication
Are pregnant or planning a pregnancy this year
Want guaranteed acceptance with no health questions

Your current plan vs. private plan options

A quick side-by-side of how the two usually differ. No prices here, because a real number depends on you.

Your current planPrivate plan options

Network

Often a local HMO or EPO tied to your state or region. Care outside the area is mostly limited to emergencies.

PPO options with national networks from major carriers, so in-network care is available in other states.

Deductible type

Usually one large deductible that most care counts against first, often combined for medical and prescriptions.

A range of designs: some with copays for office visits and generics before the deductible, others HSA-qualified.

Doctor choice

In-network doctors only, and HMOs usually need a referral before you see a specialist.

Choose in-network doctors and specialists without a referral. Many PPOs also cover some out-of-network care.

General comparison only. Your current plan may differ, plan details vary by carrier and state, and the policy documents govern.

Example: a self-employed family paying full price

The kind of call we get every week during open enrollment.

A self-employed contractor, his wife and their two kids came to us after their renewal notice. Their income put them over the subsidy cutoff, so they were paying full price for a Silver HMO on the Marketplace: a $16,000 family deductible, a local-only network, and a referral every time one of the kids needed a specialist. We ran their subsidy number to confirm there was no credit on the table, walked them through the health questions, and compared private PPO options side by side. They were approved for a PPO with a national network and copays for office visits, and switched once the new policy was issued.

Before$1,690/moMarketplace Silver HMO, full price

After$1,080/moPrivate PPO, national network

Difference$7,320/yrabout $610 a month

Illustrative example, figures rounded and details changed for privacy. Not a quote or a promise of savings: private plans are medically underwritten, and your price depends on your ages, ZIP code, health and the plan you choose. Some applicants pay more than the quoted rate or are not approved.

Get my side-by-side comparisonFree, no obligation, and nothing changes until you say so.

The honest part: health questions

Private plans are cheaper for some people because the carrier gets to decide whom it covers. When you apply, it reviews your answers (and often your prescription history) and can respond in one of four ways:

Accept you at the quoted rate. The common outcome for applicants in good health.
Accept you at a higher rate. The quote you first see is for a standard risk.
Accept you with an exclusion. The policy is issued but a named condition is carved out.
Decline you. No policy is issued, and you can still enroll in a Marketplace plan during an enrollment window.

We go through the questions with you before anything is submitted, so the decision is not a surprise. And never cancel the coverage you have until a new policy is approved and issued in writing.

How the comparison works

We are an independent, licensed brokerage. Carriers pay our commission, so the comparison costs you nothing.

Check your subsidy

We confirm what the Marketplace would really cost you after any credit.

Check your doctors

We look up the doctors and prescriptions you care about in each network.

Compare side by side

Marketplace and private options together, with the trade-offs spelled out.

Switch safely

Nothing gets cancelled until your new policy is issued.

Private health insurance: common questions

Can I switch to a private plan mid-year?

Generally, yes. Medically underwritten private plans are not tied to open enrollment, so you can apply in any month. If you are approved, you choose a start date, and you cancel your current plan only after the new policy is issued in writing. Two things to know first: money you have already paid toward this year's deductible usually does not carry over to a new plan, and if you have been getting an advance premium tax credit on a Marketplace plan, end that plan properly so your tax reconciliation is clean.

Do private plans cover pre-existing conditions?

Not the way ACA plans do. Marketplace plans must cover pre-existing conditions. Underwritten private plans ask health questions, and the carrier can accept you at the quoted rate, charge more, exclude a specific condition, or decline the application. If you have an ongoing condition, are pregnant, or take a maintenance medication, a Marketplace plan is often the safer choice, and we will tell you that up front. Always get any exclusion language in writing before you drop the coverage you have.

Do I need to wait for a special enrollment period?

Not for an underwritten private plan. Open enrollment and special enrollment periods are rules for ACA Marketplace plans; private underwritten plans accept applications year-round, subject to approval. If you want a Marketplace plan instead, open enrollment for 2027 coverage runs November 1, 2026 to January 15, 2027 in most states, and outside that window you need a qualifying life event.

Is private health insurance cheaper than a Marketplace plan?

It depends on whether you qualify for a premium tax credit. If you do, the credit only works on Marketplace plans, and a private plan rarely beats a subsidized premium. If your income is above the cutoff, you pay the full Marketplace price, and that is where a privately underwritten plan for a healthy applicant often comes in lower. We check your subsidy number before quoting either one.

Can I be turned down for a private plan?

Yes. That is the trade for the lower price and the wider network. Based on your answers and, in some cases, a prescription history check, a carrier can accept you, charge more than the quoted rate, exclude a condition, or decline you. Applying does not obligate you to anything, and a decline does not affect your right to enroll in a Marketplace plan during an enrollment window.

Do subsidies work with private plans?

No. Premium tax credits exist only on Marketplace plans, so with a private plan you pay the full premium. Self-employed people can generally still deduct their premiums under the self-employed health insurance deduction, which applies to both types of plan. Ask your tax professional how it applies to you.

What is private health insurance?

Here it means major medical coverage bought directly from an insurance company or through a broker, rather than through HealthCare.gov or a state exchange. The key difference is underwriting: a private plan asks health questions and decides whether to cover you, while a Marketplace plan must accept everyone who applies during an enrollment window.

Stop paying full price without checking

Tell us your ZIP, ages and rough income. We come back with your Marketplace number and the private PPO options that fit, side by side.

Compare my options