Non-Marketplace Options

Limited Benefit Plan

A limited benefit health insurance plan is a type of health coverage that offers specific, pre-defined benefits for various medical services. Unlike comprehensive health insurance plans that provide extensive coverage for a wide range of health care needs, limited benefit plans focus on offering a set amount of coverage for specific services. Here are some key features:

1. Specified Benefits: These plans have a specific payout limit for each covered service, such as doctor visits, hospital stays, or prescription drugs.
2. Lower Premiums: Since the coverage is more limited, premiums are usually lower compared to comprehensive health insurance plans.
3. Out-of-Pocket Costs: Patients may face higher out-of-pocket costs for services that exceed the plan's coverage limits.
4. Limit to Pre-Existing Conditions: These plans require applicants to complete underwriting. The insurance company may decline applicants, exclude pre-existing conditions, or offer the insurance at a higher cost.

5. These plans typically do not require you to use a specific network to receive care, although yu may receive preferred pricing if applicable.

These plans can be a good option for individuals who want some level of financial protection without the higher costs associated with comprehensive plans. However, it's important to carefully review the terms and limitations to ensure it meets your health care needs. If you need more extensive coverage, a more comprehensive plan might be a better fit.

Off-Exchange Plans

Off-Exchange plans are the same as On-Exchange plans without a Marketplace subsidy. These plans are purchased directly through the carriers.