Most people think they have to wait
Every week I get a call that goes something like this. Someone looked at their latest premium bill, did the math on what they are actually paying for what they are actually using, and decided they need to make a change. Then they ask me when Open Enrollment starts, because they have resigned themselves to waiting six or eight months to do anything about it.
I have to stop them right there.
Open Enrollment is the window for signing up for or changing a Marketplace plan. The Marketplace, also called Obamacare or the Exchange depending on who you grew up listening to, runs on a federal calendar. That calendar does not apply to the rest of the health insurance industry.
Private health insurance is a different product, sold by different carriers, priced on different rules. You can apply any day of the year. You can change carriers any day of the year. You do not need a qualifying life event. You do not need a special enrollment period. If you are healthy enough to qualify, you can have a new policy in place inside of a week.
Most Americans have never heard this because the only insurance advertising they see in heavy rotation is for the Marketplace and for Medicare. Private plans do not run Super Bowl commercials. They get sold by independent brokers, and there are fewer of us than there used to be.
Why private is often cheaper for the right person
Here is the part that usually gets people's attention.
The Marketplace is priced on your income. The lower your income, the bigger your subsidy, and the less your plan costs you out of pocket. That is great if you qualify for subsidies. It is terrible if you do not, because then you pay the full unsubsidized premium, which in 2026 is higher than it has ever been.
Private insurance is priced on your health. You fill out an application, a carrier underwriter looks at your medications and your conditions, and they quote you a premium based on what kind of risk you represent. If you are in generally good health, that premium is usually a fraction of what you would pay for an unsubsidized Marketplace plan with comparable coverage.
There is another pricing difference that matters. Marketplace plans rate you up every year on your birthday, which is part of why your premium keeps climbing even when nothing else has changed. Most private carriers price in age brackets instead. One price from age 19 to 26. Another from 27 to 36. Another from 37 to 46. You only get a rate increase when you age into the next bracket, not every single year.
For a healthy 34-year-old small business owner paying $780 a month on a Bronze Marketplace plan with a $9,000 deductible, switching to a private plan with a lower deductible and a premium in the $300s is a conversation that takes fifteen minutes and saves them several thousand dollars a year.
A real example
A family of four came to me last year on a Marketplace plan that was costing them close to $1,800 a month. Mom had a prescription her doctor had been pushing her to try for years, and she kept putting it off because the copay under her current plan was painful.
I ran her family through the private market. All four of them were in decent health, no disqualifying conditions. We moved them onto a private plan that cut their premium in half. With the savings, mom started the medication her doctor had been recommending for years. Her blood pressure came down. Her doctor was happy. She was happy.
Nothing about their situation changed except which door they walked through to buy coverage. That is the part that frustrates me about how this industry is structured. The option was always there. Nobody had told them.
Who private is not for
I want to be straight about this because I do not like being sold to, and I assume you do not either.
Private insurance is not the right answer for everyone. If you have a serious pre-existing condition, if you take expensive daily medications, if you have ongoing treatment for something significant, private carriers will either decline to cover you or will quote you a premium higher than the Marketplace would cost. In those situations, the Marketplace is doing what it was designed to do, which is provide coverage to people the private market will not.
If you qualify for significant Marketplace subsidies based on your income, stay on the Marketplace. The math almost never works out in private's favor once real subsidies are involved.
Private is not for everyone. It is for the person in the middle. Generally healthy, moderate to higher income, frustrated with their premium, and unaware that another door exists.
What to ask if you are shopping
Whether you end up on a private plan, stay on the Marketplace, or switch to an indemnity or hybrid product, there are five questions that should drive the conversation.
Your income. Not because a broker needs it for nosy reasons, but because it determines whether you qualify for Marketplace subsidies in the first place.
Your age. For pricing tiers on private plans.
Your health conditions and daily medications. This is the single biggest factor in whether private insurance works for you.
Your family size. Who needs to be on the policy.
Your comfort with deductibles and copays. Some people sleep better with a low deductible and a higher premium. Other people would rather pay less monthly and bet on staying healthy. Neither is wrong. They are different tradeoffs.
A decent broker will ask all five. A lazy broker will ask one or two and try to sell you whatever pays the best commission.
The carriers I work with
I carry appointments with 16 different carriers, including the ones most people have heard of and some they have not. Manhattan Life, UnitedHealthOne, and Allstate are among my most-quoted for health. For dental I lean on Best One Dental where it is available. For vision, VSP is in most states and I usually recommend it.
Being independent means I am not locked into pushing one carrier. If BCBS has the right plan for you, I write you on BCBS. If Cigna has it, I write you on Cigna. My income is a commission from whichever carrier you end up with, and they all pay in roughly the same range, which means my job is to find the one that fits your situation instead of the one that pays me the best.
If you want to run your numbers
If any of this sounds like your situation, my phone is (702) 379-9084, my booking calendar is on my website, and I work with people in 38 states. My consultations do not cost anything and there is no obligation to switch. I will tell you if you should stay where you are. I tell people that all the time.
Whatever you do, do not wait until November because you think you have to. The option to shop is sitting right there, and for a lot of people, it has been the whole time.