Private Health Insurance, State by State
Private, medically underwritten health plans are priced on your age, zip code and health instead of your income, and they can start the first of any month if approved. Each state regulates them a little differently. Pick your state.
- Florida
- Texas
- Georgia
- North Carolina
- Ohio
- Tennessee
- South Carolina
- Missouri
- Mississippi
- Montana
- Nebraska
- Nevada
- Oklahoma
- Indiana
- Kansas
- Kentucky
- Louisiana
- Maryland
- Michigan
- South Dakota
- Utah
- Virginia
- Wisconsin
- West Virginia
- Wyoming
- Alabama
- Arkansas
- Colorado
- Delaware
- Iowa
- Illinois
How a private plan gets priced
Four things set the premium: your age, your zip code, whether you use tobacco and your answers to the health questions on the application. Household income is not one of them. That is the main difference from a Marketplace plan, where the tax credit and therefore your real price depend on what you expect to earn this year.
Because income never enters the formula, a raise, a big commission check or a strong year for your business does not change what you pay, and there is no credit to reconcile on your tax return.
Who it tends to fit
Private plans work best for reasonably healthy people who earn above the 2027 subsidy line: self-employed owners and contractors, families with one or two high earners, early retirees living on savings and anyone who needs coverage to start mid-year without waiting for open enrollment. Many plans use national PPO networks, which helps if you travel or split time between two states.
They are a poor fit for anyone with a serious or ongoing health condition, a pregnancy or surgery already planned. Those households are better served by the Marketplace, which has to accept everyone during an enrollment window.
Accident coverage the Marketplace does not offer
A private plan can be paired with accident coverage, a separate policy from your medical plan. Marketplace plans do not offer it. What it includes varies by plan, and I go over the details with you before you apply.
How accident coverage worksWhat applying looks like
We start with a short call about who needs coverage, your doctors and prescriptions. I price private options in your state next to the Marketplace for comparison, then you apply for the one that fits. The insurer reviews your health answers, sometimes with a brief phone interview, and usually decides within days: approved, approved with an exclusion, or declined. Approved plans can start on the first of the next month, and I never cancel your current coverage until the new plan is in force.
Other topics by state
- Self-Employed Health Insurance
- COBRA Alternatives
- Small Business Health Insurance
- Early Retiree Health Insurance
- Turning 26 Health Insurance
- Health Insurance When Moving
- Short-Term Health Insurance
- Health Insurance by Occupation
Want a quote instead? Compare plans. The full guide explains the basics.