Updated: 06/12/2025
If you’re under age 65 and need to buy your own individual health insurance, you may be wondering where to start and who can help you. Here are some key points to keep in mind while you review your options.
First, assuming you’re looking for comprehensive major medical coverage, it’s important to review whether a plan is ACA-compliant, as plans that are not ACA-compliant are not guaranteed to provide comprehensive coverage. You can only enroll in an ACA-compliant plan during the ACA’s annual open enrollment period or during a special enrollment period.
There are several types of resources available to help you find comprehensive ACA-compliant coverage. You don’t have to pay anything to utilize these resources. Take a look at your options described below.
Each state uses a health insurance Marketplace/exchange. In 31 states, HealthCare.gov is the Marketplace platform that residents use to enroll in coverage for 2025, while the District of Columbia and 19 states operate their own health insurance exchanges.1 If you start at HealthCare.gov and select a state that runs its own exchange, you’ll be directed to the correct website.
You must enroll through the Marketplace to qualify for premium subsidies or cost-sharing reductions. But in many states, you can enroll in a Marketplace plan without using the Marketplace/exchange.2 But you don’t have to complete the process by yourself.
In Georgia, which runs its own Marketplace/exchange, called Georgia Access, and the 31 states that use HealthCare.gov as their Marketplace, you can enroll in a Marketplace plan directly on HealthCare.gov, or GeorgiaAccess.gov, or via a private entity’s website such as www.INSXCloud.com.3 INSXCloud is one of the entities approved by the Centers for Medicare & Medicaid Services (CMS) to offer an enhanced direct enrollment (EDE) experience that allows consumers to select and enroll in Marketplace coverage and qualify for subsidies without having to visit HealthCare.gov or GeorgiaAccess.gov.
State-run Marketplaces other than Georgia do not currently allow Marketplace enrollments to be completed on a third-party platform.
All EDEs can facilitate enrollment in Marketplace plans along with the Marketplace’s determination of whether the consumer is eligible for advance payments of the premium tax credit and other financial assistance, same as if they used the Marketplace platform. EDEs can facilitate the process of applying through the Marketplace for a determination as to eligibility for financial assistance from the federal government, just as the consumer would be able to do if they used the Marketplace website. And they may offer additional features that help you shop, compare plans and enroll.
But many EDEs can also facilitate enrollment in ACA-compliant off-Marketplace plans. This is useful if, for example, your employer offers an ICHRA4 and allows you to payroll deduct your share of the premiums. If you wish to take advantage of that opportunity, you’ll can enroll in off-exchange coverage.5 Sales agencies can also offer various non-ACA-compliant plans such as dental, vision, accident supplements, critical illness plans, or short-term health insurance on EDE platforms. To clarify, financial assistance (premium subsidies and cost-sharing reductions) cannot be used with any sort of off-Marketplace plans (or in connection with an ICHRA on or off exchange), including ACA-compliant major medical plans or non-ACA-compliant plans.
Most EDEs are issuers (insurance companies) and are required to display only their own plans on their EDE platforms. EDEs operated by web brokers must display all of the plans that a consumer would see if they went directly to the Marketplace website. If the EDE does not facilitate enrollment for every plan available to the consumer on Marketplace.gov (or GeorgiaAccess.gov), the EDE must prominently display a disclaimer to clarify this, and provide a link to HealthCare.gov for the consumer to enroll in one of those plans.6
EDEs must clearly differentiate between the various Marketplace plans and off-exchange (ACA-compliant and supplemental) options available via their websites and prominently communicate information about public financial assistance.7)
Regardless of whether you want to enroll directly through the Marketplace, via an EDE, or through an insurance company or sales agency, a licensed insurance agent or broker can help you with the process.
There is no fee to use an agent or broker. They are usually paid a commission by the insurance company, but the premium you pay for your coverage is the same regardless of whether you enroll on your own or use an agent or broker’s assistance. This is because the cost of insurance company marketing, including sales commissions, is incorporated into the premiums. You’ll pay the same premiums regardless of whether you receive help from an agent or broker, however.
Many agents and brokers can facilitate enrollment in all of the plans available in a given area, but that’s not always the case. You should always ask the agent or broker whether there are any carriers they don’t represent. As described above, if you use a web broker’s EDE platform to enroll, the platform will contain language disclosing that it does not offer enrollment support for every plan available on the federal Marketplace in your area if that is the case.
If you’re enrolling in a Marketplace plan, the agent or broker will help you complete the process either via the Marketplace website (HealthCare.gov or a state-run platform) or an EDE platform. They will then be a point of contact you can use if you have basic questions or problems with your coverage after you’re enrolled and can refer you to your carrier when appropriate.
If you need help with enrolling in Marketplace coverage, Medicaid or CHIP, a Navigator or Certified Application Counselor (CAC) can help you with the process.8
Navigators and CACs are trained and certified by CMS. While states are allowed to impose additional training or licensure requirements, states are not allowed to require that Navigators obtain an insurance producer license (which is required for agents and brokers).9 Without an insurance producer license, Navigators cannot provide plan recommendations the way a licensed agent or broker can.
But they can help you understand the available plans, premiums, and financial assistance, and they can help you complete the enrollment process.
There is no fee to get help from a Navigator or CAC. You can find a local agent or assister near you using this tool on the HealthCare.gov website.
To be clear, you can choose to enroll without any assistance using HealthCare.gov or the state-run Marketplace in your state. But if you want help with the process, Navigators and CACs can provide it.
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