Private Health Insurance Plans

Private Health Insurance Plans — No Open Enrollment Required

You probably landed here because something stopped working. Maybe your employer plan ended last week. Maybe your spouse switched jobs. Maybe you opened a 1099 quote on the marketplace and the number gave you a small heart attack.

Most people don't think about private-market health insurance until ACA prices it out of reach.

If you're healthy, between jobs, self-employed, or paying way too much through a spouse, the private market is where a lot of brokers stop looking — and where most of the savings live.

Here's what's actually on the menu.

What "private market" means in 2026

Private-market health plans are sold by carriers directly through licensed brokers, year-round. They're not part of the ACA federal marketplace. They're medically underwritten, which means the carrier asks health questions before issuing the policy.

The trade-off is real:

• Lower premiums for healthy applicants
• No subsidy (you pay the full premium yourself)
• Most don't cover preexisting conditions in the first 12 months
• Most are not ACA-compliant — meaning they don't satisfy the same federal rules major medical does
• Maternity is generally excluded

This is the right fit for some households. It's the wrong fit for others. The only honest way to know which you are is to look at the products, your situation, and the math.

The three private-market product families we work

1. UHC TriTerm Medical (short-term major medical)

TriTerm is UnitedHealthcare's short-term, limited-duration medical plan. It's structured like a real major-medical plan — actual deductible, actual coinsurance, actual out-of-pocket maximum — but it's sold in three back-to-back terms that get you up to roughly three years of continuous coverage on a single application.

Four plan variants exist: Value (lowest premium), Copay Select Max (predictable office visits), Plan 80 Max (balanced 20% coinsurance), and Plan 100 Max (closest to an ACA experience with 0% coinsurance after deductible).

Compliance: Short-term limited-duration medical. Medically underwritten. Preexisting conditions not covered in first 12 months. Not ACA-compliant.

Available in 14 states only: AL · AR · AZ · FL · GA · IA · IN · KY · LA · MO · MS · NE · TN · WV. If you live outside those states, TriTerm isn't an option — but two of the next three usually are.

2. UHC HPG (Health ProtectorGuard)

HPG is a fixed-indemnity plan. It pays a stated dollar amount per covered medical event, regardless of the actual bill. There's no out-of-pocket cap, no traditional deductible, and no coinsurance — those concepts don't exist for this product.

It comes as a 12-plan matrix: pick one of four hospital base tiers (Choice, Select, Preferred, Premier) and pair it with one of three WORx levels (the wellness/office-visit/Rx side). HPG also includes unlimited $0 virtual visits through HealthiestYou by Teladoc and an Optum Perks Rx discount card.

Compliance: Fixed indemnity plan. Pays stated benefit amounts per covered service. Not a substitute for major medical / ACA coverage.

Best fit: healthy adults who want predictable per-event payouts and the freedom to use any provider.

3. Allstate HealthBridge PPO (short-term major medical, PPO network)

HealthBridge is Allstate's short-term medical PPO. It runs on either the Aetna Open Choice network (30 states) or the Cigna PPO network (11 states, all of which also have Aetna). Five plan variants exist: Essentials, Enhanced, Copay Enhanced, HSA Compatible, and Guaranteed Issue.

The Renewable option matters: with Renewable, preexisting conditions can be covered after the first 12 months — most short-term plans never get there.

Coverage maximums range from $100,000 (Guaranteed Issue) up to $5,000,000 (Copay Enhanced).

Compliance: Short-term medical insurance. Medically underwritten. Preexisting conditions not covered in first 12 months (may be covered after 12 months with Renewable option). Not ACA-compliant.

HealthBridge PPO is the lead product in Texas, Illinois, and Ohio — TriTerm isn't sold in those three states.

4. Allstate Health Access (fixed-benefit, sold in 24 states)

Fixed-benefit plan with a 3-year rate guarantee. Three benefit tiers (Metal Gap, Core, Plus) plus a Guaranteed Issue version with no health questions. No annual or lifetime maximums.

Compliance: Fixed-benefit medical plan. Pays stated benefit amounts per covered service. Not a substitute for major medical / ACA coverage. No annual or lifetime maximums.

When private market is the right call

• You're healthy enough to pass underwriting
• You're between jobs and have a 6-36 month coverage gap before something else is in place
• You don't qualify for meaningful ACA subsidies (income too high, or the math doesn't work in your state)
• You want a real PPO network and predictable cost protection
• You want to use any doctor without network restrictions (HPG / Health Access)

When ACA is the better call

• You have a preexisting condition that you'll need ongoing care for
• You're pregnant or planning to be in the next 12 months
• Your household income lands in the subsidy zone
• You need maternity, mental health, or chronic-care coverage
• Open Enrollment is open and the marketplace plan in your state actually fits

We'd rather route you to ACA when ACA is the answer than push a private plan that won't cover what you need. That's not heroic — that's the job.

How underwriting works

Carriers ask 8–25 health questions, depending on the product. The decision tree usually looks like:

• Issued at standard rates — your application clears, premium is what was quoted
• Issued with a rider or rate adjustment — coverage exists with conditions
• Declined — the carrier won't issue the policy

If you're declined on private-market, that's usually a signal to look at ACA, Allstate Guaranteed Issue (no health questions, lower benefit caps), or a different timing strategy.

We read your intake first and tell you which products you have a real shot at before you sit on hold with a carrier.

What you're paying for

Premium is one number. The honest comparison is total cost — premium plus deductible plus expected out-of-pocket. A $180/month premium with a $10,000 deductible isn't actually cheaper than a $340/month premium with a $2,500 deductible if you're going to use the plan.

Our proposals show both numbers, side by side, on every plan we recommend.

The 3-minute path

Fill out the intake form. We read it. You get 2–3 plans that actually fit, with what each one costs you, what it pays out, and the trade-offs. You ask questions. We answer them. If a plan fits, we send the enrollment link. If nothing fits, we say so.

Find my fit

Or call: (989) 365-1641 · +1 (989) 365-1641

FAQ

Q1 · Can I keep my doctor on a private-market plan?

With HPG and Health Access, yes — they're fixed-benefit plans with no network restrictions, so you can use any provider (network discounts available, not required). With TriTerm and HealthBridge PPO, you'll want to check whether your doctor is in the Choice, Choice Plus, Aetna Open Choice, or Cigna PPO network depending on the plan. We check that for you before recommending.

Q2 · Will a private plan cover my prescriptions?

Each product handles Rx differently. HPG has fixed dollar amounts per fill (varies by WORx level) and includes the Optum Perks discount card. TriTerm and HealthBridge run prescription benefits through their major-medical structure (subject to deductible and coinsurance, varies by plan). Health Access does not cover prescriptions directly. We check your medication list against each product before quoting.

Q3 · What happens if I get sick during the first 12 months?

For a non-preexisting illness or injury, you're covered per the plan terms from day one (subject to any waiting period on wellness benefits). For something that's considered preexisting under the carrier's lookback rules, the plan won't pay for treatment of that specific condition during the first 12 months. With HealthBridge's Renewable option, preexisting can be covered starting month 13 — that's a feature worth looking at if your situation calls for it.

Q4 · Can I switch back to ACA later if my situation changes?

Yes. Open Enrollment runs Nov 1–Dec 15 every year. Outside that window, a qualifying life event (job change, marriage, birth, Medicaid loss, move) opens a Special Enrollment Period. A private-market plan ending or losing coverage can sometimes count as a qualifying event, but not always — we'd flag the timing before you commit so you don't end up stranded.

Q5 · Why does this cost less than ACA?

Three reasons. First, private-market plans are medically underwritten — the carrier knows what risk it's taking on, so the premium reflects your actual health profile. Second, they don't cover everything ACA covers (no maternity, limited mental health, preexisting exclusions in year one). Third, no government subsidies are involved, so there's no federal funding offsetting premiums for you specifically — but there's also no income limit on who can buy.

Plan availability varies by state. Short-term limited-duration medical plans are not ACA-compliant and do not satisfy minimum essential coverage requirements. Fixed indemnity plans are not a substitute for major medical / ACA coverage. Full Count Insurance is an independent insurance brokerage. Some plans referenced are not available in all states. Coverage subject to underwriting approval.

See if a private plan fits