Got Surprised by ACA Prices? Explore These More Affordable Health Insurance Alternatives Before Jan. 15

Rising Health Insurance Costs: Exploring Your Coverage Options

Health insurance expenses continue to climb, but there are a variety of ways to secure coverage.

Main Points to Remember

• Premiums for ACA (Obamacare) plans have surged in 2026, leading many to look for alternative health insurance options as the January 15 open enrollment deadline nears.
• Alternatives such as private non-ACA plans, short-term policies, and health care sharing ministries may offer lower monthly payments, but typically provide much less comprehensive coverage than top ACA plans.
• Evaluate your family’s health needs, carefully review plan details, and consider worst-case scenarios before making a decision for 2026.

As open enrollment for ACA plans draws to a close, many individuals facing steep premium hikes are considering options outside the Health Insurance Marketplace.

Rebecca Rush, who lives in Boulder, Colorado, spent much of the 2026 ACA open enrollment period in disbelief at the rising costs. Her 2025 Bronze plan, which came with a $9,500 deductible, was set to jump from $760 to $1,001 per month—one of the more affordable choices available to her.

“It was a financial strain,” Rush explained. “Each year, I’ve had to settle for less coverage just to keep my premiums manageable, but I still end up paying a lot out-of-pocket.”

When a private insurance broker reached out, Rush was open to alternatives. For the first time since the ACA exchanges launched in 2013, she selected a plan outside the marketplace.

“Now my monthly payment is $565, and the deductible is much more reasonable,” she said. However, her new plan does not include maternity, mental health, or prescription drug coverage. “I’m a bit nervous because I’m not sure how it will work out.”

Rush, who works independently, is not alone in facing these tough choices. As the January 15 deadline for 2026 enrollment approaches, many others are in a similar situation.

According to research by KFF, ACA insurers are increasing 2026 premiums by an average of 26%. Those who previously benefited from enhanced premium tax credits, which have now expired, could see their monthly payments more than double.

Why This Is Important

If you don’t receive health insurance through your job, you might be confronted with high costs for ACA Marketplace plans. Understanding the alternatives, including their benefits and drawbacks, is essential.

ACA Plans: Setting the Standard for Consumer Protections

While there are less expensive options than ACA plans, these alternatives often come with significant compromises. The ACA not only established insurance marketplaces but also set minimum standards for consumer protections on plans sold through them.

What ACA Marketplace Plans Must Provide

• Coverage for 10 essential health benefits, such as preventive care, maternity, mental health, and prescription drugs
• No denial of coverage or treatment for pre-existing conditions
• Compliance with federal limits on annual out-of-pocket maximums ($10,600 for individuals and $21,200 for families in 2026)

Plans purchased outside the marketplace or through alternative means are not required to meet these standards and do not qualify for subsidies, often resulting in lower costs but much less robust coverage.

“Lower premiums usually mean less protection,” noted Brandy Thompson, CEO of benefitbay. “Don’t make a decision based solely on price—be sure you understand what you’re giving up.”

Four Alternatives to ACA Health Insurance

If you’re weighing your options before the January 15 deadline, here are the most common alternatives to ACA plans, along with their potential advantages and disadvantages.

1. Private Health Insurance Not Compliant with ACA

Description: These are plans sold outside the ACA exchanges by insurers, agents, or brokers, available both during and outside open enrollment. They may have restrictions and are not eligible for subsidies.

Advantages:

• Possibly lower monthly premiums
• Enrollment is often available year-round
• May offer wider provider networks

Drawbacks:

• Often do not cover all 10 essential health benefits required by ACA
• May require medical underwriting
• Can exclude or charge higher rates for pre-existing conditions

2. Short-Term Health Insurance

Description: These private plans offer coverage for a limited time, typically one to twelve months. Short-term insurance is best suited as a temporary solution for healthy individuals, as it excludes pre-existing conditions and has significant coverage limits.

“If you face a major health event, short-term plans may deny claims, limit payouts, or not cover follow-up care,” Thompson warns.

Advantages:

• Lower monthly payments
• Quick and simple application process
• Can provide temporary coverage

Drawbacks:

• Very high deductibles
• No coverage for pre-existing conditions
• Limited benefits for most services

3. Health Care Sharing Ministries

Description: These are typically faith-based organizations where members contribute monthly to help cover each other’s medical expenses. Also called health cost-sharing ministries, they are not technically insurance and offer limited benefits with minimal government oversight.

Advantages:

• Lower monthly costs
• Open enrollment throughout the year
• Easy to join

Drawbacks:

• Membership may require adherence to certain beliefs
• No guarantee of coverage
• Lack of consumer protections

4. Fixed Indemnity Insurance

Description: This supplemental insurance pays a predetermined amount for specific medical events, such as hospital stays or doctor visits, regardless of the total bill. Indemnity plans typically pay you directly, giving you flexibility but less comprehensive coverage.

Advantages:

• Lower cost compared to traditional insurance
• Year-round application
• Control over how you use the funds and where you receive care

Drawbacks:

• Low benefit limits
• Potential reimbursement difficulties
• May deny claims for pre-existing conditions

Who Should Consider ACA Alternatives?

Given the trade-offs, non-ACA options are generally not recommended for those with chronic or unpredictable health issues, ongoing medication needs, or special medical requirements.

“Most non-ACA plans are best suited for people with predictable health needs and a higher risk tolerance,” Thompson explained.

For example, Rush felt comfortable choosing an off-market plan from Freedom Life Insurance Company of America, part of USHEALTH Group, Inc. (a United Healthcare company), because she is healthy, has no chronic conditions, and her medical history helped her avoid exclusions during underwriting.

“It’s not the right choice for everyone,” she admitted, “but I understand what I’m signing up for and the limitations involved.”

What Steps to Take Before January 15

To make an informed decision before the open enrollment deadline, consider these actions:

• Verify your eligibility for subsidies: Households earning between 100% and 400% of the federal poverty level may still qualify for premium tax credits, and those between 100% and 250% may also receive cost-sharing reductions. Remember, these benefits are only available with marketplace plans.
• Review state regulations: Some states have unique rules for ACA alternatives. For example, New York bans short-term health insurance, while 30 states exempt health care sharing ministries from insurance laws. Make sure you know what’s allowed and what protections exist in your state.
• Compare total costs: While low premiums are attractive, frequent out-of-pocket expenses can quickly add up. Evaluate deductibles, copays, coinsurance, and out-of-pocket maximums to determine the most affordable option overall.
• Read all plan documents: Go beyond marketing materials and summaries. “Pay close attention to exclusions, benefit limits, and provider access,” Thompson advised. “Ask how the plan would handle a major medical event, not just routine care.”