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Non-ACA health insurance: what you can buy in 2027
Looking for health insurance outside Obamacare? Four kinds of non-ACA coverage, compared side by side with an ACA plan: short-term, health sharing, private underwritten and fixed-benefit gap. Plus who can buy the ACA catastrophic plan in 2027.
Coverage outside the ACA. Every trade-off shown.
The short answer. You can buy health coverage that is not an ACA plan. The main kinds are short-term medical plans, health sharing programs, private plans that ask health questions, and fixed-benefit gap policies. Each one works differently on price, and each one gives up some ACA protections. The word "catastrophic" has one official meaning: the ACA catastrophic plan, which people under 30 or with a hardship exemption can buy. America First Healthcare is an independent insurance agency. A licensed advisor compares both sides on a free 15-minute call, and tells you to keep your current coverage if it already fits.
Open Enrollment for 2027 runs November 1, 2026 to January 15, 2027 in HealthCare.gov states. Enroll by December 15 for coverage that starts January 1 (HealthCare.gov, dates and deadlines). Non-ACA products follow their own enrollment rules, so price an ACA plan first while the window is open.
What "non-ACA" means
The Affordable Care Act (ACA), also called Obamacare, sets rules for the plans sold on HealthCare.gov. Every Marketplace plan covers the same 10 essential health benefits, such as hospital stays, emergency care and prescription drugs (HealthCare.gov, what Marketplace plans cover). No Marketplace plan can reject you or charge you more for a condition you had before coverage started (HealthCare.gov).
A non-ACA product is one that does not have to follow those rules. That changes what it covers and who it can turn away. The table and the figure below put each kind next to an ACA plan.
Your options, side by side
| Kind of coverage | What it is | Conditions you have today | Essential health benefits | Premium tax credit |
|---|---|---|---|---|
| ACA Marketplace plan (the baseline) | Comprehensive insurance under ACA rules | Must cover them | All 10 | Yes, if your income qualifies |
| Short-term medical plan | Temporary insurance, outside the ACA rules | Not protected. Plans can exclude them | Not required to cover them all | No |
| Health sharing ministry | Members share bills. Not insurance | Not required to cover them | Not required | No |
| Private plan that asks health questions | Off-Marketplace plan with medical underwriting | Can decline you, charge more or exclude a condition | Only what the policy lists | No |
| Fixed or hospital indemnity (gap) | Pays a set cash amount for an event, usually on top of a core plan | ACA protections do not apply | Not major medical | No |
Sources: short-term plans are not subject to the pre-existing condition rules and are not "individual health insurance coverage", and fixed indemnity is an "excepted benefit" (CMS fact sheet, March 28, 2024); short-term plans need not cover every essential health benefit (healthinsurance.org); health sharing (NAIC and Michigan DIFS); the tax credit, available only through the Marketplace (HealthCare.gov). The private underwritten path is on our private health insurance plans page and in how to choose a private health insurance plan.
Fit check
Which kind of coverage fits you? 3 taps
Compare Bronze, private and core-plus-gap
- For a full year, compare a Bronze plan with any tax credit first. The credit works only on Marketplace plans.
- A private plan with health questions, or a high-deductible core plus gap coverage, can also fit a healthy household. Ask which kind it is, in writing.
Is there a non-ACA catastrophic plan?
Not as a defined product. On HealthCare.gov, a Catastrophic plan is an ACA plan with low monthly premiums and a very high deductible. It is open to people under 30 and to people who qualify for a hardship or affordability exemption (HealthCare.gov, catastrophic health plans). It covers the same 10 essential health benefits, free preventive services and at least three primary care visits before you meet the deductible.
Outside the ACA, "catastrophic" is a sales word. It usually points to one of the kinds in the table: a short-term plan, an underwritten major-medical plan with a high deductible, or a high-deductible core plan with a fixed-benefit gap policy. Ask which kind it is, in writing. Our guides on catastrophic health coverage and catastrophic health insurance over 40, over 50 and over 60 show the ACA plan, the age prices and the core-plus-gap stack.
What changed for 2027. The 2027 Marketplace rule would have let more adults over 30 qualify for a catastrophic plan through a hardship exemption based on income. On July 16, 2026, a federal court in Maryland stayed that part of the rule while the case, City of Columbus v. Kennedy, goes on. CMS confirmed in an August 4, 2026 statement that the income route is not available for 2027 plans. The case is still open, so check HealthCare.gov before you apply. The 2027 out-of-pocket limit is $12,000 for one person and $24,000 for a family (HealthCare.gov), and an ACA catastrophic plan's deductible is set at that limit.
Short-term medical plans
A short-term plan is temporary insurance built as a bridge. The 2024 federal rule limited a short-term plan to an initial term of 3 months and a total of 4 months, including renewals, for plans sold on or after September 1, 2024. Before that, the limit was under 12 months at first and up to 36 months in total (CMS fact sheet). In August 2025 the federal government said it would not prioritize enforcing that rule, and 36-month plans have returned in many states (healthinsurance.org). The length you can buy depends on your state and the carrier.
What to know before you buy one:
- Health questions at the start. Applicants answer questions about their medical history. Many plans review your records when you file a claim and can cancel coverage if the application was wrong.
- Conditions you have today are generally excluded. The CMS fact sheet says short-term plans are not subject to the ACA's pre-existing condition protections.
- Benefits can be missing. KFF found the most commonly excluded are maternity care, mental health care, preventive care and prescription drugs (October 2025, as reported by healthinsurance.org).
- Some states do not allow them. healthinsurance.org lists 14 states and the District of Columbia where short-term plans are not available.
- They are not a home. Our advisors submitted 273 short-term applications from July 1 to October 13, 2026. The median monthly price was $407, and the middle half ran $272 to $661. That was higher than the median for health sharing ($241) or a Marketplace plan before any tax credit ($161). Source: America First Healthcare sales records, read October 14, 2026.
Health sharing programs
A health care sharing ministry is a membership program. Members pay a monthly share, and the program uses it to help pay other members' eligible bills. The NAIC says ministries are not insurance, cannot guarantee that a claim gets paid, and do not have to follow the ACA's protections. 30 states explicitly exempt them from insurance regulation (NAIC). Half of the 1,153 health-sharing applications we submitted in that window were $241 a month or less. The full guide, with the questions to ask before you join, is health sharing ministries: how they work and what members pay. The faith-based version is in Christian health insurance: your 4 options.
Fixed or hospital indemnity: the gap layer
A fixed-benefit policy pays a set cash amount for an event, such as a hospital stay, "regardless of the amount of expenses a consumer incurs" (CMS). Federal rules call it an excepted benefit. It is not major medical, so it never replaces a core plan. Stacked on a high-deductible core plan, it can help pay the deductible. Alone, it leaves the large bill open. How one pays, with an illustrative example, is in hospital indemnity insurance: what it is and how it pays.
What about the tax penalty?
The federal fee for having no health coverage "no longer applies" (HealthCare.gov). A few states run their own requirement. New Jersey residents "must have minimum essential health coverage, qualify for an exemption, or remit a Shared Responsibility Payment" (New Jersey Treasury). If you live in a state with its own rule, check its exemption list before you rely on a non-ACA product.
How a licensed advisor helps
On a free review, the advisor:
- Asks about your household, your income, your doctors and your prescriptions.
- Prices an ACA plan with any tax credit, then the non-ACA options, with every cost and exclusion shown.
- Tells you to keep your current plan if it already fits.
- Helps you apply if you decide to move forward.
The call takes about 15 minutes, by phone, at a time you pick. It costs you nothing. HealthCare.gov notes that agents and brokers are generally paid by the insurance companies whose plans they represent (HealthCare.gov, find local help). You can check any agent's license on the NIPR license lookup. More on how advisors work is on talk to a licensed health insurance advisor near you.
When you can enroll
ACA Marketplace plans have a window. In HealthCare.gov states, Open Enrollment for 2027 coverage runs November 1, 2026 to January 15, 2027, and December 15 is the last day to enroll for coverage that starts January 1. States that run their own exchange set their own dates. Every state is in Open Enrollment 2027 dates by state. After January 15 you need a qualifying life event, explained in missed Open Enrollment? Special Enrollment Periods explained. What is sold also differs by state. Start from health insurance by state.
FAQ
What is non-ACA health insurance?
It is coverage that does not have to follow the Affordable Care Act's rules. The main kinds are short-term medical plans, health sharing programs, private plans that ask health questions, and fixed-benefit policies. Each can leave out protections such as covering conditions you have today.
Is there a non-ACA catastrophic health insurance plan?
Not as a defined product. HealthCare.gov defines a Catastrophic plan as an ACA plan for people under 30 or with a hardship or affordability exemption. Outside the ACA, "catastrophic" is a sales word for short-term, underwritten major-medical or core-plus-gap coverage. Ask which kind it is, in writing.
Can I get health insurance without Obamacare?
Yes. You can buy non-ACA coverage in most states, and the federal fee for having no coverage no longer applies, according to HealthCare.gov. Some states run their own coverage requirement, such as New Jersey. Compare what you give up: conditions you have today, essential health benefits and the premium tax credit.
Do non-ACA plans cover pre-existing conditions?
Often they do not. The CMS fact sheet says short-term plans are not subject to the pre-existing condition protections, and Michigan's insurance department says health sharing ministries do not have to cover them. Every Marketplace plan must cover them.
What is the cheapest alternative to an ACA plan?
It depends on your age, state and health. In our applications from July 1 to October 13, 2026, the median monthly price was $241 for health sharing, $407 for a short-term plan and $161 for a Marketplace plan before any tax credit. A tax credit can lower the Marketplace price further. Price an ACA plan first.
Can I use a premium tax credit on a non-ACA plan?
No. HealthCare.gov says the premium tax credit is available only through the Marketplace.
What if I already have a plan I like?
Then the advisor tells you to keep it. The free review compares what you have with what else is available, and keeping your current plan is one of the answers.
References
- Catastrophic health plans, HealthCare.gov.
- What Marketplace health insurance plans cover and coverage for pre-existing conditions, HealthCare.gov.
- Premium tax credit, out-of-pocket maximum/limit, fee for not being covered and dates and deadlines, HealthCare.gov.
- Short-term limited duration insurance and independent, noncoordinated excepted benefits coverage, CMS fact sheet, March 28, 2024.
- Short-term health insurance, healthinsurance.org. Checked November 13, 2026.
- Not all products are health insurance, NAIC. Published November 8, 2022, last modified November 11, 2024.
- DIFS Reminds Consumers That Health Care Sharing Ministries Are Not Health Insurance, Michigan DIFS, January 23, 2024.
- New Jersey Health Insurance Mandate, New Jersey Department of the Treasury.
- America First Healthcare sales records: 2,582 priced health applications submitted July 1 to October 13, 2026, read October 14, 2026 (aggregates only; method in how much health insurance costs per month).
Availability by state
Plan availability and rules vary by state. Tell us your state and a licensed advisor will walk through what is actually available there.