Individual Health Insurance Options in 2026

The five categories of individual coverage

Most people default to comparing ACA Marketplace plans and stop there, but the full menu is broader. Here's what actually exists:

ACA Marketplace plans are the most familiar path, and the only one where premium tax credits apply. Private off-Marketplace plans follow the same ACA coverage rules but skip the subsidy — worth considering if your income is too high to qualify for a tax credit anyway, since off-Marketplace plans sometimes offer more plan variety in a given area.

Catastrophic plans are a category many people don't know exists: available only to those under 30, or anyone with a hardship or affordability exemption, they carry very low premiums and a high deductible roughly matching the ACA's out-of-pocket maximum. They still cover all ten essential health benefits and include three primary care visits a year plus preventive care before the deductible applies — but they're not eligible for premium tax credits, so they only make financial sense if you wouldn't qualify for a subsidy anyway.

Short-term plans and COBRA: the two "gap" options

Short-term medical insurance is medically underwritten — your health history affects approval and pricing — and it isn't required to cover pre-existing conditions or the ACA's essential health benefits. It works best as a genuine bridge: between jobs, waiting on new employer coverage, or after missing Open Enrollment. Many states cap how long a short-term plan can run and whether it can be renewed, so check your state's specific rules.

COBRA is different: it lets you keep your exact former employer plan, same network and same benefits, for up to 18 months (sometimes 36 in certain situations) after leaving a job. The tradeoff is cost — you pay the full premium your employer used to subsidize, plus up to a 2% administrative fee, which often makes COBRA the most expensive option on this list dollar for dollar. The U.S. Department of Labor publishes detailed COBRA continuation coverage rules at DOL.gov, worth reviewing if you're weighing COBRA against a Marketplace plan after a job loss.

A health share program is sometimes mentioned alongside these, but it's structurally different — it's a cost-sharing arrangement between members, not a regulated insurance contract, and isn't required to follow state insurance law the way the categories above are.

What actually determines your premium

Within any ACA-compliant category, insurers can only price your premium based on a handful of factors: your age, your location, whether you use tobacco, and the metal tier and plan you choose. Health status, gender, and pre-existing conditions cannot factor into your price — that protection applies across ACA Marketplace, off-Marketplace private, and catastrophic plans alike.

Metal tiers — Bronze, Silver, Gold, and Platinum — describe how costs split between you and the insurer on average, not the quality of care. Bronze carries the lowest premium and highest deductible; Platinum is the reverse. Silver deserves extra attention if you're subsidy-eligible, since it's the only tier where cost-sharing reductions apply.

Subsidies and cost-sharing reductions for 2026

The temporary, enhanced premium tax credits that expanded subsidy eligibility and increased subsidy amounts expired on December 31, 2025. KFF estimates that change is raising average out-of-pocket Marketplace premiums by roughly 114% nationally in 2026. The base ACA premium tax credit still exists, though, for households between 100% and 400% of the federal poverty level — it's worth re-checking your specific numbers every year rather than assuming last year's subsidy still applies, since the House passed a three-year extension of the enhanced credits in January 2026 and the Senate had not acted as of this writing. Current federal guidance is available at IRS.gov.

Cost-sharing reductions are a second, separate benefit worth knowing about: available to households under 250% of the federal poverty level, they lower your deductible and copays rather than your premium — but they only apply to Silver-tier plans. A subsidized Silver plan can end up with better cost sharing than an unsubsidized Gold plan, which is exactly what shoppers who default to Bronze for the lowest premium often miss.

None of this applies to catastrophic plans, short-term plans, or COBRA — subsidies are exclusive to ACA Marketplace coverage.

What's guaranteed no matter which category you choose

Every ACA-compliant plan — Marketplace, off-Marketplace, or catastrophic — must cover ten essential health benefit categories, including maternity care, mental health treatment, and prescription drugs, and none can deny you or charge more for a pre-existing condition. That floor doesn't extend to short-term plans, which are medically underwritten and can exclude pre-existing conditions entirely, or to health share programs, which aren't legally insurance at all.

COBRA sits in its own spot here: since it continues your exact former employer plan, whatever that plan covered, COBRA covers — no new underwriting, no new exclusions, just the same benefits at full, unsubsidized cost.

Enrollment paths for each category

ACA Marketplace plans — including catastrophic — follow an annual Open Enrollment window. For 2027 coverage, that's November 1, 2026 through January 15, 2027 in most states, with a December 15, 2026 deadline to secure a January 1 start. Outside that window, a qualifying life event opens a Special Enrollment Period.

Short-term plans and health share programs are typically available to enroll in year-round, since they aren't bound by ACA enrollment rules. COBRA has its own timeline entirely: you generally have 60 days after losing employer coverage to elect it, and if you do, it can be applied retroactively to the day your old coverage ended.

Choosing between categories

If you qualify for a subsidy, an ACA Marketplace plan is almost always the strongest starting point — the tax credit alone frequently outweighs any other consideration. If you don't qualify and are under 30 or hold a hardship exemption, a catastrophic plan can make sense if you're healthy and mainly want protection from a worst-case scenario.

If you're between jobs and expect new employer coverage within a few months, a short-term plan can bridge the gap more cheaply than COBRA — but if you have an ongoing prescription or a specialist relationship you don't want to interrupt, COBRA's guaranteed continuation of your exact old plan may be worth the higher cost, at least temporarily while you shop the Marketplace properly.

A licensed broker can run your specific numbers across all five categories — something worth doing before defaulting to whichever option your former employer's HR packet happens to mention first.

A quick checklist

• Check your ACA subsidy eligibility before assuming you don't qualify.
• Confirm whether you're eligible for a catastrophic plan if you're under 30 or hold a hardship exemption.
• If you recently left a job, confirm your COBRA election deadline — typically 60 days.
• Ask directly whether a short-term plan excludes any condition you currently manage.
• Check your state's specific short-term plan duration and renewability rules.
• Confirm your enrollment deadline for whichever category you're choosing.
• Compare all viable categories with a licensed broker before enrolling.

Common questions about individual health insurance options

Have a question that isn't answered below? Our full health insurance FAQ page covers more, and our blog has deeper guides on specific coverage types.