How to apply for individual health insurance

By Holly Bengfort on September 9, 2025 at 7:00 AM

If you have an employer who offers you a stand-alone health reimbursement arrangement (HRA), you have access to a personalized health benefit. With this form of employer-sponsored coverage, you have the power to choose your own individual policy. Once you select a plan and pay the premium, your employer reimburses you, tax-free, for that premium.

The freedom to choose your own policy is great for your healthcare. But it can be daunting to shop for your own insurance plan if you've never done it before. While there are several ways to shop for individual health insurance, the most common way is through the federal Health Insurance Marketplace or state exchanges.

In this article, we'll walk you through the five-step process of shopping and applying for Marketplace coverage. That way, you can choose the right plan for you and your family.

In this blog post, you'll learn:

How the Affordable Care Act helps those seeking affordable health insurance coverage.
How to apply for individual health insurance, and which basic financial and personal information you need to get started.
How your employer can provide a tax-free reimbursement for your insurance premiums with an HRA.

What is individual health insurance?

Individual health insurance is a health plan that individuals purchase for themselves from a public or private exchange. It can refer to self-only coverage that a person purchases for themselves or a family plan that covers an entire household. Either way, it's not job-based or offered by an employer. It's also not selected or sponsored by an employer, unlike a traditional group health plan.

Individuals can buy these policies on their own or through a certified agent or broker. Brokers can help individuals understand and navigate insurers, health plan choices, and health insurance premiums.

Since the Affordable Care Act (ACA) went into effect, many Americans have shopped for affordable health coverage through online Health Insurance Marketplaces, which include the federal Marketplace and state-based exchanges.

Terry Green is the President of eSports Insurance¹. As an insurance broker with more than 20 years of experience in the industry, he assures you that purchasing your own plan isn't as tricky as it may seem.

"The application process itself is typically straightforward," Green said. "Come prepared with information like your income, family details, and any medical conditions. Check if your doctors, hospitals, and prescription drugs are in-network for the plans you're interested in."

Thanks to federal government regulations, insurers can no longer deny individual health insurance to individuals with preexisting medical conditions. Those shopping for individual coverage on a public exchange may also have access to federal premium tax credits. These credits are available to those who qualify based on their income. This health insurance subsidy helps Americans with their monthly premium costs.

Additionally, the Marketplace only offers qualified health plans. This means they cover the ten essential health benefits. You may also be able to enroll in ancillary policies like dental and vision coverage if they’re available in your area.

When can you apply for individual health insurance?

You can usually only sign up for a health plan during the Open Enrollment Period at the end of the year. Currently, this generally runs from November 1 through January 15 in most states.

However, due to a new final rule, the annual Open Enrollment Period will begin on November 1 and end on December 15 for all states with public exchanges operating on the federal Health Insurance Marketplace². This new timeline will become effective for the 2026 Open Enrollment Period for coverage beginning January 1, 2027.

Special enrollment opportunities exist if you experience certain qualifying life events. These special enrollment periods allow you to shop for a plan outside of the regular open enrollment period.

Some major life changes that would qualify you for a special enrollment period include:

The offer of a new health benefit, like an HRA
Loss of existing coverage
Moving to a new insurance rating area
Getting married or having a baby

Where can you purchase an individual policy?

You can buy your individual or family policy from a public or private exchange. Private insurance exchanges are online resources that include buying directly from a health insurance company, a licensed broker, or an insurance agent. Public exchanges include the federal and state marketplaces. In the steps below, we'll cover how to apply for individual health insurance on the public exchanges.

Health insurance terms to know

Before you get started, it's helpful to familiarize yourself with common industry terms. This can help you make informed decisions and avoid costly surprises when comparing your health insurance options. Terms like deductible, premium, copay, coinsurance, and out-of-pocket maximum directly impact how much you’ll pay for coverage and care.

Here are the Top 8 health insurance terms you need to know.

Step 1: Go to HealthCare.gov or your state's exchange

The ACA created the online Health Insurance Marketplaces, both the federal Marketplace and state-based exchanges, to help Americans sign up for their own individual and family health insurance coverage.

To compare health plan choices, you'll need to see if your state has its own health insurance exchange. You can check on our state-by-state guide. If your state doesn't have its own exchange, you can find a Marketplace health insurance plan at HealthCare.gov³.

Depending on your state, if your employer administers your HRA with PeopleKeep by Remodel Health, you can shop for an individual policy right from your PeopleKeep dashboard.

Step 2: Complete the online Marketplace application

When you visit the federal or state public exchange, you'll need to create an account to get started.

Whether you're applying for a policy for the first time or renewing your current health insurance plan, the Marketplace website will walk you through several questions via online forms to help determine your age, income level, and location.

You can expect to provide the following information during the application process:

Date of birth
Social Security number
Contact information, such as your mailing address, ZIP code, email address, and mobile phone number
Tax filing status*
Number of dependents*
Current job and household income information*
You must also provide the Social Security number of anyone helping you pay for the policy to determine household income eligibility, even if they aren't directly applying for the health coverage.
Other income information such as pensions, rental income, received alimony, unemployment benefits, disability benefits, etc.*
Current insurance information, if applicable, such as how you're insured (employer coverage, Medicaid, individual health insurance, etc.)*
Payment information, such as a credit card or bank draft (ACH) information

*The exchanges only ask these questions if you apply for federal financial assistance (i.e., premium tax credits, cost-sharing, Medicaid, CHIP coverage, etc.).

Aside from your tobacco use, there won't be any questions about your medical history. The ACA mandated that no one should pay more for insurance because of their preexisting health conditions. So there's no need to worry about having any medical records on hand.

Completing the form should take 15–30 minutes. After that, you'll receive email updates on your application status.

You can also enroll in coverage over the phone or by mailing in a paper application⁴.

Step 3: Choose a plan

Once you've completed your application, you're ready to choose a plan. The website displays all the available insurance options in four metallic tiers: bronze, silver, gold, and platinum. Catastrophic plans are also available to those who qualify.

If you're generally healthy and want low-cost health coverage, a bronze plan may be your best choice. A bronze plan will generally have the lowest monthly premium. But you'll pay more out-of-pocket when you receive medical care. This could be a good option if you don't plan on needing a lot of medical services but want coverage if you're in an accident.

Conversely, a platinum plan will generally have the highest monthly premium costs. But you'll pay the least when you receive medical services. This could be a good option if you have many medical needs or visit your doctor often.

It's important to note that these metal tiers have nothing to do with the quality of care you'll receive. They simply determine how you and your health insurance company will split your healthcare costs.

Green recommends focusing on coverage that matches your needs and budget. He said you should also compare plans and quotes from reputable insurance companies. If you need a little extra help in your coverage decision-making process, he recommends working with a broker.

"For most people, purchasing individual health insurance is easier than expected if you do your research and get guidance from a broker," Green said. "We work directly with clients to compare plans, explain coverage, and help you avoid confusion."

Additionally, HealthCare.gov has a number you can call⁵ to talk to one of their health benefits navigators who can offer enrollment assistance.

Step 4: Pay your first premium

All health plans are “guaranteed-issue.” This means insurers accept all eligible individuals, no matter what. So you won't need to wait and see if the insurer accepts your application.

Once you select a plan, you'll make your first payment before your coverage starts. This is known as a binder payment. In most cases, you'll get redirected from the Marketplace to your health insurance company's website to enter your credit card information for your first payment. Or, the Marketplace will bill you for your premium and forward the payment to your insurance carrier.

Once purchased, you'll receive an insurance card and documents by mail. Even if you leave your current job, your plan will stay with you since it's not tied to your employment, as it would be with a group health insurance plan.

Step 5: If your employer offers an HRA, submit your premium for reimbursement

If your employer offers you a qualified small employer HRA (QSEHRA) or an individual coverage HRA (ICHRA), they can reimburse you tax-free for your health insurance premiums.

Depending on how they customize the plan, they may also reimburse you for other qualifying medical expenses, such as:

Doctor's office visits
Prescription drug costs
Certain medical equipment

All you need to do is submit documentation to your employer that shows the following:

The premium amount
The coverage date
The insurance provider

After your employer reviews and approves the documentation, you'll automatically get reimbursed every month up to your allowance amount. If your premium exceeds your monthly allowance, you'll simply pay what's left out of pocket. If your employer uses PeopleKeep by Remodel Health, we review your expense submissions. This keeps your medical needs private while your employer only sees the amount of the reimbursement request.

Note: If you enroll in a health plan through PeopleKeep's integrated shopping experience, you won't need to manually submit your premiums for reimbursement. Our software will take care of that for you.

Conclusion

Finding affordable health insurance coverage that meets your unique healthcare needs is easier than ever. Whether you're shopping through the Health Insurance Marketplace or a private exchange, you can find a plan that works for you. If you want the support of an expert, you can work with a licensed broker to select the right plan for you and your family.

If your employer offers you an HRA, you can use your allowance to pay for your monthly premium and other healthcare expenses. This makes your individual health insurance policy even more affordable than you may think.

This article was originally published on July 8, 2021. It was last updated on September 9, 2025.