How to apply for individual health insurance

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 qualifying 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 shopping for your own insurance plan can be daunting if you've never done it before. The most common ways to shop for individual coverage are through the federal Health Insurance Marketplace, a state-based exchange, directly through an insurance company, or with help from a licensed broker.

If this seems confusing, don’t worry! Once you know where to apply and what information to gather, applying for individual health insurance is generally a straightforward process.

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 qualify for 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.

If you apply through a Marketplace, the application also determines whether you qualify for other financial assistance, such as cost-sharing reductions or Medicaid/CHIP. This is one important difference between applying through the Marketplace and buying a plan directly from an insurer. Federal subsidies are not available for off-exchange plans.

Lastly, 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. For 2027 coverage, HealthCare.gov currently lists Open Enrollment as November 1, 2026, through January 15, 2027 for states that use the federal exchange. If you enroll by December 15 and pay your first premium, known as a binder payment, your coverage will start January 1, 2027. If you enroll between December 16 and January 15, your coverage will start February 1.²

However, the 2027 dates have been subject to a recent federal court ruling. In 2025, the Centers for Medicare & Medicaid Services (CMS) finalized a rule that would have shortened the annual Open Enrollment Period beginning with 2027 coverage³. But in June 2026, a federal district court vacated the shortened enrollment provision after finding that CMS hadn’t properly justified the change⁴. The federal government appealed, and the case is still pending.

Because the legal battle is still ongoing, consumers should check their local exchange for the latest enrollment dates before applying.

While the federal Health Insurance Marketplace has issued its 2027 dates, people in a state with its own Marketplace should check their state exchange directly, as many have their own enrollment schedules.

Don’t know if your state has its own exchange? See our blog post.

What if you miss Open Enrollment Period?

Outside of Open Enrollment, you must experience certain qualifying life events to enroll in Marketplace coverage. 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 a stand-alone 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?

Before you apply for individual health coverage, decide if you want to shop on a public or private exchange.

Here are your options:

1. Apply through a public Marketplace: You can apply through the federal Marketplace at HealthCare.gov or through your state's own health insurance exchange⁵. The Marketplace lets you compare available plans and determines whether you qualify for premium tax credits or other Marketplace savings.
1. HealthCare.gov also allows consumers to apply by phone, get help from a local enrollment assister, use a certified enrollment partner, or submit a paper application.
2. Apply on a private exchange: You can also purchase individual coverage directly from an insurance company or through a licensed insurance agent or broker. The insurer will guide you through its application and enrollment process, which may take place on the insurer's website or with an agent.
1. Keep in mind that you can only apply for premium tax credits or other federal subsidies through a public exchange. If you think you may qualify for a premium tax credit, compare your options through the Marketplace before purchasing coverage directly from an insurer.

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, 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: Gather the information and documents you'll need

Having your information ready before you start can make the application process much faster.

Depending on your situation, you may need:

• 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. You’ll also need SSNs for any dependents you plan to include on the policy.
• 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.).

Step 2: Go to HealthCare.gov, your state's exchange, or work directly with a carrier or broker

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.gov. On the federal Marketplace, you can enter your ZIP code, household information, and estimated income to compare plans and estimated prices before completing the full application.

You can also buy coverage directly from an insurance carrier or work with an insurance broker to explore all available on- and off-exchange plans in your area.

If your employer offers you an HRA through PeopleKeep, you can shop for individual health insurance directly through your PeopleKeep dashboard.

Step 3: Complete the application

When you visit the federal or state public exchange, you'll need to create an account to get started with your online application. For off-exchange coverage, you can visit an insurance company’s website or work with a broker to get started.

Whether you're applying for a policy for the first time or renewing your current health insurance plan, the application will ask questions about your household, income, location, and current health coverage to determine what coverage is available (and, if on-exchange, any financial assistance you may qualify for). This is why it’s crucial to gather the information and documents in step one beforehand.

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

Completing the online form should take 15 to 30 minutes. After that, you'll receive email updates on your application status. You can also apply by phone, work with a local assister, use a certified enrollment partner, or mail a paper application⁶.

Step 4: Compare and choose a plan

After you complete your application, you can choose a plan. Exchanges display 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 expect to need many medical services but want coverage if you're in an accident.

Conversely, a Platinum plan generally has the highest monthly premium. 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 with your coverage decision-making, 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 call to speak with one of its health benefits navigators, who can offer enrollment assistance⁷.

If you’re enrolling in coverage through PeopleKeep’s platform, you’ll have access to a licensed Benefit Advisor.

Step 5: Submit your application and complete any verification

After you select a plan, submit your application and review your eligibility results carefully. The Marketplace will tell you whether you qualify for financial assistance and whether you need to take any additional steps.

In some cases, the Marketplace will ask you to submit documents to verify information on your application. For example, you may be asked to provide documents verifying income, citizenship, or immigration status.

If this happens, log in to your Marketplace account and check your eligibility notice for instructions and deadlines. Failing to provide requested information by the deadline could affect your financial assistance or Marketplace coverage.

Step 6: Pay your first premium

All health plans are “guaranteed-issue.” This means insurers accept all eligible individuals, no matter what, as long as you provide all required information and they verify it.

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 you purchase a plan, you'll receive an insurance card and documents by mail. Even if you leave your current job, your plan will stay with you because it's not tied to your employment, unlike with a group health insurance plan.

If you don't receive confirmation that your coverage is active, contact the insurance company.

Step 7: If your employer offers a stand-alone HRA, submit your premium for reimbursement

If your employer offers you a qualified small employer HRA (QSEHRA) or a CHOICE Arrangement, formerly known as 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

If you’re offered a QSEHRA or ICHRA through PeopleKeep, you can shop for health insurance and ancillary coverage, such as dental and vision insurance, directly from your account. You can also meet with our in-house benefits specialists to help you choose the right plan for you and your family.

Once you enroll in qualifying coverage, 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.

At PeopleKeep, our team reviews your expense submissions. This keeps your medical needs private while your employer only sees the amount of the reimbursement request.

If you enroll through our integrated shopping experience, your premium information may be handled automatically, so you don't have to submit each premium expense manually.

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 can make your individual health insurance policy more affordable than you think.

This article was originally published on July 8, 2021. It was last updated on September 14, 2026.

References

1. eSports Insurance
2. A quick guide to the Health Insurance Marketplace®
3. Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability
4. City of Columbus et al v. Kennedy et al
   
5. Health Insurance Marketplace
   
6. Application for Health Coverage & Help Paying Costs
7. Health Insurance Marketplace - Contact Us