Can You Still Get Covered During Open Enrollment If You Earn Too Much for Subsidies?
Short answer: yes. Absolutely.
This is one of the most common misunderstandings I hear from higher earners every fall. People assume that because they don't qualify for ACA subsidies, the marketplace — and open enrollment itself — isn't for them. That's not how it works.
Subsidies are just one way to pay for a plan. Not qualifying for financial help doesn't disqualify you from coverage. You can still buy a marketplace plan at full price, and you have options outside the marketplace too. Here's the full picture for 2027.
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Earning Too Much Doesn't Lock You Out
Let's clear this up first: there is no income limit on buying health insurance. The income limits only apply to subsidies — the premium tax credits that lower your monthly bill.
With the enhanced subsidies expiring and the 400%-of-poverty-level cap back for 2027 (that's $63,840 for a single person, $86,560 for a couple, $132,000 for a family of four, based on 2026 federal poverty guidelines), a lot of households that got help in 2025 will get zero in 2027. That stings. But it doesn't leave you uninsured — it just means you're shopping at full price.
And when you're shopping at full price, the smart move is to shop everywhere, not just on the exchange.
Your Three Paths to Coverage
Path 1: A marketplace plan at full price. You can enroll in any plan on Healthcare.gov or your state exchange during open enrollment (November 1, 2026 – January 15, 2027) and simply pay the full premium. The advantage: guaranteed issue. No health questions, no medical underwriting, pre-existing conditions covered from day one. The disadvantage: cost. Unsubsidized premiums are the highest prices in the market, because you're buying from a risk pool that includes everyone.
Path 2: A private off-exchange plan. These are medically underwritten health plans sold outside the marketplace, typically on national PPO networks. Because applicants generally need to be in relatively good health to qualify, the risk pool is healthier. These private off-exchange PPO plans usually cost almost half as much as a full-price marketplace plan with no subsidies, as long as there are no major health conditions. That's a life-changing difference when there's no subsidy softening the blow.
The honest caveats: you'll answer health questions, and certain conditions can mean a decline or exclusion. These plans aren't ACA-equivalent — they don't cover pre-existing conditions the way marketplace plans do. But if you're healthy and your main worry is a major hospitalization or surgery wiping out your savings, they're built exactly for that.
Path 3: Short-term coverage. Short-term plans can fill a gap — say you're between jobs or waiting for a new plan year. They're the cheapest option of all, but also the thinnest: limited benefits, no pre-existing condition coverage, and term limits. Think of them as a bridge, not a destination.
What Changes When the Subsidy Disappears
When you had a subsidy, shopping was simple: pick the plan with the best value after the credit. Without one, you're exposed to the real price of coverage — and the real price varies enormously by where you shop.
Here's what surprises most higher earners: the unsubsidized marketplace plan and the private off-exchange plan can look similar on the surface — both say "PPO," both cover hospitalizations — but the private plan's monthly premium is often roughly half. Over a year, that's thousands of dollars back in your pocket.
That gap exists for a reason (underwriting), and it's not the right trade for everyone. If you have significant ongoing medical needs or pre-existing conditions, the marketplace's guaranteed issue is worth paying for. But if you're healthy, paying full marketplace price out of habit is just overpaying.
A Note on Timing
Open enrollment runs November 1, 2026 through January 15, 2027, with December 15 as the deadline for coverage starting January 1. Private off-exchange plans are available year-round, so you're not locked to these dates for Path 2 — but if you want everything lined up cleanly for January 1, shop in November and decide by mid-December.
One more thing: don't confuse "I can't get a subsidy" with "I shouldn't look at the marketplace at all." Run the numbers both ways. In a handful of states and situations, an unsubsidized marketplace plan still makes sense. The mistake isn't picking one or the other — it's only checking one.
The Bottom Line
Earning too much for subsidies doesn't mean earning too much for coverage. You have the same open enrollment window as everyone else, plus an entire off-exchange market that most subsidy-eligible shoppers never bother to check. In 2027, with the subsidy cliff back, that off-exchange market is where a lot of higher earners are going to find their answer.
See what coverage actually costs you — get a free quote at myprivatehealthinsurance.com or call 561-927-9469.
Justin Brain is a licensed health insurance agent (licensed since 2016, National Producer Number (NPN) #17940663) and founder of My Private Health Insurance in Fort Lauderdale, Florida. He has helped self-employed professionals, 1099 contractors, and small business owners in 33 states secure private, off-exchange health coverage — often at about half the cost of full-price marketplace plans. His team specializes in medically underwritten PPO plans for people who earn too much for ACA subsidies.