INDIVIDUALS & FAMILIES
Health Coverage Built Around Your Life
Whether you're self-employed, between jobs, losing employer coverage, or simply exploring your options, PEARL helps individuals and families understand and compare health insurance both through the ACA Marketplace and outside the exchange.
For Georgia residents, we can help you explore coverage available through Georgia Access, including potential financial assistance when eligible, as well as off-exchange health insurance options.
Two Ways to Access Individual & Family Health Coverage
Health insurance isn't one-size-fits-all. Depending on your household, income, healthcare needs, and eligibility for financial assistance, coverage may be available through the ACA Marketplace or outside the exchange. PEARL helps you understand both paths before you decide.
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ON-EXCHANGE COVERAGE
ACA Marketplace Coverage
ACA-compliant individual and family health plans available through the federal Health Insurance Marketplace or a state-based Marketplace, such as Georgia Access. Eligible households may qualify for premium tax credits and, in some cases, cost-sharing reductions.
OFF-EXCHANGE COVERAGE
Private Health Insurance Options
Health coverage available outside the Marketplace. Options may vary in benefits, provider networks, eligibility requirements, and consumer protections depending on the type of coverage.
Which Coverage Path May Be Right for You?
There’s no one-size-fits-all answer. The right path depends on your situation, eligibility for financial assistance, healthcare needs, and the type of coverage available to you. Here are some common reasons people explore each option.
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Marketplace Coverage
MAY BE WORTH EXPLORING IF YOU:
- Want to determine whether you qualify for premium tax credits to lower your monthly cost.
- May qualify for cost-sharing reductions that can lower deductibles, copays, and out-of-pocket costs.
- Need ACA-compliant individual or family health coverage.
- Have experienced a qualifying life event such as marriage, birth of a child, loss of coverage, or more.
- Are enrolling during the Annual Open Enrollment Period
Private / Off-Exchange Coverage
MAY BE WORTH EXPLORING IF YOU:
- Want to compare options outside the Marketplace that may fit your needs or budget.
- Don't qualify for Marketplace financial assistance based on your household income.
- Are looking for different carrier, provider network, or plan design options
- Want to understand alternatives that may have different benefits, rules, or pricing.
- Prefer to choose coverage based on your specific needs rather than subsidy elgibility.
Coverage for Where Life Takes You
Self-Employed
Between Jobs
Losing Employer Coverage
Turning 26
Retiring Before Medicare
Life Changes
You don't have to know which path to choose before contacting PEARL.
We'll learn about your situation, review your options, and help you understand which path may fit your needs — with clarity, confidence, and no pressure.
Personalized Guidance
Understand All Your Options
Clear Comparisons
Ongoing Support
Let's Find the Right Coverage Path for You
Whether your best option is through the Marketplace or outside the exchange. PEARL is here to help you make and informed decision.