Who Can Use The Health Insurance Exchange? 
The simplest way to think ofhealth insurance exchanges is think of them like a Walmart , Target , Cosco , Kroger , etc. or even more similar - Amazon.com.Thehealth exchange is an online place to shop for health insurance , where insurance companies -LRB- like Blue Cross , Humana , UnitedOne , etc -RRB- can elect to have their health plans available for enrollmentSome states have their own exchanges in which they received federal dollars to operate , while other states opted for the federal government to handle the exchange through healthcare.gov . Just as anyone can walk into a Walmart or log on to Amazon.com , anyone can log on to an exchange and shop for health insurance . The plans on the exchange may be limited in the number of doctors & hospitals in the network in order to save premium dollars . For example , in TN , BCBS launched their `` E '' network , which has roughly 5000 providers state wide , where their other networks have ~ 45,000 & ~ 55,000 providers . The premiums for the `` E '' network are significantly lower . An insurance company may have addition plans available if you purchase directly through them . This is typically called off-marketplace , while enrolling through the exchange is on-marketplace . So ... if you had more choices off-marketplace , why would anyone want to enroll in a plan through the marketplace/health insurance exchange ? You can only obtain the government premium subsidy through the exchange . In other words , depending on your income , you could pay less through the marketplace . When you register , for example at healthcare.gov , there will be an opportunity for you to input your income from the previous year . If you are under 400 % -LRB- about $ 44k for individual -RRB- you could qualify for the subsidy , reducing the premium you would have to pay for your plan . After the insurance company receives your part of the payment , the insurance company tells the government you have paid & then the government pays the subsidy , so you get immediate relief . One final thought ... open enrollment ended 03/31 , so unless you have lost coverage involuntarily or had another qualifying event , you would be ineligible to enroll in individual health insurance until the next open enrollment . 