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You can purchase health insurance directly from private carriers like UnitedHealthcare, Aetna, or Cigna.

Companies like Allianz Care , AXA Global Healthcare , and Blue Cross Blue Shield Global provide worldwide coverage for expats and travelers.

HealthCare.gov serves most states and is the official source for plans under the Affordable Care Act (ACA).

Buying "off-exchange" means you work directly with the provider, often through their website.

Brokers serve as intermediaries who can help you compare multiple plans across different companies at no extra cost to you.

Resources like Expat Financial offer tailored advice and quotes from multiple international insurers.