An off-marketplace health insurance lead is a consumer, usually aged 18 to 64, whose household income is above the ACA subsidy range and who has no major health conditions, which makes them a candidate for a private (non-marketplace) plan rather than a subsidized plan on healthcare.gov or a state exchange.
Why most health insurance leads are marketplace leads
Almost every health insurance lead sold to agents starts with an ad that says some version of “cheap health insurance.” That ad attracts everyone, and most people who respond qualify for a premium subsidy. For those consumers the right answer is a marketplace plan, often with a very low premium, which pays the agent a small commission and can be charged back if the client drops coverage at open enrollment.
Lead vendors sell all of those responses because every response costs them the same to generate. The agent pays for the whole batch and discovers on the phone which ones they could actually help.
What makes a lead off-marketplace
Two answers, collected before the consumer becomes a lead: household income and health history. If monthly household income is above the subsidy threshold for the household size, and the applicant reports no major conditions in the last five years, they are a candidate for private coverage. If either answer goes the other way, they belong on the marketplace.
The order matters. Asking these questions after the lead has been sold is “qualification,” and the agent has already paid. Asking them before the lead exists is screening, and the marketplace-bound consumer is never sold to anyone.
- Age 18 to 64
- Household income above the ACA subsidy range
- No major health conditions in the last five years, self-reported
- A verified, working phone number
- Consent naming the specific agent who will call
What agents can write for these prospects
Private individual plans, short-term medical where available, hospital indemnity, association and group-style plans, and supplemental products. Availability varies by state and carrier. These plans can generally be written any month of the year, which is why off-marketplace leads are valuable outside open enrollment.
How U65 Leads generates them
U65 Leads runs its own consumer quiz at realhealthplans.org. Every prospect answers the income question and the health question before seeing a result. Prospects who belong on the marketplace are routed to marketplace guidance and are never sold. Those who pass verify their phone number and consent to a call from one named agent. That lead is delivered to that agent alone, in real time, at a flat $20.
Questions
Are off-marketplace leads the same as private health insurance leads?
Yes. Both terms describe consumers who are candidates for non-marketplace coverage. “Off-marketplace” emphasizes what they are not: subsidy-eligible marketplace shoppers.
Can an off-marketplace lead still buy a marketplace plan?
They can, at full price with no subsidy. In practice they usually compare private options first because the marketplace offers them no cost advantage.
How do you know the income answer is honest?
It is asked before the consent screen and before any result, so there is nothing to gain by inflating it. Leads that turn out to be marketplace-eligible can be flagged for replacement.
Updated September 12, 2026 · Glossary