If your income is below 400% of the federal poverty level ($64,960 for a couple or $98,400 for a family of four), you qualify for a subsidy to help with your premiums if you buy on an exchange. (For people whose income is less than 250% of the federal poverty level, insurers may still offer an additional subsidy to help them cover deductibles and co-payments, but as of early September it was unclear whether they would be reimbursed by the federal government.) If your income is near or exceeds that cutoff, also check out options off the exchanges. You may find different insurers or more provider networks.