 [ Symptoms ] what is the difference between health insurance plans offered on the exchanges and private plans off of the exchanges  are the off exchange plans now required to cover all of the same essential benefits as those under the aca [ Disease ] regarding exchange or off exchange plans all are required to cover the 10 essential health benefits outlined under the law if you do not qualify for a subsidy it is probably a good idea to also shop plans that are off exchange because you will have more options from which to choose and you will likely find that the provider networks are much broader than plans sold through the exchange