Bottom line: If you are not eligible for a subsidy, you should strongly consider purchasing “off the exchange”. If you are eligible for a subsidy, you must purchase “on the exchange”. If you can afford it, my recommendation is to reconcile the totaly subsidy on your 2014 tax rerturn. By doing that, you don’t have to reveal all the detailed infromation that Medicaid wants. The downside is you will not be advanced the subsidy.