It's difficult to recommend a strategy without knowing your location, income and healthcare needs. Here is what works for my wife and me.
We use the local ACA exchange (Covered California). We are both retired and we are able to keep our income low enough to qualify for ACA subsidies. We are in good health with no chronic conditions. We signed up for a high deductable Bronze plan with an HSA. We make sure to contribute the maximum every year to the HSA. This builds up a large balance of tax free money and it also reduces our MAGI and thus increases our subsidy. We are able to keep our premium payments under $100 a month but we have deductables of $6500 and max out of pocket of $13000. I'm doing this form memory but I think the numbers are close to correct.
