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You can get health insurance in many ways, but you can generally group plans under two large categories: private and public.
Private health insurance is the most common way Americans get coverage. Here’s how it works.
Private health insurance is coverage provided by a private entity (such as UnitedHealthcare or Kaiser Permante) and not the government. Insurance provided by the state or federal government is considered public health insurance.
The U.S. Census estimates that 66.5% of Americans have a private health plan compared to 34.8% of those with public plans.
There are several different types of private health insurance that you can buy.
Offers plans in all 50 states and Washington, D.C.
On Healthcare Marketplace's Website
Offers plans in all 50 states and Washington, D.C.
On Healthcare Marketplace's Website
Offers plans in all 50 states and Washington, D.C.
On Healthcare Marketplace's Website
Employers often offer group health insurance as part of their benefits package. This coverage may be available to you only, or coverage may be extended to your spouse and dependents at a higher price.
The Affordable Care Act (ACA) mandates that businesses with 50 full-time employees or more provide comprehensive health insurance that pays for at least 60% of health insurance costs. Businesses that don’t offer the minimum affordable health insurance coverage may be subject to a tax penalty.
Almost half of all Americans receive employer-sponsored health insurance, according to the Kaiser Family Foundation.
You can also purchase health insurance through the Affordable Care Act (ACA) marketplace at Healthcare.gov. The marketplace allows you to compare available health insurance plans and enroll via a variety of methods, including online, over the phone and in person.
The federal government offers its health insurance marketplace in most states, while a handful of states have their own exchanges. When applying for ACA health insurance, you enter household and income information. Based on that information, the marketplace estimates the cost of health insurance once possible premium tax credits and subsidies are taken into account.
You can also buy individual health insurance directly from a health insurance company.
These plans don’t have to comply with ACA regulations. For instance, they may not provide all of the essential health benefits found in ACA plans, such as:
Without needing to meet ACA regulations, you may buy cheaper health insurance directly from an insurer that doesn’t have as much coverage as one found on the marketplace. Health insurance companies often also offer similar plans as those found on the marketplace.
One important difference between the marketplace and buying directly from an insurance company is that plans purchased directly from a company don’t qualify for premium tax credits or subsidies like the marketplace plans. That may not impact you if your household income exceeds tax credit and subsidy limits, but if you qualify for those cost savings, you should stick with a marketplace plan.
Most states allow low-cost, short-term health insurance , which offers limited coverage for a limited time. These health plans offer cheap coverage, but they don’t offer the protections found in standard health insurance.
Short-term health plans can also exclude pre-existing conditions and have limits on prescription drug benefits, doctor visits and covered services. Short-term plans also don’t generally cover maternity care or mental health.
You might consider a short-term health plan if you lose your job-related coverage and don’t want to pay for COBRA health insurance until you get new employer-sponsored coverage again. Or you may just prefer the low costs of a short-term plan, knowing that those plans don’t offer the coverage found in a standard health plan and you will pay much more for care when you need it.
Short-term health insurance typically lasts for an initial 364 days, with the option for renewal for up to 36 months in most states. But some states have additional stipulations and some states, including California, don’t allow short-term health insurance plans.
Catastrophic health insurance is a type of coverage found on the ACA marketplace that provides the same level of coverage found in an ACA plan but with an exorbitant deductible.
A catastrophic health insurance plan deductible in 2022 is $8,700. Once you reach the deductible, a catastrophic plan picks up the rest of your health care costs for the year.
These policies aren’t for everyone. You must be under age 30 or qualify for a hardship exemption. For instance, you may qualify for a hardship exemption if you’re homeless.
A catastrophic plan could be a choice for a young person who only wants a safety net plan with comprehensive coverage, but this low-cost option comes with hefty out-of-pocket costs when you need care.
Medicare, Medicaid and CHIP plans are not private health insurance.
Medicare is the health insurance program for qualified Americans that’s run by the federal government. About 18% of Americans have Medicare, according to the most recent data from the U.S. Census Bureau.
You must meet one of three qualifications to qualify for Medicare coverage:
Medicare is divided into Original Medicare and Medicare Advantage.
There are two parts of so-called Original Medicare coverage:
People with Original Medicare can also get prescription drug benefits through:
An alternative to Original Medicare is Medicare Advantage, also called Part C. Private health insurance companies work with the federal government to offer Medicare Advantage plans and often have supplemental benefits not found in Original Medicare.
Medicaid is a government-funded health insurance plan that is designed for low-income households. Women who are pregnant and those with disabilities may also qualify. About 18% of Americans have a Medicaid plan, according to the most recent data from the U.S. Census Bureau.
Medicaid is available in all states, but eligibility rules vary by state. Coverage begins immediately for qualified applicants. You can also visit the health insurance marketplace to complete an application and see which options are available to you.
More than 9.6 million children are enrolled in the Children’s Health Insurance Plan, or CHIP, which provides coverage to children and mothers. The low-income program is state-run and funded jointly by states and the federal government.
Some states roll CHIP into the state’s Medicaid program, while others have separate Medicaid and CHIP programs.
CHIP coverage includes several types of coverage, such as well-baby and well-child visits, dental insurance, behavioral treatment and vaccines.
Group health insurance plans offered through workplaces are often the most affordable private health insurance plans because employers subsidize costs.
If you do not qualify for an employer-sponsored plan, you can use the ACA marketplace to find coverage and purchase a plan. These plans often cost more than employer plans, but you can save money if you qualify for premium tax credits and subsidies, which reduce the costs of ACA plans.
Another option for the cheapest private health insurance is to purchase short-term health insurance. But you shouldn’t view short-term health insurance as a long-term coverage solution. These plans offer limited coverage, high out-of-pocket costs and an expiration date.
Public health insurance such as Medicaid is offered by the federal government and has requirements to get coverage, such as your age and household income. A private health plan, including an ACA marketplace plan or a group health insurance , is sold by a private entity rather than a state or federal government and it doesn’t have income or age requirements found in programs like Medicaid and Medicare.
Obamacare, also known as the Affordable Care Act, is federal law that created the marketplace and stipulates minimum coverage requirements. ACA plans are private health insurance, but only a small percentage of Americans have ACA plans. The most common type of private health plan is employer-sponsored health insurance.
COBRA is a kind of private insurance that you can buy if you lose your employer-sponsored health insurance. You can become eligible if you lose your job or your work hours get cut and you no longer qualify for a work-based plan.
A spouse or dependent may also be eligible for COBRA if the employee dies or for other reasons like divorce.
COBRA coverage provides the same coverage found in the employer-sponsored health plan, but usually without the employer’s contribution to premium payments. The individual typically has to pay all of the health insurance costs.
Lena Borrelli is a freelance financial writer with a background in business. A former business owner herself, she is very familiar with the financial services and insurance industries. Her work has most recently been published on sites like Time, Investopedia, Policygenius, Bankrate, The Simple Dollar, ADT and Home Advisor. She also works with several prominent athletes, including Rob Gronkowski’s Gronk Fitness, WWE and TMZ’s Mojo Muhtadi, and AEW’s Thunder Rosa and Shaul Guerrero.

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