Health Insurance
Health insurance helps people manage the cost of medical care by providing financial protection against covered healthcare expenses. In the United States, coverage may come through an employer, the ACA Marketplace, Medicare, Medicaid, CHIP, or other arrangements.
What Health Insurance Does
Health insurance can help pay for covered doctor visits, hospital care, prescription drugs, preventive services, and other healthcare services. The exact benefits, costs, provider networks, deductibles, copayments, coinsurance, and exclusions depend on the plan.
How Health Insurance Works
A health plan generally involves a premium and may also involve a deductible, copayments, coinsurance, and an out-of-pocket maximum. Understanding how these costs work together can help you compare plans more effectively.
How to Get Health Insurance in the US
Common sources of health coverage include employer-sponsored insurance, ACA Marketplace plans, Medicare, Medicaid, and CHIP. Eligibility and enrollment rules vary by program and circumstances.
ACA Marketplace and Metal Tiers
Marketplace plans are commonly grouped into Bronze, Silver, Gold, and Platinum metal tiers. The tier generally reflects how plan costs are divided between the plan and the member; it does not describe the quality of medical care.
HMO vs. PPO
HMO and PPO plans can differ in provider networks, referrals, out-of-network coverage, and costs. The details depend on the individual plan.
What Affects Health Insurance Costs
Premiums and out-of-pocket costs can vary based on plan design, location, age, household circumstances, eligibility for financial assistance, and other factors.
Frequently Asked Questions
What is health insurance?
Health insurance helps manage the cost of covered healthcare services according to a plan's terms.
What is a deductible?
A deductible is generally the amount you pay toward covered services before the plan begins paying according to its terms.
What is the difference between an HMO and PPO?
HMO and PPO plans can differ in provider networks, referrals, out-of-network coverage, and costs.