How to get Health Insurance in the United States

Unlike most developed countries that have a universal healthcare system, Americans must seek their own personal health insurance plan, whether through a marketplace or through their employers. 

Even with all the options for insurance, many people simply find it unaffordable. In 2018, there were nearly 30 million uninsured Americans without any guarantee of healthcare if they got sick or injured. 

In addition to the financial restrictions of purchasing insurance, many consumers find that navigating the labyrinth of healthcare choices and considerations is overwhelming, so we’ve put together a guide to help you as you explore your health insurance options.

If you are interested in learning how to get health insurance, this article is for you. We’ll walk through the different types of insurance and how to know if you qualify for them.

Types of Health Insurance in the United States

Insurance packages in the U.S. fall into one of two categories: public and private.

Public Health Insurance

Medicare

What does Medicare cost you may ask? First let’s get into what it is. Medicare is a national insurance program administered by the Social Security Administration. The law governing Medicare coverage was passed in 1965 by President Lyndon B. Johnson as a broader set of populist reforms aimed at appeasing the rising liberal movement of the era. 

Today, Medicare is very popular among the American people as a whole and especially among the elderly who receive care through this insurance program. To qualify for Medicare, you must be 65 or older or have a spouse that worked for 10 consecutive years in a job that Medicare covers.

Medicaid

Medicaid is another federal insurance program that covers 74 million Americans. Although it is more open to criticism, Medicaid is still relatively popular. To qualify for Medicaid, you must meet each states’ eligibility criteria for enrollment. The general requirements are that you must be either living at or below the poverty line or that you are disabled, pregnant, or elderly.

Private Health Insurance

The more common type of insurance in the United States is private health coverage. Many employers offer health insurance to employees as a benefit.

The quality and extent of coverage vary extensively between insurance providers and individual plans. “Cadillac plans” are more comprehensive packages that provide all types of care with little or no deductibles (out of pocket expenses). Lesser packages limit the extent of coverage and have clauses for large out of pocket expenses – hence, the skyrocketing rate of medical debt in the United States.

The most well-known private insurance companies in the United States are Blue Cross Blue Shield, Aetna, United Health, Humana, and Anthem. Together, these companies amass billions of dollars in profits each year, making health insurance one of the most influential industries in the United States.

Anyone can qualify for private health insurance. The major providers have websites where you can find information on applying. However, you should be aware that, as a customer, depending on factors such as your lifestyle and age, you may have to pay a very high premium for your insurance from a private company.

Affordable Care Act

The ACA, also known as Obamacare or the Affordable Care Act, mandated health insurance for all Americans, meaning that if you are a U.S. citizen who doesn’t purchase health insurance, you may be subject to sanction. This act was designed to bring as many people into the system as possible to pool risk and, in theory, lower the cost of healthcare for all. 

The ACA also prohibited healthcare insurance denial to applicants who have so-called “pre-existing conditions” – health conditions that existed prior to applying for insurance.

If you are unsure about your status or are uninsured, be sure to check in with a local insurance provider or marketplace to get covered to avoid being sanctioned.

Search for Insurance Through Marketplaces

There are several marketplaces where you can look for the type of insurance you need. For public programs, healthcare.gov provides easy-to-follow instructions for seeking care through the government. Applications for government programs like Medicare and Medicaid are also available on the web.

For private programs, many states have a healthcare exchange where you can shop around for different insurance packages from a number of companies. However, again, the premiums can be quite high.

When In Doubt, Research.

The resources exist online to help you find the right insurance program. Although the financial cost can be quite burdensome, most people should seek healthcare if it’s possible. In the event of a life-threatening situation that requires extensive care, you could save yourself from thousands of dollars in debt by getting insured now.