Health insurance in USA Get information on Medicaid, Medicare, the ACA health insurance marketplace, and COBRA.
How to enroll in a Health Insurance Marketplace plan
There are a wide range of Health Insurance Marketplace plans to choose from. They offer coverage for not only medical care, but also dental and vision. Find out what services all plans cover and what additional coverage is available.
To get started, go to Healthcare.gov to find your state Health Insurance Marketplace. Each state’s Marketplace has its own enrollment instructions.
During the Marketplace open enrollment period each year, you can:
- Choose a plan for the first time
- Continue in your current plan
- Make changes to your current insurance plan
- Choose a new plan to replace your current plan
If you experience a life event like moving or having a baby, you may be able to change your coverage during a special enrollment period. You may also qualify for a special enrollment period if your household income is below a certain amount.
Learn about COBRA insurance and how to get coverage
COBRA, the Consolidated Omnibus Budget Reconciliation Act, lets qualified workers keep their group health insurance for a limited time after a change in eligibility.
Learn how COBRA works
COBRA applies to most private sector businesses with 20 or more employees. It requires an employer’s group health insurance plan to continue after qualifying life events. These include:
- Termination or a reduction of a covered employee’s hours
- Divorce or legal separation from a covered employee
- Death of a covered employee
- Medicare eligibility for a covered employee
- Loss of a child’s or dependent’s health insurance coverage under the plan
Qualified beneficiaries under COBRA include:
- An employee
- Spouse
- Former spouses
- Dependent children
Find out if you are eligible for COBRA
Three basic requirements must be met for you to be able to elect to continue coverage under COBRA:
- Your group health plan must be covered by COBRA.
- A qualifying event must occur.
- You must be a qualified beneficiary for that event.
How to get COBRA coverage
When a qualifying life event happens, you or your employer will notify the health plan. The plan will send an election notice that you will have 60 days to respond to. If you elect to take COBRA coverage, your employer may pay a portion of or the full amount of your insurance premium.
How to apply for Medicaid and CHIP
Medicaid insures people with a low income. The Children’s Health Insurance Program (CHIP) covers children. Learn about eligibility and how to apply for or renew coverage.
Find out if you are eligible for Medicaid
Medicaid provides free or low-cost medical benefits to eligible:
- Adults with a low income
- Children
- People who are pregnant
- People age 65 or over
- People with disabilities
Find and check with your state’s Medicaid agency to see if you or your family members are eligible. Each state has its own requirements.
In general, eligibility depends on at least one or a combination of:
- Age
- Income level
- Number of people in your family
- If you are pregnant or have a disability
How to apply for Medicaid
You can apply for Medicaid any time of year in one of the following ways:
- Find and check with your state’s Medicaid agency to apply. You must be a resident of the state where you are applying for benefits.
- Create an account with the Health Insurance Marketplace and fill out an application. If it looks like anyone in your household qualifies for Medicaid, your information will be sent to your state agency. They will contact you about enrollment.
Find out if your child is eligible for CHIP
If your income is too high for Medicaid, your child may still qualify for the Children’s Health Insurance Program (CHIP). It covers medical and dental care for uninsured children and teens up to age 19.
CHIP qualifications are different in every state. In most cases, they depend on income. Find out if your child qualifies for coverage with CHIP.
How to apply for CHIP
You can apply for CHIP in one of the following ways:
- Find a CHIP program by state.
- Create an account with the Health Insurance Marketplace and fill out an application. If it looks like anyone in your household qualifies for CHIP, your information will be sent to your state agency. They will contact you about enrollment.
How to renew Medicaid and CHIP coverage
Your state may review your information each year to decide if you are eligible for Medicaid. If they need more information from you, they will contact you about renewing your coverage. Learn more about renewing Medicaid and CHIP coverage, including:
- How to prepare for the renewal process
- What to do if you are no longer eligible for Medicaid or CHIP
- Who to contact for more help
Find a doctor or care provider who accepts Medicaid or CHIP
Not every provider accepts Medicaid. To locate a Medicaid or CHIP medical provider, find and check with your state’s Medicaid agency.
How and when to apply for Medicare
Medicare is the federal health insurance program for people who are 65 and over. If you are under 65, you may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease (ESRD), or ALS (Lou Gehrig’s Disease).
Medicare is divided into four parts:
- Medicare Part A is insurance for hospitalization, home or skilled nursing, and hospice.
- Medicare Part B is medical insurance.
- Learn how to cancel Medicare Part A or Part B coverage if you no longer want it.
- Medicare Part C (Medicare Advantage Plans) is a private insurance option for covering hospital and medical costs.
- Medicare Part D covers prescription medications.
- Learn more about the parts of Medicare, how it works, what it costs, and how to prepare to sign up.
Enrolling in Medicare in your 60s
There are several ways to enroll in Medicare, whether you plan to retire or keep working:
- If you begin receiving Social Security retirement benefits between age 62 and up to 4 months before turning 65, you will be automatically enrolled in Medicare Part A and Part B when you turn 65.
- If you apply for Social Security 3 months before you turn 65 or later, you can sign up for Medicare when you apply for Social Security.
- The Initial Enrollment Period to sign up for Medicare begins 3 months before you turn 65 and ends 3 months after the month you turn 65–a total of 7 months. You may have to pay a penalty if you miss your Initial Enrollment Period.
- If you are not ready to receive Social Security benefits at 65 because you are still working, you can apply online for Medicare only. Or you may be able to wait until you retire to sign up during a special enrollment period. Learn more about how Medicare works if you are employed past age 65.
How to get insurance through the ACA Health Insurance Marketplace
The Affordable Care Act (ACA) gives more people access to health insurance. Use the ACA’s Health Insurance Marketplace to find health insurance options.
See if you are eligible to use the Health Insurance Marketplace. There is no income limit.
To be eligible to enroll in health coverage through the Marketplace, you:
Must live in the United States
Must be a U.S. citizen or national (or be lawfully present). Learn about eligible immigration statuses.
Cannot be incarcerated in prison or jail
Under the Affordable Care Act (ACA), you have special patient protection when you are insured through the Health Insurance Marketplace:
Insurers cannot refuse coverage based on gender or a pre-existing condition.
There are no lifetime or annual limits on coverage for essential health benefits.
Young adults can stay on their family’s insurance plan until age 26.
Learn more about your rights under the Affordable Care Act.