health insurance

What is health insurance?

  • Health insurance – also referred to as medical insurance or health care insurance – refers to insurance that covers the cost of a policyholder’s medical expenses. How much the insurance covers – and how much the policyholder pays – depends on the specifics of the policy itself, with specific rules and regulations that apply to some plans.
  • Types of insurance include individual health insurance, employer-sponsored group health insurance (both large-group and small-group), Medicare, Medicaid, CHIP, Tricare and insurance for government employees (FEHB).
  • Health insurance is regulated at both the state and federal level. States can impose various requirements and mandates that go beyond basic federal requirements, but only for fully insured health plans. Self-insured health plans are regulated at the federal level, under ERISA, and are not subject to state insurance regulations (so for example, if a state requires health insurance plans to include coverage for treatment of infertility, that mandate would not apply to self-insured group plans in the state).
  • The Affordable Care Act – also known as Obamacare – was intended to increase the percentage of Americans who have health coverage by expanding Medicaid, making private coverage more affordable via tax credits, and by requiring individual market insurers to accept all applicants, regardless of their medical history. The ACA is a federal law, so the requirements that it places on health insurance plans (for example, a requirement that all individual and small group plans cover essential health benefits) applies in every state.
  • Individual health insurance includes ACA-compliant health insurance – which is major medical insurance that was mandated by the law to include essential health benefits and offer coverage on a guaranteed-issue basis – as well as grandmothered and grandfathered plans (no longer sold to new enrollees, but still in force for people who have opted to keep them).
  • Individuals also have the option to purchase coverage that isn’t compliant with the ACA, such as short-term health insurance and other condition-specific and disease-specific coverage such as cancer insurance. These plans are available for purchase in most states, but are generally not adequate as a permanent stand-alone insurance solution.

Find affordable health plans

Since 2008, we’ve helped more than 16 million people.

(Step 1 of 2)

Read more about health insurance

The exchange enrollment numbers are out

November 15, 2013 – When will we have enough enrollment data to make a definitive conclusion about the Affordable Care Act’s success? The easiest answer is… Read more