Compare Health Insurance (US, 2026)
Marketplace, Medicare, employer, short-term — independent comparison with no sales calls.
About 92% of Americans have some form of health coverage (Census Bureau 2025). The remaining 8% — roughly 26 million people — are uninsured, with ACA Marketplace enrollment continuing to hit record highs (over 21 million enrolled for 2025 plan year). The US health insurance system is fragmented: employer-sponsored coverage for working-age adults, Medicare for 65+, Medicaid for low-income families, Marketplace plans for self-employed and those without employer options, Tricare for military, and VA healthcare for veterans. Below we explain each type, the 2026 subsidy rules, how to pick a plan by metal tier and network type, and the traps (short-term plans, junk coverage, narrow networks) to avoid.
Pick the right kind of plan
ACA Marketplace
HealthCare.gov & state exchanges. Metal tiers, subsidies, enrollment windows.
Explore Marketplace →Medicare
Parts A, B, C (Advantage), D (drugs), Medigap. Enrollment by age 65.
Medicare explained →Short-Term Plans
1–12 month gap coverage. What they cover — and what they don't.
Short-term plans →Coverage type vs. who it's for
| Type | Best for | Avg monthly cost | Enrollment window |
|---|---|---|---|
| Employer-sponsored | W-2 employees of larger employers | $110–$200 (individual share) | At hire + annual open enrollment |
| ACA Marketplace (with subsidy) | Self-employed, small-business owners, gap between jobs | $10–$200 w/ subsidy; $500+ without | Nov 1 – Jan 15 + life events |
| Medicare | 65+ or certain disabilities | $174.70 Part B + Advantage/supplement | 3 months before/after 65th birthday |
| Medicaid | Income under 138% FPL (state dependent) | $0–$10 | Year-round |
| Short-term / STLDI | Gap coverage, 1–12 months | $100–$300 | Year-round |
| COBRA | Right after job loss, usually bad value | $500–$2,000 | 60 days after job loss |
Plan network types
- HMO (Health Maintenance Organization)
- Must use in-network providers except emergencies. Requires a primary care doctor (PCP) referral for specialists. Cheapest premium. Example: Kaiser Permanente.
- PPO (Preferred Provider Organization)
- See any provider; in-network is cheaper. No referral required. Highest premium. Example: Blue Cross Blue Shield PPO.
- EPO (Exclusive Provider Organization)
- In-network only (except emergencies), but no PCP referrals required. Middle ground in cost.
- POS (Point of Service)
- HMO with some out-of-network coverage. Requires PCP referral to get lower in-network rates.
- HDHP + HSA (High-Deductible Health Plan)
- Lower premium, higher deductible ($1,650+ individual), paired with a Health Savings Account that's tax-advantaged. Best for younger healthy people or those who max out the HSA for retirement savings.
Watch out for
- Narrow networks. Marketplace plans increasingly offer narrow networks with 30–50% fewer providers than a PPO. Verify your doctors are in-network before enrolling.
- Short-term plans sold as "real" insurance. STLDI plans don't cover pre-existing conditions, often exclude mental health and maternity, and can cap annual benefits. Useful for a 3-month gap; inadequate as long-term coverage.
- Health sharing ministries. Not insurance. Members pool money to cover each other's bills — but coverage is discretionary, pre-existing conditions are excluded, and state insurance regulators can't help in disputes.
- "Fixed indemnity" plans. Pay a set dollar amount per service ($100/ER visit, $50/day hospitalization) — often marketed as low-cost health insurance but leave you exposed to catastrophic bills.
- Missing your Special Enrollment Period window. If you lose coverage, you have 60 days to enroll in Marketplace. Miss it and you wait until next open enrollment or pay uninsured.
Health insurance basics
Five main categories: (1) Employer-sponsored (covers 55% of Americans), (2) ACA Marketplace plans for individuals and families, (3) Medicare for those 65+ and some disabled individuals, (4) Medicaid for low-income families and individuals (state-administered), (5) Short-term and limited-duration plans for gap coverage. A sixth category, Health Sharing Ministries, exists outside conventional insurance but has limited consumer protections.
For a Silver ACA Marketplace plan, the 2026 national average benchmark premium is $510/month for a 40-year-old before subsidies. With subsidies, 80% of Marketplace enrollees pay $10–$200/month. Employer plans average $7,739/yr for individual coverage and $23,968/yr for family (KFF 2025), with employees paying about 17% for individual and 29% for family.
These are ACA Marketplace 'metal tiers' indicating how costs are split between you and the plan. Bronze: plan pays 60% average (cheapest premium, highest out-of-pocket). Silver: 70% (subsidies tied to Silver plans). Gold: 80%. Platinum: 90% (highest premium, lowest out-of-pocket). Silver plans with Cost-Sharing Reductions for low-income enrollees often deliver Gold-level coverage at Silver prices.
ACA Marketplace Open Enrollment runs November 1 – January 15 annually. Outside that window, you need a Special Enrollment Period (SEP) triggered by a qualifying life event: marriage, birth/adoption, loss of other coverage, move to a new area, income change. Medicare has its own windows: Initial Enrollment Period around your 65th birthday, Annual Open Enrollment October 15 – December 7, and Medicare Advantage Open Enrollment January 1 – March 31.
Essential Health Benefits required by the ACA include: ambulatory/outpatient services, emergency care, hospitalization, maternity/newborn care, mental health & substance use, prescription drugs, rehabilitative services, laboratory services, preventive/wellness services, and pediatric care (including dental & vision). Short-term plans are exempt from these requirements.
Deductible: amount you pay before insurance starts covering non-preventive services ($500–$9,200 for 2026 Marketplace). Copay: fixed amount per visit ($20–$50 typical). Coinsurance: percentage you pay after deductible (20%–40% typical). Out-of-pocket maximum: annual ceiling on your total spending ($9,450 individual / $18,900 family for 2026); after hitting it, the plan pays 100%.
Plan-network types. HMO (Health Maintenance Organization): must stay in-network, requires PCP referrals for specialists; cheapest premium. PPO (Preferred Provider Organization): freely see any provider, higher out-of-network coverage; most flexible, highest premium. EPO (Exclusive Provider): in-network only but no referrals needed. POS (Point of Service): HMO with some out-of-network coverage; middle ground.
Premium Tax Credits (subsidies) on the ACA Marketplace are available to households with incomes from 100%–400% of the Federal Poverty Level, and through 2025 (extended through 2025 by the Inflation Reduction Act; 2026 status depends on legislation). In 2026, if the extension hasn't been continued, the cliff at 400% returns. Subsidies are the difference between the benchmark Silver plan's price and a capped percentage of your income. 80% of Marketplace enrollees received subsidies in 2025.
Three options: (1) COBRA — continue your employer plan for up to 18 months at your own cost, typically $500–$2,000/month (usually the worst deal). (2) ACA Marketplace with a Special Enrollment Period — 60 days to enroll, often much cheaper than COBRA with subsidies. (3) Spouse's plan via a SEP. Compare all three; 85%+ of former employees save by switching to Marketplace.
Yes, this is called 'coordination of benefits.' Common scenarios: spouse adds you to their employer plan while you have your own; Medicare + employer plan; Medicare + Medigap. One plan pays primary, the other secondary. You can't double-claim, but secondary coverage can reduce your out-of-pocket costs substantially.