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Health Insurance
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Health System

Health Insurance

Health insurance acts as a contract to help protect you from high medical costs by covering a portion of your expenses.

How It Works

Health insurance helps protect you from high medical care costs. It is a contract between you and your insurance company. You buy a plan or policy, and the company agrees to pay part of your expenses when you need medical care.

Types of Coverage

Many people in the United States get a health insurance policy through their employers. In most cases, the employer helps pay for that insurance. Insurance through employers is often with a managed care plan. These plans contract with health care providers and medical facilities to provide care for members at reduced costs. You can also purchase health insurance on your own.

Government Programs

People who meet certain requirements can qualify for government health insurance, such as Medicare and Medicaid. The Affordable Care Act expands health insurance coverage for many people in the U.S.

Frequently Asked Questions

Without health insurance, you are responsible for paying the full cost of medical care, which can lead to significant financial burden and debt. In the United States, the individual mandate penalty for not having insurance was eliminated in 2019, but you may still face higher costs for emergency care and may be denied certain elective procedures or treatments by providers who do not accept uninsured patients. Some states may still have their own individual mandates or provide financial assistance programs for the uninsured.
The Affordable Care Act (ACA) requires most individuals to have health insurance and provides subsidies to help lower-income individuals afford premiums. It also prohibits insurers from denying coverage or charging more based on pre-existing conditions or gender. Additionally, it mandates that all plans cover essential health benefits, such as preventive care, maternity care, and prescription drugs, without cost-sharing.
deductible is the amount you must pay for covered services before your insurance plan begins to pay. An out-of-pocket maximum is the most you will pay for covered services in a plan year. Once you reach this limit, your insurance plan pays 100 percent of the costs of any covered services that are not pre-paid, for the rest of the plan year. Note that premiums are usually not counted toward the out-of-pocket maximum.
Medicare is a federal health insurance program primarily for people aged 65 and older, as well as certain younger people with disabilities or specific conditions like End-Stage Renal Disease. Medicaid is a joint federal and state program that helps with medical costs for people with limited income and resources. Eligibility for Medicaid varies by state and is generally based on income and family size, whereas Medicare eligibility is primarily based on age or disability status.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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