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class="css-4a7tih"><aside class="css-1wm8u43" data-testid="header-leaderboard" data-sticky="true"><div data-empty="true" class="css-1j2d96m"><div class="css-1hjaa0k"><span class="css-zya54r"></span></div><div id="dlb1__slot" data-adbridg-ad-class="dlb1" data-ad="true" class="css-1jpwf16"></div></div></aside></div><aside data-testid="mobile-leaderboard" class="css-pdceuf"><div class="css-11egx89"><button class="icon-hl-close-thick css-1pr9u9e"></button><div data-empty="true" class="css-1fteite"><div class="css-1hjaa0k"><span class="css-zya54r"></span></div><div id="mlb1__slot" data-adbridg-ad-class="mlb1" data-ad="true" class="css-bcus5s"></div></div></div></aside><div data-placement="subheader"></div><div><div class="css-m260rd"><div data-article-body="0" class="css-blwnmv"><div class="css-z468a2"><h1>What is health insurance?</h1><div data-preamp="social-proof-lessons"></div><div data-testid="byline"><section data-testid="byline" class="css-1r4r6jy"><div class="css-1q67gt9"><div class="css-1edxg1f"><img src="//i0.wp.com/post.medicalnewstoday.com/wp-content/uploads/sites/3/2025/01/05-09-SAmin-websize.jpg?w=105&h=105" alt=""/></div></div><div><span><span><a class="css-90fpmc css-ro87dg" target="_blank" rel="noopener noreferrer">Medically reviewed</a> by <a class="css-90fpmc css-ro87dg" target="_blank" rel="noopener noreferrer">Shilpa Amin, M.D., CAQ, FAAFP</a>, <span>Family Medicine</span>, <span>Women's Health</span>, <span>Geriatrics</span>, <span>Integrative Medicine</span>, <span>Clinical Research</span>, <span>Jurisprudence</span>, <span></span></span></span> — <span><span><span><span>Written by <a class="css-90fpmc css-ro87dg" target="_blank" rel="noopener noreferrer">Adam Felman</a></span></span></span></span> — <a class="css-90fpmc css-ro87dg" target="_blank" rel="noopener noreferrer"><span> Updated on May 10, 2023</span></a></div></section></div><div><nav class="css-wp9hsz" id="tab-bar-0" data-testid="tab-bar"><ul class="css-wy0i0w"><li class="css-gc7rbi"><a href="#definition" class="css-1qfr3bt">Definition</a></li><li class="css-gc7rbi"><a href="#types" class="css-1qfr3bt">Types </a></li><li class="css-gc7rbi"><a href="#legislation" class="css-1qfr3bt">Legislation</a></li><li class="css-gc7rbi"><a href="#summary" class="css-1qfr3bt">Summary</a></li></ul></nav><article class="article-body css-d2znx6 undefined"><div data-testid="tabbed-article-section" class="css-12va8w7"><span style="font-size:0;line-height:0"></span><span style="font-size:0;line-height:0"></span><div><div><p class="css-4aeg3z">Health insurance is a type of insurance that helps cover the cost of an insured person’s medical and surgical expenses. There are different types of health insurance in the USA.</p></div></div><div><p>Insurers use the term “provider” to describe a clinic, hospital, doctor, laboratory, healthcare practitioner, or pharmacy that provides treatment for an individual’s condition. </p></div><div><div data-preamp="serena-chatbot"></div></div><div><p>The “insured” is the owner of the <span class="keyword-mark">health insurance</span> policy or the person with the health insurance coverage.</p></div><div><p>In this article, learn more about what health insurance is, why it is important, types of plan, and legislation details.</p></div><div class="css-20w1gi"><aside class="css-0 css-0" data-testid="sticky-inline-ad" data-sticky="false"><div><div data-empty="true" class="css-1sq15os"><div class="css-1hjaa0k"><span class="css-zya54r"></span></div><div id="inline2__slot" data-adbridg-ad-class="inline2__slot" data-ad="true" class="css-1t05dkn"></div></div></div></aside></div></div><div data-testid="tabbed-article-section" class="css-1avyp1d"><span style="font-size:0;line-height:0"></span><div><h2><div><a class="chartbeat-section" name="definition">What is it?</a></div></h2></div><span style="font-size:0;line-height:0"></span><div><div><figure class="css-yhe8zq"><span class="css-rwmw5v"><span class="css-mjp0j9"><picture class="css-16pk1is"><source srcSet="//i0.wp.com/post.medicalnewstoday.com/wp-content/uploads/sites/3/2021/06/GettyImages-107797664_header-1024x575.jpg?w=1575 750w" media="(min-width: 1190px)"/><source srcSet="//i0.wp.com/post.medicalnewstoday.com/wp-content/uploads/sites/3/2021/06/GettyImages-107797664_header-1024x575.jpg?w=1575 750w" media="(min-width: 990px)"/><source srcSet="//i0.wp.com/post.medicalnewstoday.com/wp-content/uploads/sites/3/2021/06/GettyImages-107797664_header-1024x575.jpg?w=1845 879w" media="(min-width: 768px)"/><img src="//i0.wp.com/post.medicalnewstoday.com/wp-content/uploads/sites/3/2021/06/GettyImages-107797664_header-1024x575.jpg?w=1155&h=1528" alt="" class="css-1jytyml"/></picture></span><hl-share-overlay class="css-1mqo1cs"><a class="css-90fpmc icon-hl-pinterest css-by55vd" target="_blank" rel="noopener noreferrer nofollow" data-event="Any Page|Image Pinterest Click|Icon Clicked" data-element-event="OPEN|CONTENTBLOCK|Any Page|Article Body|BUTTON|Image Widget Pinterest Click|" href="https://www.pinterest.com/pin/create/button/?url=https%3A%2F%2Fwww.medicalnewstoday.com%2Farticles%2F323367&media=https%3A%2F%2Fpost.medicalnewstoday.com%2Fwp-content%2Fuploads%2Fsites%2F3%2F2021%2F06%2FGettyImages-107797664_header-1024x575.jpg&description=Health%20insurance%3A%20Types%20and%20legislation" title="Share on Pinterest" data-pin-custom="true" data-share-url="https://post.medicalnewstoday.com/wp-content/uploads/sites/3/2021/06/GettyImages-107797664_header-1024x575.jpg"><span class="css-z1zfa">Share on Pinterest</span></a></hl-share-overlay></span><figcaption class="css-13b3g0x">PhotoAlto/Frederic Cirou/Getty Images</figcaption></figure></div></div><div><p>Depending on the type of health insurance coverage a person has, either the insured pays costs out of pocket and receives reimbursement, or the insurer makes payments directly to the provider.</p></div><div><p>In countries without universal healthcare coverage, such as the United States, health insurance is commonly included in employer benefit packages.</p></div><div><p>Following the introduction of the <a href="https://www.medicalnewstoday.com/articles/247287.php" class="content-link css-90fpmc">Affordable Care Act</a> in 2010, the number of people without insurance fell by over <a rel="noopener noreferrer" href="https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population/" target="_blank" class="content-link css-90fpmc">20 million</a> to reach the lowest ever level in 2016, according to the Kaiser Family Foundation (KFF). </p></div><div><p>However, from 2017, the number of adults without insurance rose again by 2.2 million, from 26.7 million in 2016 to 28.9 million in 2019. Between 2016 and 2019, the percentage of people without insurance rose from 10% to 10.9%. However, the rate of people with health insurance is still higher than it was before the introduction of the Affordable Care Act.</p></div><div><p>A <a rel="noopener noreferrer" href="https://www.commonwealthfund.org/publications/issue-briefs/2012/apr/gaps-health-insurance-why-so-many-americans-experience-breaks" target="_blank" class="content-link css-90fpmc">2012 report</a> from the Commonwealth Fund states that one-quarter of all U.S. citizens of working age have experienced a gap in health insurance coverage. Many people in the survey lost their health insurance when they became unemployed or changed jobs. </p></div><div><p>The KFF adds that Black people and those with low incomes are <a rel="noopener noreferrer" href="https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population/" target="_blank" class="content-link css-90fpmc">more likely</a> to have no insurance than other groups.</p></div><div><p>The level of treatment a person receives in emergency departments varies significantly depending on what type of health insurance they have.</p></div></div><div data-testid="tabbed-article-section" class="css-1avyp1d"><span style="font-size:0;line-height:0"></span><div><h2><div><a class="chartbeat-section" name="types">Types</a></div></h2></div><span style="font-size:0;line-height:0"></span><div><p>There are two main types of health insurance: private and public, or government. There are also a few other, more specific types. The following sections will look at each of these in more detail.</p></div><div><h3>Private health insurance </h3></div><div><p>The Centers for Disease Control and Prevention (CDC) say that the U.S. healthcare system relies heavily on private health insurance. In the National Health Interview Survey, researchers found that <hl-trusted-source source="Centers for Disease Control and Prevention (CDC)" rationale="Governmental authority"><a rel="noopener noreferrer" href="https://www.cdc.gov/nchs/fastats/health-insurance.htm" target="_blank" class="content-link css-90fpmc">63.7%</a></hl-trusted-source> of people under the age of 65 years in the U.S. have a type of private health insurance coverage.</p></div><div><h3>Public, or government, health insurance</h3></div><div><p>With this type of insurance, the state subsidizes healthcare in exchange for a premium. <a class="content-link css-90fpmc keywords" title="What is Medicare / Medicaid?" href="https://www.medicalnewstoday.com/articles/what-are-medicare-and-medicaid">Medicare</a>, <a class="content-link css-90fpmc keywords" title="What is Medicare / Medicaid?" href="https://www.medicalnewstoday.com/articles/what-are-medicare-and-medicaid">Medicaid</a>, the Veterans Health Administration, and the Indian Health Service are examples of public health insurance in the U.S.</p></div><div><h3>Other types</h3></div><div><p>Some people may also define an insurer by the way it administers its plans and connects with providers. Here are some examples of the <a rel="noopener noreferrer" href="https://www.ncsl.org/research/health/health-insurance-plan-types-and-definitions.aspx" target="_blank" class="content-link css-90fpmc">types of plan</a> available.</p></div><div><h4>Managed care plans</h4></div><div><p>With this type of plan, the insurer will have contracts with a network of providers to provide lower cost medical care to its policyholders. There will be penalties and additional costs added to out-of-network hospitals and clinics, but they will provide some treatment.</p></div><div><p>The more expensive the policy, the more flexible it is likely to be with the network of hospitals.</p></div><div><h4>Indemnity, or Fee-for-Service, plans</h4></div><div><p>A Fee-for-Service plan covers treatment equally among all providers, allowing the insured to choose their preferred place of treatment. The insurer will typically pay <a rel="noopener noreferrer" href="https://www.ncsl.org/research/health/health-insurance-plan-types-and-definitions.aspx" target="_blank" class="content-link css-90fpmc">80%</a> of costs on an indemnity plan, while the individual pays the remaining costs as a coinsurance.</p></div><div><h4>Health Maintenance Organization plans</h4></div><div><p>These are organizations that provide medical care directly to the insured. The policy will usually have a dedicated primary care physician who will coordinate all necessary care.</p></div><div><p>Health Maintenance Organization (HMO) plans will usually only fund treatment referred by a family doctor and will have negotiated fees for each medical service to minimize costs. This is usually the cheapest type of plan.</p></div><div><h4>Preferred Provider Organization plans</h4></div><div><p>A Preferred Provider Organization (PPO) plan is similar to an indemnity plan in that it allows the insured to visit any doctor they prefer. The PPO plan also has a network of approved providers with which it has negotiated costs.</p></div><div><p>The insurer will pay less for treatment with out-of-network providers. However, people with a PPO plan can self-refer to specialists without having to visit a primary care physician.</p></div><div><h4>Point-of-Service plans</h4></div><div><p>A Point-of-Service plan functions as a combination of an HMO plan and a PPO plan. The insured can choose between coordinating all treatment through a primary care physician, receiving treatment within the insurer’s provider network, and using non-network providers. The type of plan they have will dictate the progress of treatment.</p></div><div><h3>Why is the type of insurance plan important?</h3></div><div><p>The type of plan a person has dictates how they will approach getting the treatment they need and how much money they will need to pay on the day they receive it.</p></div><div><p>In 2003, the U.S. Congress introduced a new option: the Health Savings Account (HSA). It is a combination of an HMO plan, a PPO plan, an indemnity plan, and a savings account with tax benefits. However, in plan year 2020, a policyholder must pair this type with an existing health plan that has a deductible of over <a rel="noopener noreferrer" href="https://www.healthcare.gov/glossary/health-savings-account-hsa/" target="_blank" class="content-link css-90fpmc">$1,400</a> for individuals or $2,800 for families.</p></div><div><p>HSAs can top up coverage, extending existing plans to cover a wider range of treatments. If an employer pays for an HSA on behalf of their employees, the payments are tax-free. An individual can build up funds in the HSA while they are healthy and save for instances of poor health later in life.</p></div><div><p>However, people with chronic conditions, such as <a class="content-link css-90fpmc keywords" title="What is Diabetes?" href="https://www.medicalnewstoday.com/info/diabetes/">diabetes</a>, might not be able to save a large amount in their HSA, as they regularly have to pay high medical costs for the management of their health concern.</p></div><div><p>These plans often carry very high deductibles, meaning that although premiums can be lower, people often end up paying the full expenses of any required medical treatment.</p></div><div><p>There is more overlap as plan types evolve. The distinctions between policy types are becoming more and more blurred.</p></div><div><p>The majority of indemnity plans use managed care techniques to control costs and ensure that there are enough resources to pay for appropriate care. Similarly, many managed care plans have adopted some characteristics of Fee-for-Service plans.</p></div><span class="css-zya54r"></span></div><div data-testid="tabbed-article-section" class="css-1avyp1d"><span style="font-size:0;line-height:0"></span><div><h2><div><a class="chartbeat-section" name="legislation">Legislation</a></div></h2></div><span style="font-size:0;line-height:0"></span><div><p>In the U.S., having some degree of insurance is legally necessary as part of the Affordable Care Act. A person without health insurance has to pay a fine.</p></div><div><p>However, policymakers <a href="https://www.healthcare.gov/fees/fee-for-not-being-covered/" target="_blank" rel="noopener noreferrer" class="content-link css-90fpmc">removed the Individual Mandate</a> in the Affordable Care Act from the legislation in 2019. Insurance is no longer an individual legal requirement in the U.S.</p></div><div><p>If the policy also covers the children in the family, a person is allowed to be on their parents’ insurance until the age of <a href="https://www.hhs.gov/healthcare/about-the-aca/young-adult-coverage/index.html" target="_blank" rel="noopener noreferrer" class="content-link css-90fpmc">26 years</a>, even if they are:</p></div><div><ul><li>married</li><li>living away from home</li><li>not financially dependent on their parents</li><li>eligible to be included on their employer’s coverage</li></ul></div><div><p>Insurance is regulated at state level, meaning that buying a policy in one state is different from doing so in another.</p></div><div><p>Although state legislation can affect the price of a policy, the important decisions about a person’s coverage and reimbursements rest with the insurer. People should be sure to have their broker or customer services representative discuss the impact of any changing legislation on their particular policy.</p></div><div class="css-20w1gi"><aside class="css-0 css-0" data-testid="sticky-inline-ad" data-sticky="false"><div><div data-empty="true" class="css-1sq15os"><div class="css-1hjaa0k"><span class="css-zya54r"></span></div><div id="inline9__slot" data-adbridg-ad-class="inline9__slot" data-ad="true" class="css-1t05dkn"></div></div></div></aside></div></div><div data-testid="tabbed-article-section" class="css-1avyp1d"><span style="font-size:0;line-height:0"></span><div><h2><div><a class="chartbeat-section" name="summary">Summary</a></div></h2></div><span style="font-size:0;line-height:0"></span><div><p>Health insurance helps covers the cost of an insured individual’s medical and surgical expenses. There are various plan types, and they vary in terms of what they cover and how a person can access treatment.</p></div><div><p>Currently, a person in the U.S. must have some form of health insurance coverage. Anyone without a form of coverage may need to pay a fine.</p></div></div></article><span class="css-zya54r"></span></div><p data-testid="last-medically-reviewed" class="css-1kir5of"><span> </span></p><div class="css-5b5f7q"><ul><li itemProp="genre"><a class="css-90fpmc" data-event="Navigation|article tag click|Public Health" href="https://www.medicalnewstoday.com/categories/public-health">Public Health</a></li><li itemProp="genre"><a class="css-90fpmc" data-event="Navigation|article tag click|Health Insurance / Medical Insurance" href="https://www.medicalnewstoday.com/categories/health_insurance">Health Insurance / Medical Insurance</a></li><li itemProp="genre"><a class="css-90fpmc" data-event="Navigation|article tag click|Medicare / Medicaid / SCHIP" href="https://www.medicalnewstoday.com/categories/medicare-medicaid">Medicare / Medicaid / SCHIP</a></li></ul></div><div><div class="css-8q0s1n css-10dx3t"><div class="css-15lc7zf"><h3 id="bylineArticleTools">How we reviewed this article:</h3><div class="css-1g9ioi4"><button type="button" class="css-kxscys"><div class="css-rre5oz"><span class="css-1d75hb8"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" fill="none" viewBox="0 0 20 20"><path fill="currentColor" fill-rule="evenodd" d="M0 10C0 4.477 4.477 0 10 0s10 4.477 10 10-4.477 10-10 10S0 15.523 0 10Zm18.5 0a8.5 8.5 0 1 0-17 0 8.5 8.5 0 0 0 17 0ZM10 4c-.823 0-1.5.677-1.5 1.518C8.5 6.323 9.177 7 10 7c.841 0 1.5-.677 1.5-1.482A1.5 1.5 0 0 0 10 4Zm0 4.5a1 1 0 0 1 1 1V15a1 1 0 1 1-2 0V9.5a1 1 0 0 1 1-1Z" clip-rule="evenodd"></path></svg></span><span>Sources</span></div></button></div><div class="css-une8nx"><div class="css-1xn3edc css-1rkrrlx"><div id="article-resources" role="region" class="css-1ugaz02"><div class="css-0">Medical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our <a class="css-90fpmc" href="https://www.medicalnewstoday.com/articles/process">editorial policy</a>.</div><ul class="css-1vedeqe"><li class="css-1ti7iub"><cite><span>Collins, S. R., <em>et al</em>. (2012). Gaps in health insurance: Why so many Americans experience breaks in coverage and how the Affordable Care Act will help.</span><br/><a class="css-90fpmc css-1ivue52" target="_blank" rel="noopener noreferrer" href="https://www.commonwealthfund.org/publications/issue-briefs/2012/apr/gaps-health-insurance-why-so-many-americans-experience-breaks">https://www.commonwealthfund.org/publications/issue-briefs/2012/apr/gaps-health-insurance-why-so-many-americans-experience-breaks</a></cite></li><li class="css-1ti7iub"><cite><span>Health insurance coverage. (2021). </span><br/><a class="css-90fpmc css-1ivue52" target="_blank" rel="noopener noreferrer" href="https://www.cdc.gov/nchs/fastats/health-insurance.htm">https://www.cdc.gov/nchs/fastats/health-insurance.htm</a></cite></li><li class="css-1ti7iub"><cite><span>Health insurance plan types and definitions. (2011).</span><br/><a class="css-90fpmc css-1ivue52" target="_blank" rel="noopener noreferrer" href="https://www.ncsl.org/research/health/health-insurance-plan-types-and-definitions.aspx">https://www.ncsl.org/research/health/health-insurance-plan-types-and-definitions.aspx</a></cite></li><li class="css-1ti7iub"><cite><span>Health Savings Account (HSA). (n.d.).</span><br/><a class="css-90fpmc css-1ivue52" target="_blank" rel="noopener noreferrer" href="https://www.healthcare.gov/glossary/health-savings-account-hsa/">https://www.healthcare.gov/glossary/health-savings-account-hsa/</a></cite></li><li class="css-1ti7iub"><cite><span>No health insurance? See if you'll owe a fee. (n.d.).</span><br/><a class="css-90fpmc css-1ivue52" target="_blank" rel="noopener noreferrer" href="https://www.healthcare.gov/fees/fee-for-not-being-covered/">https://www.healthcare.gov/fees/fee-for-not-being-covered/</a></cite></li><li class="css-1ti7iub"><cite><span>Pulling it together: Rising health costs are not just a federal budget problem. (2011).</span><br/><a class="css-90fpmc css-1ivue52" target="_blank" rel="noopener noreferrer" href="https://www.kff.org/health-costs/perspective/pulling-it-together-rising-health-costs-are/">https://www.kff.org/health-costs/perspective/pulling-it-together-rising-health-costs-are/</a></cite></li><li class="css-1ti7iub"><cite><span>Questions and answers about health insurance: A consumer guide. (2007).  </span><br/><a class="css-90fpmc css-1ivue52" target="_blank" rel="noopener noreferrer" href="https://www.in.gov/idoi/files/Questions_and_Answers_About_Health_Insurance.pdf">https://www.in.gov/idoi/files/Questions_and_Answers_About_Health_Insurance.pdf</a></cite></li><li class="css-1ti7iub"><cite><span>Tolbert, J., <em>et al</em>. (2020). Key facts about the uninsured population. </span><br/><a class="css-90fpmc css-1ivue52" target="_blank" rel="noopener noreferrer" href="https://www.kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/">https://www.kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/</a></cite></li><li class="css-1ti7iub"><cite><span>Young adult coverage. (2017).</span><br/><a class="css-90fpmc css-1ivue52" target="_blank" rel="noopener noreferrer" href="https://www.hhs.gov/healthcare/about-the-aca/young-adult-coverage/index.html">https://www.hhs.gov/healthcare/about-the-aca/young-adult-coverage/index.html</a></cite></li></ul></div></div></div></div><div class="css-2wv3mf" data-testid="share-tools"><p>Share this article</p><div class="css-14uyzrw"><div class="button-wrapper print"><a class="css-xqmvw1 print button icon icon-hl-print" target="_blank" title="Print this page"></a></div><div class="button-wrapper email"><a class="css-xqmvw1 email button icon icon-hl-email" target="_blank" title="Email this page"></a></div><div class="button-wrapper facebook"><a class="css-xqmvw1 facebook button icon icon-hl-facebook" href="https://www.facebook.com/sharer/sharer.php?u=https%3A%2F%2Fwww.medicalnewstoday.com%2Farticles%2F323367%3Futm_medium%3Dsocial%26utm_source%3Dfacebook%26utm_campaign%3Dsocial-sharebar-referred-desktop" rel="noopener 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LINK|FOOTER|Any Page|Read This Next|LINK|How to find private health insurance|rn0" href="https://www.medicalnewstoday.com/articles/323370?utm_source=ReadNext" aria-label="image-link" data-ga4="Read Next button clicks" data-testid="image-link" aria-hidden="true" tabindex="-1"><div class="css-79elbk"><span class="css-rwmw5v css-1pf0x3y"><span class="css-1767n2d"><lazy-image alt="How to find private health insurance" src="https://media.post.rvohealth.io/wp-content/uploads/sites/3/2020/02/323370_1100-732x549.jpg" srcSet="https://media.post.rvohealth.io/wp-content/uploads/sites/3/2020/02/323370_1100-732x549.jpg 200w" className="css-1lyqwde"></lazy-image></span></span><span class="css-1fb1nmp"><span class="css-a10gts"></span></span></div></a></figure><div class="css-u8uhak"><a class="css-xqmvw1 css-i4o77u" data-event="engagement|bottom page content promo click|/articles/323370;engagement|bottom page content promo click index|1" data-element-event="INTERNAL LINK|FOOTER|Any Page|Read This 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href="https://www.medicalnewstoday.com/articles/323370?utm_source=ReadNext" data-testid="text-link" data-ga4="Read Next button clicks" aria-hidden="true" tabindex="-1">Health insurance can be costly, and insurers are firm about applying their often rigid policies. There are many factors in choosing cover for you and…</a></p><a class="css-90fpmc css-1mj85ht" data-event="engagement|bottom page content promo click|/articles/323370;engagement|bottom page content promo click index|1" data-element-event="INTERNAL LINK|FOOTER|Any Page|Read This Next|LINK|How to find private health insurance|rn0" href="https://www.medicalnewstoday.com/articles/323370?utm_source=ReadNext" data-ga4="Read Next button clicks">READ MORE<span class="icon-hl-arrow-right css-1bisyf5"></span></a></div></div></div><section class="css-17lceqi css-1ub4i5m"><div data-empty="true" class="css-vhteyv"><div class="css-1hjaa0k"><span class="css-zya54r"></span></div><div id="DCMR1__slot" data-adbridg-ad-class="DCMR1" data-ad="true" class="css-prb4v6"></div></div></section></div></div></li><li class="css-b26b7j"><div class="css-m260rd"><div class="css-1h1rean"><div class="css-z468a2 css-w8u3o4"><span class="css-zya54r"></span></div><section class="css-17lceqi css-1ub4i5m"><div data-empty="true" class="css-vhteyv"><div class="css-1hjaa0k"><span class="css-zya54r"></span></div><div id="DCMR1__slot" data-adbridg-ad-class="DCMR1" data-ad="true" class="css-prb4v6"></div></div></section></div></div></li><li class="css-b26b7j"><div class="css-m260rd"><div class="css-1h1rean"><div class="css-z468a2 css-w8u3o4"><div class="css-k3xa71"><span style="font-size:0;line-height:0"></span><figure class="css-1pvwan1"><a class="css-xqmvw1" data-event="engagement|bottom page content promo click|/articles/where-can-i-go-for-medical-care-without-insurance;engagement|bottom page content promo click index|2" data-element-event="INTERNAL LINK|FOOTER|Any Page|Read This Next|LINK|What medical care is available without insurance?|rn1" href="https://www.medicalnewstoday.com/articles/where-can-i-go-for-medical-care-without-insurance?utm_source=ReadNext" aria-label="image-link" data-ga4="Read Next button clicks" data-testid="image-link" aria-hidden="true" tabindex="-1"><div class="css-79elbk"><span class="css-rwmw5v css-1pf0x3y"><span class="css-1767n2d"><lazy-image alt="What medical care is available without insurance?" src="https://media.post.rvohealth.io/wp-content/uploads/sites/3/2020/08/GettyImages-514836594-thumbnail-732x549.jpg" srcSet="https://media.post.rvohealth.io/wp-content/uploads/sites/3/2020/08/GettyImages-514836594-thumbnail-732x549.jpg 200w" className="css-1lyqwde"></lazy-image></span></span><span class="css-1fb1nmp"><span class="css-a10gts"></span></span></div></a></figure><div class="css-u8uhak"><a class="css-xqmvw1 css-i4o77u" data-event="engagement|bottom page content promo click|/articles/where-can-i-go-for-medical-care-without-insurance;engagement|bottom page content promo click index|2" data-element-event="INTERNAL LINK|FOOTER|Any Page|Read This Next|LINK|What medical care is available without insurance?|rn1" href="https://www.medicalnewstoday.com/articles/where-can-i-go-for-medical-care-without-insurance?utm_source=ReadNext" data-testid="title-link" data-ga4="Read Next button clicks">What medical care is available without insurance?</a><section data-testid="byline" class="css-ni3p9e"><div class="css-1pz7193"><div class="css-1edxg1f"><lazy-image alt="" src="https://media.post.rvohealth.io/wp-content/uploads/sites/3/2019/12/alana-biggers-1.png"></lazy-image></div></div><div><span><span>Medically reviewed by <a class="css-90fpmc css-ro87dg" href="https://www.medicalnewstoday.com/reviewers">Alana Biggers, M.D., MPH</a></span></span></div></section><p><a class="css-2fdibo css-v34bze" data-event="engagement|bottom page content promo click|/articles/where-can-i-go-for-medical-care-without-insurance;engagement|bottom page content promo click index|2" data-element-event="INTERNAL LINK|FOOTER|Any Page|Read This Next|LINK|What medical care is available without insurance?|rn1" href="https://www.medicalnewstoday.com/articles/where-can-i-go-for-medical-care-without-insurance?utm_source=ReadNext" data-testid="text-link" data-ga4="Read Next button clicks" aria-hidden="true" tabindex="-1">For many people, insurance remains unaffordable. 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click|/articles/323858;engagement|bottom page content promo click index|3" data-element-event="INTERNAL LINK|FOOTER|Any Page|Read This Next|LINK|What are Medicare and Medicaid?|rn2" href="https://www.medicalnewstoday.com/articles/323858?utm_source=ReadNext" aria-label="image-link" data-ga4="Read Next button clicks" data-testid="image-link" aria-hidden="true" tabindex="-1"><div class="css-79elbk"><span class="css-rwmw5v css-1pf0x3y"><span class="css-1767n2d"><lazy-image alt="What are Medicare and Medicaid?" src="https://media.post.rvohealth.io/wp-content/uploads/sites/3/2020/02/323858_2200-732x549.jpg" srcSet="https://media.post.rvohealth.io/wp-content/uploads/sites/3/2020/02/323858_2200-732x549.jpg 200w" className="css-1lyqwde"></lazy-image></span></span><span class="css-1fb1nmp"><span class="css-a10gts"></span></span></div></a></figure><div class="css-u8uhak"><a class="css-xqmvw1 css-i4o77u" data-event="engagement|bottom page content promo click|/articles/323858;engagement|bottom page content promo click index|3" data-element-event="INTERNAL LINK|FOOTER|Any Page|Read This Next|LINK|What are Medicare and Medicaid?|rn2" href="https://www.medicalnewstoday.com/articles/323858?utm_source=ReadNext" data-testid="title-link" data-ga4="Read Next button clicks">What are Medicare and Medicaid?</a><section data-testid="byline" class="css-ni3p9e"><div class="css-1pz7193"><div class="css-1edxg1f"><lazy-image alt="" src="https://media.post.rvohealth.io/wp-content/uploads/sites/3/2019/12/alana-biggers-1.png"></lazy-image></div></div><div><span><span>Medically reviewed by <a class="css-90fpmc css-ro87dg" href="https://www.medicalnewstoday.com/reviewers">Alana Biggers, M.D., MPH</a></span></span></div></section><p><a class="css-2fdibo css-v34bze" data-event="engagement|bottom page content promo click|/articles/323858;engagement|bottom page content promo click index|3" data-element-event="INTERNAL LINK|FOOTER|Any Page|Read This Next|LINK|What are Medicare and Medicaid?|rn2" href="https://www.medicalnewstoday.com/articles/323858?utm_source=ReadNext" data-testid="text-link" data-ga4="Read Next button clicks" aria-hidden="true" tabindex="-1">Medicare and Medicaid are state- and federal-funded health insurance plans that enable people with a low income to access healthcare in the United…</a></p><a class="css-90fpmc css-1mj85ht" data-event="engagement|bottom page content promo click|/articles/323858;engagement|bottom page content promo click index|3" data-element-event="INTERNAL LINK|FOOTER|Any Page|Read This Next|LINK|What are Medicare and Medicaid?|rn2" href="https://www.medicalnewstoday.com/articles/323858?utm_source=ReadNext" data-ga4="Read Next button clicks">READ MORE<span class="icon-hl-arrow-right css-1bisyf5"></span></a></div></div></div><section class="css-17lceqi css-1ub4i5m"><div data-empty="true" class="css-vhteyv"><div class="css-1hjaa0k"><span class="css-zya54r"></span></div><div id="DCMR2__slot" data-adbridg-ad-class="DCMR2" data-ad="true" class="css-prb4v6"></div></div></section></div></div></li><li class="css-b26b7j"><div class="css-m260rd"><div class="css-1h1rean"><div class="css-z468a2 css-w8u3o4"><div class="css-k3xa71"><span style="font-size:0;line-height:0"></span><figure class="css-1pvwan1"><a class="css-xqmvw1" data-event="engagement|bottom page content promo click|/articles/hsa-vs-fsa;engagement|bottom page content promo click index|4" data-element-event="INTERNAL LINK|FOOTER|Any Page|Read This Next|LINK|Health savings account vs. Flexible spending account|rn3" href="https://www.medicalnewstoday.com/articles/hsa-vs-fsa?utm_source=ReadNext" aria-label="image-link" data-ga4="Read Next button clicks" data-testid="image-link" aria-hidden="true" tabindex="-1"><div class="css-79elbk"><span class="css-rwmw5v css-1pf0x3y"><span class="css-1767n2d"><lazy-image alt="Health savings account vs. Flexible spending account" src="https://media.post.rvohealth.io/wp-content/uploads/sites/3/2022/11/mom_daughter_fsa_vs_hsa_glasses_732x549_thumb-732x549.jpg" srcSet="https://media.post.rvohealth.io/wp-content/uploads/sites/3/2022/11/mom_daughter_fsa_vs_hsa_glasses_732x549_thumb-732x549.jpg 200w" className="css-1lyqwde"></lazy-image></span></span><span class="css-1fb1nmp"><span class="css-a10gts"></span></span></div></a></figure><div class="css-u8uhak"><a class="css-xqmvw1 css-i4o77u" data-event="engagement|bottom page content promo click|/articles/hsa-vs-fsa;engagement|bottom page content promo click index|4" data-element-event="INTERNAL LINK|FOOTER|Any Page|Read This Next|LINK|Health savings account vs. Flexible spending account|rn3" href="https://www.medicalnewstoday.com/articles/hsa-vs-fsa?utm_source=ReadNext" data-testid="title-link" data-ga4="Read Next button clicks">Health savings account vs. Flexible spending account</a><p><a class="css-2fdibo css-v34bze" data-event="engagement|bottom page content promo click|/articles/hsa-vs-fsa;engagement|bottom page content promo click index|4" data-element-event="INTERNAL LINK|FOOTER|Any Page|Read This Next|LINK|Health savings account vs. Flexible spending account|rn3" href="https://www.medicalnewstoday.com/articles/hsa-vs-fsa?utm_source=ReadNext" data-testid="text-link" data-ga4="Read Next button clicks" aria-hidden="true" tabindex="-1">FSAs and HSAs are medical savings accounts, but they differ in that FSAs can provide funds more quickly, whereas HSAs are more flexible. Learn more…</a></p><a class="css-90fpmc css-1mj85ht" data-event="engagement|bottom page content promo click|/articles/hsa-vs-fsa;engagement|bottom page content promo click index|4" data-element-event="INTERNAL LINK|FOOTER|Any Page|Read This Next|LINK|Health savings account vs. Flexible spending account|rn3" href="https://www.medicalnewstoday.com/articles/hsa-vs-fsa?utm_source=ReadNext" data-ga4="Read Next button clicks">READ MORE<span class="icon-hl-arrow-right css-1bisyf5"></span></a></div></div></div><section class="css-17lceqi css-1ub4i5m"></section></div></div></li><li class="css-b26b7j"><div class="css-m260rd"><div class="css-1h1rean"><div class="css-z468a2 css-w8u3o4"><div class="css-k3xa71"><span style="font-size:0;line-height:0"></span><figure class="css-1pvwan1"><a class="css-xqmvw1" data-event="engagement|bottom page content promo click|/articles/fsa;engagement|bottom page content promo click index|5" data-element-event="INTERNAL LINK|FOOTER|Any Page|Read This Next|LINK|What to know about a flexible spending account|rn4" href="https://www.medicalnewstoday.com/articles/fsa?utm_source=ReadNext" aria-label="image-link" data-ga4="Read Next button clicks" data-testid="image-link" aria-hidden="true" tabindex="-1"><div class="css-79elbk"><span class="css-rwmw5v css-1pf0x3y"><span class="css-1767n2d"><lazy-image alt="What to know about a flexible spending account" src="https://media.post.rvohealth.io/wp-content/uploads/sites/3/2022/11/flexible_spending_account_glasses_732x549_thumb-732x549.jpg" srcSet="https://media.post.rvohealth.io/wp-content/uploads/sites/3/2022/11/flexible_spending_account_glasses_732x549_thumb-732x549.jpg 200w" className="css-1lyqwde"></lazy-image></span></span><span class="css-1fb1nmp"><span class="css-a10gts"></span></span></div></a></figure><div class="css-u8uhak"><a class="css-xqmvw1 css-i4o77u" data-event="engagement|bottom page content promo click|/articles/fsa;engagement|bottom page content promo click index|5" data-element-event="INTERNAL LINK|FOOTER|Any Page|Read This Next|LINK|What to know about a flexible spending account|rn4" href="https://www.medicalnewstoday.com/articles/fsa?utm_source=ReadNext" data-testid="title-link" data-ga4="Read Next button clicks">What to know about a flexible spending account</a><section data-testid="byline" class="css-ni3p9e"><div class="css-1pz7193"><div class="css-1edxg1f"><lazy-image alt="" src="https://media.post.rvohealth.io/wp-content/uploads/sites/3/2022/10/Debra-Sullivan-500x500-Bio.png"></lazy-image></div></div><div><span><span>Medically reviewed by <a class="css-90fpmc css-ro87dg" href="https://www.medicalnewstoday.com/reviewers">Debra Sullivan, Ph.D., MSN, R.N., CNE, COI</a></span></span></div></section><p><a class="css-2fdibo css-v34bze" data-event="engagement|bottom page content promo click|/articles/fsa;engagement|bottom page content promo click index|5" data-element-event="INTERNAL LINK|FOOTER|Any Page|Read This Next|LINK|What to know about a flexible spending account|rn4" href="https://www.medicalnewstoday.com/articles/fsa?utm_source=ReadNext" data-testid="text-link" data-ga4="Read Next button clicks" aria-hidden="true" tabindex="-1">An FSA allows employees to use their non-taxed income to pay for their medical expenses, such as medications and medical devices. Learn more here. </a></p><a class="css-90fpmc css-1mj85ht" data-event="engagement|bottom page content promo click|/articles/fsa;engagement|bottom page content promo click index|5" data-element-event="INTERNAL LINK|FOOTER|Any Page|Read This Next|LINK|What to know about a flexible spending account|rn4" href="https://www.medicalnewstoday.com/articles/fsa?utm_source=ReadNext" data-ga4="Read Next button clicks">READ MORE<span class="icon-hl-arrow-right css-1bisyf5"></span></a></div></div></div><section class="css-17lceqi css-1ub4i5m"></section></div></div></li></ul></div></div></div><span class="css-zya54r"></span><span class="css-zya54r"></span></div><div class="css-i9gxme"></div><footer class="css-1ocfdvu"><div class="css-1dppxl0"><hl-social-nav></hl-social-nav><div class="css-1b2ri56"><div class="css-uktbta css-1tn87m4"><hl-newsletter-cta buttonText="SUBSCRIBE" source="footer_newsletter_link" subscribeEventTracking="Newsletter Acquisition|footer_newsletter_link|submit" className="css-13njx2h" category="Newsletter Acquisition" formatType="footer" name="footer_newsletter_link" productId="footer_newsletter_link" variant="footer_newsletter_link"></hl-newsletter-cta><div class="css-16bllps css-17cs55w">© 2025 Healthline Media UK Ltd, Brighton, UK. 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Adam…"]}}],"medicalReviewers":[{"id":164,"name":{"display":"Shilpa Amin, M.D., CAQ, FAAFP","first":"Shilpa","last":"Amin, MD, CAQ, FAAFP"},"userLogin":"Peacefulplanet2013","links":{"website":"","facebook":"","linkedin":"","twitter":"","instagram":"","tiktok":""},"link":"/reviewers/shilpa-amin-md-caq-faafp","type":{"value":"medical_reviewer","label":"Medical Advisor"},"nid":"155612","specialties":["family medicine","women's health","geriatrics","integrative medicine","clinical research","jurisprudence",""],"guestTitle":"","bio":{"text":"\u003cp\u003e\u003cspan style=\"font-weight: 400\"\u003eDr. Shilpa Amin is an \u003c/span\u003e\u003ca href=\"https://www.abms.org/board-certification/\"\u003e\u003cspan style=\"font-weight: 400\"\u003eABMS board certified\u003c/span\u003e\u003c/a\u003e\u003cspan style=\"font-weight: 400\"\u003e physician specializing in family medicine, geriatrics, and integrative medicine. Dr. Amin’s clinical work experience has ranged from private internal medicine and family practice to urgent care, long-term care, and public health. Dr. Amin is a fellow of the American Academy of Family Physicians.\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEducation\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n\u003cli style=\"font-weight: 400\"\u003e\u003cspan style=\"font-weight: 400\"\u003eLoyola University, MJ\u003c/span\u003e\u003c/li\u003e\n\u003cli style=\"font-weight: 400\"\u003e\u003cspan style=\"font-weight: 400\"\u003eMayo Clinic Graduate School of Biomedical Sciences, MBSc\u003c/span\u003e\u003c/li\u003e\n\u003cli style=\"font-weight: 400\"\u003e\u003cspan style=\"font-weight: 400\"\u003eGeorge Washington University School of Medicine, MD\u003c/span\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eCertifications\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n\u003cli style=\"font-weight: 400\"\u003e\u003cspan style=\"font-weight: 400\"\u003eAmerican Board of Family Medicine \u0026#8211; Family Medicine\u003c/span\u003e\u003c/li\u003e\n\u003cli style=\"font-weight: 400\"\u003e\u003cspan style=\"font-weight: 400\"\u003eAmerican Board of Family Medicine \u0026#8211; Geriatric Medicine\u003c/span\u003e\u003c/li\u003e\n\u003cli style=\"font-weight: 400\"\u003e\u003cspan style=\"font-weight: 400\"\u003eAmerican Board of Physician Specialties \u0026#8211; Integrative Medicine\u003c/span\u003e\u003c/li\u003e\n\u003cli style=\"font-weight: 400\"\u003e\u003cspan style=\"font-weight: 400\"\u003eCertificate of Added Qualifications in Geriatrics\u003c/span\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eProfessional Accomplishments\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n\u003cli style=\"font-weight: 400\"\u003e\u003cspan style=\"font-weight: 400\"\u003eMasters in biomedical sciences (clinical research)\u003c/span\u003e\u003c/li\u003e\n\u003cli style=\"font-weight: 400\"\u003e\u003cspan style=\"font-weight: 400\"\u003eMasters in jurisprudence (health law, healthcare compliance)\u003c/span\u003e\u003c/li\u003e\n\u003cli style=\"font-weight: 400\"\u003e\u003cspan style=\"font-weight: 400\"\u003eWomen’s Health Fellowship at Mayo Clinic\u003c/span\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eAffiliations\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n\u003cli style=\"font-weight: 400\"\u003e\u003ca href=\"https://www.aafp.org/home.html\"\u003e\u003cspan style=\"font-weight: 400\"\u003eAmerican Academy of Family Physicians (AAFP)\u003c/span\u003e\u003c/a\u003e\u003c/li\u003e\n\u003c/ul\u003e\n"},"avatar":{"title":"CVS Health","width":1600,"height":1067,"src":"https://post.medicalnewstoday.com/wp-content/uploads/sites/3/2025/01/05-09-SAmin-websize.jpg"},"bioBlurb":{"nodes":["Dr. Shilpa Amin is an ABMS board certified physician specializing in family medicine, geriatrics, and integrative medicine. Dr. Amin’s clinical work experience…"]}}],"editors":[{"role":"Editor","name":{"display":"Yvette Brazier"}}],"pinterestImage":{"path":"https://media.post.rvohealth.io/wp-content/uploads/sites/3/2021/05/GettyImages-107797664_thumb.jpg"},"hideFeedback":false,"isMedicare":false,"isBlog":false,"publishSource":"wordpress","isAmpSupported":false,"categories":[{"name":"Public Health","slug":"public-health","link":"/categories/public-health","children":[]},{"name":"Health Insurance / Medical Insurance","slug":"health_insurance","link":"/categories/health_insurance","primary":true,"children":[]},{"name":"Medicare / Medicaid / SCHIP","slug":"medicare-medicaid","link":"/categories/medicare-medicaid","children":[]}],"language":{"en":"https://www.medicalnewstoday.com/articles/323367/","x-default":"https://www.medicalnewstoday.com/articles/323367/","current":"en"},"lang":"en","links":[],"colorScheme":"default","isContentSeries":false,"brandCTAs":[],"clusterNavLinks":[],"clusterUrls":[],"clusterLinks":{},"pathingTilesData":{},"pathingCardsData":{},"inArticlePathingCardsData":[],"quantitativeTrustData":{},"isPrependRecipeH2":false,"recipes":[],"hideTabs":false,"tabs":[{"id":"_noHeaderPrefixedContent","title":null,"header":null,"body":[{"tagName":"div","source":"\u003cp class=\"css-4aeg3z\"\u003eHealth insurance is a type of insurance that helps cover the cost of an insured person’s medical and surgical expenses. There are different types of health insurance in the USA.\u003c/p\u003e"},{"tagName":"p","source":"Insurers use the term “provider” to describe a clinic, hospital, doctor, laboratory, healthcare practitioner, or pharmacy that provides treatment for an individual’s condition. "},{"tagName":"div","attributes":{"data-preamp":"serena-chatbot"},"source":""},{"tagName":"p","source":"The “insured” is the owner of the \u003cspan class=\"keyword-mark\"\u003ehealth insurance\u003c/span\u003e policy or the person with the health insurance coverage."},{"tagName":"p","source":"In this article, learn more about what health insurance is, why it is important, types of plan, and legislation details."}]},{"id":"definition","title":"Definition","isCollapsable":false,"header":["What is it?"],"body":[{"tagName":"div","source":"\u003cfigure class=\"css-yhe8zq\"\u003e\u003cspan class=\"css-rwmw5v\"\u003e\u003cspan class=\"css-mjp0j9\"\u003e\u003cpicture class=\"css-16pk1is\"\u003e\u003csource srcSet=\"//i0.wp.com/post.medicalnewstoday.com/wp-content/uploads/sites/3/2021/06/GettyImages-107797664_header-1024x575.jpg?w=1575 750w\" media=\"(min-width: 1190px)\"/\u003e\u003csource srcSet=\"//i0.wp.com/post.medicalnewstoday.com/wp-content/uploads/sites/3/2021/06/GettyImages-107797664_header-1024x575.jpg?w=1575 750w\" media=\"(min-width: 990px)\"/\u003e\u003csource srcSet=\"//i0.wp.com/post.medicalnewstoday.com/wp-content/uploads/sites/3/2021/06/GettyImages-107797664_header-1024x575.jpg?w=1845 879w\" media=\"(min-width: 768px)\"/\u003e\u003cimg src=\"//i0.wp.com/post.medicalnewstoday.com/wp-content/uploads/sites/3/2021/06/GettyImages-107797664_header-1024x575.jpg?w=1155\u0026h=1528\" alt=\"\" class=\"css-1jytyml\"/\u003e\u003c/picture\u003e\u003c/span\u003e\u003chl-share-overlay class=\"css-1mqo1cs\"\u003e\u003ca class=\"css-90fpmc icon-hl-pinterest css-by55vd\" target=\"_blank\" rel=\"noopener noreferrer nofollow\" data-event=\"Any Page|Image Pinterest Click|Icon Clicked\" data-element-event=\"OPEN|CONTENTBLOCK|Any Page|Article Body|BUTTON|Image Widget Pinterest Click|\" href=\"https://www.pinterest.com/pin/create/button/?url=https%3A%2F%2Fwww.medicalnewstoday.com%2Farticles%2F323367\u0026media=https%3A%2F%2Fpost.medicalnewstoday.com%2Fwp-content%2Fuploads%2Fsites%2F3%2F2021%2F06%2FGettyImages-107797664_header-1024x575.jpg\u0026description=Health%20insurance%3A%20Types%20and%20legislation\" title=\"Share on Pinterest\" data-pin-custom=\"true\" data-share-url=\"https://post.medicalnewstoday.com/wp-content/uploads/sites/3/2021/06/GettyImages-107797664_header-1024x575.jpg\"\u003e\u003cspan class=\"css-z1zfa\"\u003eShare on Pinterest\u003c/span\u003e\u003c/a\u003e\u003c/hl-share-overlay\u003e\u003c/span\u003e\u003cfigcaption class=\"css-13b3g0x\"\u003ePhotoAlto/Frederic Cirou/Getty Images\u003c/figcaption\u003e\u003c/figure\u003e"},{"tagName":"p","source":"Depending on the type of health insurance coverage a person has, either the insured pays costs out of pocket and receives reimbursement, or the insurer makes payments directly to the provider."},{"tagName":"p","source":"In countries without universal healthcare coverage, such as the United States, health insurance is commonly included in employer benefit packages."},{"tagName":"p","source":"Following the introduction of the \u003ca href=\"https://www.medicalnewstoday.com/articles/247287.php\" class=\"content-link css-90fpmc\"\u003eAffordable Care Act\u003c/a\u003e in 2010, the number of people without insurance fell by over \u003ca rel=\"noopener noreferrer\" href=\"https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population/\" target=\"_blank\" class=\"content-link css-90fpmc\"\u003e20 million\u003c/a\u003e to reach the lowest ever level in 2016, according to the Kaiser Family Foundation (KFF). "},{"tagName":"p","source":"However, from 2017, the number of adults without insurance rose again by 2.2 million, from 26.7 million in 2016 to 28.9 million in 2019. Between 2016 and 2019, the percentage of people without insurance rose from 10% to 10.9%. However, the rate of people with health insurance is still higher than it was before the introduction of the Affordable Care Act."},{"tagName":"p","source":"A \u003ca rel=\"noopener noreferrer\" href=\"https://www.commonwealthfund.org/publications/issue-briefs/2012/apr/gaps-health-insurance-why-so-many-americans-experience-breaks\" target=\"_blank\" class=\"content-link css-90fpmc\"\u003e2012 report\u003c/a\u003e from the Commonwealth Fund states that one-quarter of all U.S. citizens of working age have experienced a gap in health insurance coverage. Many people in the survey lost their health insurance when they became unemployed or changed jobs. "},{"tagName":"p","source":"The KFF adds that Black people and those with low incomes are \u003ca rel=\"noopener noreferrer\" href=\"https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population/\" target=\"_blank\" class=\"content-link css-90fpmc\"\u003emore likely\u003c/a\u003e to have no insurance than other groups."},{"tagName":"p","source":"The level of treatment a person receives in emergency departments varies significantly depending on what type of health insurance they have."}]},{"id":"types","title":"Types ","isCollapsable":false,"header":["Types"],"body":[{"tagName":"p","source":"There are two main types of health insurance: private and public, or government. There are also a few other, more specific types. The following sections will look at each of these in more detail."},{"tagName":"h3","source":"Private health insurance "},{"tagName":"p","source":"The Centers for Disease Control and Prevention (CDC) say that the U.S. healthcare system relies heavily on private health insurance. In the National Health Interview Survey, researchers found that \u003chl-trusted-source source=\"Centers for Disease Control and Prevention (CDC)\" rationale=\"Governmental authority\"\u003e\u003ca rel=\"noopener noreferrer\" href=\"https://www.cdc.gov/nchs/fastats/health-insurance.htm\" target=\"_blank\" class=\"content-link css-90fpmc\"\u003e63.7%\u003c/a\u003e\u003c/hl-trusted-source\u003e of people under the age of 65 years in the U.S. have a type of private health insurance coverage."},{"tagName":"h3","source":"Public, or government, health insurance"},{"tagName":"p","source":"With this type of insurance, the state subsidizes healthcare in exchange for a premium. \u003ca class=\"content-link css-90fpmc keywords\" title=\"What is Medicare / Medicaid?\" href=\"https://www.medicalnewstoday.com/articles/what-are-medicare-and-medicaid\"\u003eMedicare\u003c/a\u003e, \u003ca class=\"content-link css-90fpmc keywords\" title=\"What is Medicare / Medicaid?\" href=\"https://www.medicalnewstoday.com/articles/what-are-medicare-and-medicaid\"\u003eMedicaid\u003c/a\u003e, the Veterans Health Administration, and the Indian Health Service are examples of public health insurance in the U.S."},{"tagName":"h3","source":"Other types"},{"tagName":"p","source":"Some people may also define an insurer by the way it administers its plans and connects with providers. Here are some examples of the \u003ca rel=\"noopener noreferrer\" href=\"https://www.ncsl.org/research/health/health-insurance-plan-types-and-definitions.aspx\" target=\"_blank\" class=\"content-link css-90fpmc\"\u003etypes of plan\u003c/a\u003e available."},{"tagName":"h4","source":"Managed care plans"},{"tagName":"p","source":"With this type of plan, the insurer will have contracts with a network of providers to provide lower cost medical care to its policyholders. There will be penalties and additional costs added to out-of-network hospitals and clinics, but they will provide some treatment."},{"tagName":"p","source":"The more expensive the policy, the more flexible it is likely to be with the network of hospitals."},{"tagName":"h4","source":"Indemnity, or Fee-for-Service, plans"},{"tagName":"p","source":"A Fee-for-Service plan covers treatment equally among all providers, allowing the insured to choose their preferred place of treatment. The insurer will typically pay \u003ca rel=\"noopener noreferrer\" href=\"https://www.ncsl.org/research/health/health-insurance-plan-types-and-definitions.aspx\" target=\"_blank\" class=\"content-link css-90fpmc\"\u003e80%\u003c/a\u003e of costs on an indemnity plan, while the individual pays the remaining costs as a coinsurance."},{"tagName":"h4","source":"Health Maintenance Organization plans"},{"tagName":"p","source":"These are organizations that provide medical care directly to the insured. The policy will usually have a dedicated primary care physician who will coordinate all necessary care."},{"tagName":"p","source":"Health Maintenance Organization (HMO) plans will usually only fund treatment referred by a family doctor and will have negotiated fees for each medical service to minimize costs. This is usually the cheapest type of plan."},{"tagName":"h4","source":"Preferred Provider Organization plans"},{"tagName":"p","source":"A Preferred Provider Organization (PPO) plan is similar to an indemnity plan in that it allows the insured to visit any doctor they prefer. The PPO plan also has a network of approved providers with which it has negotiated costs."},{"tagName":"p","source":"The insurer will pay less for treatment with out-of-network providers. However, people with a PPO plan can self-refer to specialists without having to visit a primary care physician."},{"tagName":"h4","source":"Point-of-Service plans"},{"tagName":"p","source":"A Point-of-Service plan functions as a combination of an HMO plan and a PPO plan. The insured can choose between coordinating all treatment through a primary care physician, receiving treatment within the insurer’s provider network, and using non-network providers. The type of plan they have will dictate the progress of treatment."},{"tagName":"h3","source":"Why is the type of insurance plan important?"},{"tagName":"p","source":"The type of plan a person has dictates how they will approach getting the treatment they need and how much money they will need to pay on the day they receive it."},{"tagName":"p","source":"In 2003, the U.S. Congress introduced a new option: the Health Savings Account (HSA). It is a combination of an HMO plan, a PPO plan, an indemnity plan, and a savings account with tax benefits. However, in plan year 2020, a policyholder must pair this type with an existing health plan that has a deductible of over \u003ca rel=\"noopener noreferrer\" href=\"https://www.healthcare.gov/glossary/health-savings-account-hsa/\" target=\"_blank\" class=\"content-link css-90fpmc\"\u003e$1,400\u003c/a\u003e for individuals or $2,800 for families."},{"tagName":"p","source":"HSAs can top up coverage, extending existing plans to cover a wider range of treatments. If an employer pays for an HSA on behalf of their employees, the payments are tax-free. An individual can build up funds in the HSA while they are healthy and save for instances of poor health later in life."},{"tagName":"p","source":"However, people with chronic conditions, such as \u003ca class=\"content-link css-90fpmc keywords\" title=\"What is Diabetes?\" href=\"https://www.medicalnewstoday.com/info/diabetes/\"\u003ediabetes\u003c/a\u003e, might not be able to save a large amount in their HSA, as they regularly have to pay high medical costs for the management of their health concern."},{"tagName":"p","source":"These plans often carry very high deductibles, meaning that although premiums can be lower, people often end up paying the full expenses of any required medical treatment."},{"tagName":"p","source":"There is more overlap as plan types evolve. The distinctions between policy types are becoming more and more blurred."},{"tagName":"p","source":"The majority of indemnity plans use managed care techniques to control costs and ensure that there are enough resources to pay for appropriate care. Similarly, many managed care plans have adopted some characteristics of Fee-for-Service plans."}]},{"id":"legislation","title":"Legislation","isCollapsable":false,"header":["Legislation"],"body":[{"tagName":"p","source":"In the U.S., having some degree of insurance is legally necessary as part of the Affordable Care Act. A person without health insurance has to pay a fine."},{"tagName":"p","source":"However, policymakers \u003ca href=\"https://www.healthcare.gov/fees/fee-for-not-being-covered/\" target=\"_blank\" rel=\"noopener noreferrer\" class=\"content-link css-90fpmc\"\u003eremoved the Individual Mandate\u003c/a\u003e in the Affordable Care Act from the legislation in 2019. Insurance is no longer an individual legal requirement in the U.S."},{"tagName":"p","source":"If the policy also covers the children in the family, a person is allowed to be on their parents’ insurance until the age of \u003ca href=\"https://www.hhs.gov/healthcare/about-the-aca/young-adult-coverage/index.html\" target=\"_blank\" rel=\"noopener noreferrer\" class=\"content-link css-90fpmc\"\u003e26 years\u003c/a\u003e, even if they are:"},{"tagName":"ul","source":"\u003cli\u003emarried\u003c/li\u003e\u003cli\u003eliving away from home\u003c/li\u003e\u003cli\u003enot financially dependent on their parents\u003c/li\u003e\u003cli\u003eeligible to be included on their employer’s coverage\u003c/li\u003e"},{"tagName":"p","source":"Insurance is regulated at state level, meaning that buying a policy in one state is different from doing so in another."},{"tagName":"p","source":"Although state legislation can affect the price of a policy, the important decisions about a person’s coverage and reimbursements rest with the insurer. People should be sure to have their broker or customer services representative discuss the impact of any changing legislation on their particular policy."}]},{"id":"summary","title":"Summary","isCollapsable":false,"header":["Summary"],"body":[{"tagName":"p","source":"Health insurance helps covers the cost of an insured individual’s medical and surgical expenses. There are various plan types, and they vary in terms of what they cover and how a person can access treatment."},{"tagName":"p","source":"Currently, a person in the U.S. must have some form of health insurance coverage. Anyone without a form of coverage may need to pay a fine."}]}],"hasAffiliateLinks":false,"affiliates":[],"isDisclaimer":false,"isOwnedAndOperatedPresent":false,"propsFor":{"articleResources":[{"displayLink":"commonwealthfund.org/publications/issue-briefs/2012/apr/gaps-health-insurance-why-so-many-americans-experience-breaks","link":"https://www.commonwealthfund.org/publications/issue-briefs/2012/apr/gaps-health-insurance-why-so-many-americans-experience-breaks","title":{"tagName":"span","source":"Collins, S. R., \u003cem\u003eet al\u003c/em\u003e. (2012). Gaps in health insurance: Why so many Americans experience breaks in coverage and how the Affordable Care Act will help."}},{"displayLink":"cdc.gov/nchs/fastats/health-insurance.htm","link":"https://www.cdc.gov/nchs/fastats/health-insurance.htm","title":{"tagName":"span","source":"Health insurance coverage. (2021).\u0026nbsp;"}},{"displayLink":"ncsl.org/research/health/health-insurance-plan-types-and-definitions.aspx","link":"https://www.ncsl.org/research/health/health-insurance-plan-types-and-definitions.aspx","title":{"tagName":"span","source":"Health insurance plan types and definitions. (2011)."}},{"displayLink":"healthcare.gov/glossary/health-savings-account-hsa/","link":"https://www.healthcare.gov/glossary/health-savings-account-hsa/","title":{"tagName":"span","source":"Health Savings Account (HSA). (n.d.)."}},{"displayLink":"healthcare.gov/fees/fee-for-not-being-covered/","link":"https://www.healthcare.gov/fees/fee-for-not-being-covered/","title":{"tagName":"span","source":"No health insurance? See if you\u0026apos;ll owe a fee. (n.d.)."}},{"displayLink":"kff.org/health-costs/perspective/pulling-it-together-rising-health-costs-are/","link":"https://www.kff.org/health-costs/perspective/pulling-it-together-rising-health-costs-are/","title":{"tagName":"span","source":"Pulling it together: Rising health costs are not just a federal budget problem. (2011)."}},{"displayLink":"in.gov/idoi/files/Questions_and_Answers_About_Health_Insurance.pdf","link":"https://www.in.gov/idoi/files/Questions_and_Answers_About_Health_Insurance.pdf","title":{"tagName":"span","source":"Questions and answers about health insurance: A consumer guide. (2007). \u0026nbsp;"}},{"displayLink":"kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/","link":"https://www.kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/","title":{"tagName":"span","source":"Tolbert, J., \u003cem\u003eet al\u003c/em\u003e. (2020). Key facts about the uninsured population.\u0026nbsp;"}},{"displayLink":"hhs.gov/healthcare/about-the-aca/young-adult-coverage/index.html","link":"https://www.hhs.gov/healthcare/about-the-aca/young-adult-coverage/index.html","title":{"tagName":"span","source":"Young adult coverage. (2017)."}}],"byline":{"authors":[{"id":904,"name":{"display":"Adam Felman","first":"Adam","last":"Felman"},"link":"/authors/adam-felman","type":{"value":"author","label":"Author"},"nid":"","specialties":[],"guestTitle":"","bio":{"text":"\u003cp\u003eAdam Felman is an Editor for Medical News Today and Greatist. Outside of work, he is a hearing impaired musician, producer, and rapper who gigs globally. Adam also owns every Nic Cage movie and has a one-eyed hedgehog called Philip K. 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She has an undergraduate degree in applied psychology and criminology from the University of Brighton, in the U.K. She is currently undertaking her Ph.D. part-time at Lancaster University, where she is researching into patient experiences of diabetes distress.\u0026quot;}\" data-sheets-userformat=\"{\u0026quot;2\u0026quot;:769,\u0026quot;3\u0026quot;:{\u0026quot;1\u0026quot;:0},\u0026quot;11\u0026quot;:4,\u0026quot;12\u0026quot;:0}\"\u003eLouise Morales-Brown is a social researcher within the civil service, collecting evidence of social issues to inform and evaluate policy decisions. 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