Health Insurance and Coverage

Health insurance in the United States offers diverse options to meet the needs of various populations, including seniors, federal employees, low-income families, and individuals purchasing coverage on their own. Navigating this landscape involves understanding programs like the ACA Marketplace, Medicare, Medicaid, and the Federal Employee Health Benefits (FEHB) program.

Medicare and Senior Coverage

Medicare provides essential health coverage for seniors 65 and older, including options such as Medicare Advantage Plans and prescription drug coverage under Part D. Annual enrollment periods help beneficiaries review and adjust their plans to meet changing needs. It is important to be aware of long-term sustainability challenges facing Medicare as the population ages (learn more).

ACA Marketplace and Subsidies

The ACA Health Insurance Marketplace enables individuals and families to compare plans and access subsidies that make coverage more affordable. Eligibility and subsidy amounts may change with income fluctuations, so understanding premium tax credits and income effects is critical. Marketplace plans vary in coverage levels, such as Bronze, Silver, Gold, and Platinum, offering choices for different budgets and health needs.

Medicaid and CHIP

Medicaid provides health coverage for low-income individuals and families, with eligibility and income limits varying by state. Many states have expanded coverage under the ACA. The Children’s Health Insurance Program (CHIP) offers affordable insurance for children. Both programs are accessible year-round, with requirements to update personal information to maintain coverage.

Federal Employee Benefits and Life Changes

Federal employees and retirees can choose from over 120 plans under the Federal Employee Health Benefits (FEHB) program. Premiums are rising, with an average increase of 12.3% for 2026, driven by rising healthcare costs and an aging enrollee population. Special enrollment periods allow plan changes outside open enrollment due to qualifying life events such as marriage or job loss (more info).