A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1999.
Call our agency partners 866-553-3223
Call our agency partners 866-553-3223

Medicare & Medicaid

Medicare & Medicaid

Featured

Featured
ACA open enrollment: what’s new for 2025
Open enrollment for 2025 ACA (Affordable Care Act)-compliant health insurance is just around the corner. Let’s take a look at the various changes that consumers should be aware of this fall.

Featured

Featured
Fact check: Is the $6,400 subsidy real or a scam?
Ads on social media – promising a $6,400 subsidy – have been flagged as misleading. Here's what you need to know about the $6,400 subsidy scam.

Find the affordable health insurance coverage you need.

health_insurance
health_insurance

3 things you should know about buying individual and family health insurance for 2025

Read our Open Enrollment Guide image title

Open enrollment is here!

Open enrollment for ACA Marketplace health insurance runs Nov. 1-Jan. 15 in most states—the perfect time to comparison shop for affordable plans.

Calculate your estimated subsidy image title

You might qualify for no or low premiums

Most Marketplace enrollees are eligible for enhanced subsidies through 2025, thanks to the Inflation Reduction Act. Based on income, you may save.

Tips for comparison shopping image title

It’s more than just the price

Finding the best health insurance is about more than premiums. Are your doctors in-network? Is your Rx covered? What are the quality ratings?


What coverage are you looking for?

Navigating health insurance can be daunting. But with the right partner, it doesn’t have to be. Since 1999, healthinsurance.org has been the trusted online resource for affordable coverage. Learn from our policy experts, get quick quotes, and find the best health plan for you.

Supplemental insurance

tab-content-image-mobile
Read our guide to supplemental insurance options.
tab-content-image

Short-term limited duration coverage

tab-content-image-mobile
Read our guide to short-term health insurance.
tab-content-image

Affordable Care Act coverage

tab-content-image-mobile
View our state guides to ACA coverage.
tab-content-image

Medicare

tab-content-image-mobile
Learn more about Medicare.
tab-content-image

Dental coverage

tab-content-image-mobile
Learn about dental insurance.
tab-content-image

Explore health insurance in your state

When it comes to health coverage, the state where you live impacts your options. Select your state to learn more about health insurance options in your area.


Individual health insurance: Is it right for you?

Right now, more Americans than ever are buying comprehensive Affordable Care Act (ACA)-compliant individual and family health insurance plans.2 The ACA created income-based subsidies to make these plans more affordable – or even zero-cost.3

And those subsidies are now more widely available as a result of the American Rescue Plan and Inflation Reduction Act.4 ACA-compliant individual and family plans may be a good fit for people who are …


Frequently asked questions

Frequently asked questions

What are individual health insurance plans?

Individual health insurance plans are purchased by people who don’t have major medical coverage through an employer-sponsored health plan or a government health plan such as Medicare, Medicaid, Children’s Health Insurance Program (CHIP) or Tricare.

Since 2014, all ACA-compliant individual health insurance plans have been required to cover essential health benefits (outpatient care, emergency services, hospitalization, mental health and substance use disorder services, prescription drugs, rehab services, lab services, preventive and wellness services, pregnancy, maternity and newborn care, and pediatric services) without annual or lifetime benefit caps, and they cover pre-existing conditions.5

How much can I expect to pay for individual and family health insurance?

What you pay for coverage depends on your age, income, where you live and whether you use tobacco. Thanks to the Affordable Care Act, your medical history will not affect your premiums, and neither will your gender.

Keep in mind that many people do qualify for income-based premium subsidies that offset a significant portion of their monthly costs. Across the nearly 20 million people who received premium subsidies in 2024, the average after-subsidy premium was about $74/month.6

Can health insurance that costs me less still provide comprehensive coverage?

Yes! The key is to understand that it’s income-based subsidies that keep the monthly premiums less expensive. You’re still buying ACA-compliant health coverage, but people who qualify for the subsidies do not have to pay the full premiums that go along with those plans.

Instead, many Marketplace enrollees are eligible for subsidies that can cover a significant portion of the premium! Just know that even if your after-subsidy portion of the premium is less expensive, the coverage itself is still robust.

Do I qualify for ACA (Obamacare) subsidies?

Your eligibility for premium tax credits is based on the relationship between your household income and the federal poverty guidelines.7 So your age, location, and income will all factor into determining your eligibility. But many Marketplace applicants will qualify for premium subsidies, and many also qualify for financial assistance to reduce their out-of-pocket costs.6

You can use our premium subsidy calculator to understand more about your subsidy eligibility. It only takes a few minutes and all you have to provide is your zip code, age, household size, and income.

When can I enroll in an ACA plan during the year?

You can enroll in an ACA-compliant individual or family health plan during open enrollment or during a special enrollment period. In most states, open enrollment runs from November 1 to January 15. Read our Guide to Open Enrollment.

Special enrollment periods can be available at any time of the year, and are generally linked to a specific qualifying life event, such as losing health coverage, having a baby, moving to a new area, or getting married. Read our Guide to Special Enrollment Periods.

Do I qualify for Medicaid in my state?

Medicaid benefits and eligibility is different in every state. Click on your state on this map to learn more about eligibility rules where you live.

Learn more about the federal poverty level and how it’s used to determine your eligibility for Medicaid. Use our federal poverty level calculator.

Federal poverty level calculator

Would ACA subsidies lower your health insurance premiums?

Use our 2025 subsidy calculator to see if you’re eligible for ACA premium subsidies – and your potential savings if you qualify.
* This tool provides ACA premium subsidy estimates based on your household income. healthinsurance.org does not collect or store any personal information from individuals using our subsidy calculator.

Obamacare subsidy calculator *

+

Add ages of other family members to be insured.

Include yourself, your spouse, and children claimed as dependents on your taxes.

Modified Adjusted Gross Income (MAGI)

For most taxpayers, your MAGI is close to AGI (Line 11 of your Form 1040).

Estimated annual subsidy

Provide information above to get an estimate


healthinsurance.org is the voice of experience

Talking about health insurance since 1999.

We’ve been helping people understand and navigate the individual health insurance market since 1999. More than 2.9 million readers viewed our pages in 2023.

Tools for health insurance shoppers.

Millions of users have utilized our Obamacare Subsidy Calculator and other resources.

Partnerships with leading members of the health insurance industry.

We vet our business partners carefully, so our readers can feel confident when comparing plans that range from individual and family, to dental and Medicare.

Experience with health reform.

Our insurance analysts have been analyzing health reform efforts – including the Affordable Care Act – since 2008.


image image

Discuss your coverage needs with our agency partners.

Call 866-553-3223

Footnotes

  1. “Medicare Monthly Enrollment" CMS.gov, June 2024. 
  2. Health Insurance Marketplaces 2024 Open Enrollment Report” CMS.gov. Accessed May 10, 2024 
  3. Access to Marketplace Plans with Low Premiums on the Federal Platform” ASPE / HHS.gov, March 29, 2021 
  4. Fact Sheet: What happens to premiums if the extra help from the American Rescue Plan expires?” HHS.gov, June 22, 2022 
  5. Health insurance rights & protections” HealthCare.gov, Accessed August 2023 
  6. 2024 Marketplace Open Enrollment Period Public Use Files” CMS.gov, March 22, 2024  
  7. Subsidized coverage” HealthCare.gov, Accessed August, 2023