Jessica Fox Last Updated On: August 1, 2023

Private or Public Health Insurance

In this country there is a dual health insurance system. We do not have a government medical care system that covers all citizens. We have a split between a private system that provides medical coverage through insurance companies and government plans which cover certain segments of the population.

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Table of Contents

Private Health Insurance

In 2019, more than 70+% of people in this country were covered by some form of health insurance whether public or private. The private health insurance industry through individual, family and group health insurance plans provides coverage for the non elderly population. These plans can be purchased through government marketplaces and exchanges or through an employer. The Affordable Care Act provided for some uniformity in the coverages and made portability and pre-existing conditions priorities for private health insurance providers. Each year an open enrollment period takes place for individual and family health care plans. Currently this period is from November 1st to December 15th for coverage beginning on January 1st. Employer health care plans have their own enrollment periods and regulations about when eligibility for coverage begins, Employer health plans with some exceptions are subject to meeting the guidelines of the ACA.

Public Health Insurance

Medicare, Medicaid and CHIP programs represent the three largest public health insurance programs. Medicare covers retirees and others who qualify. Qualification for the majority of the population insured by Medicare is through contributions through Social Security. Medicaid and CHIP programs cover low income individuals, families and children as well as some elderly persons through a program jointly funded by states and the federal government. These programs though jointly funded and administered by the state vary from state to state as far as eligibility and what is provided for and covered. Though not strictly a health insurance, veterans of the armed forces also can obtain health care benefits through the Veterans Administration. The VA operates clinics and hospitals throughout the country to provide those healthcare benefits.

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The ACA and Private Insurance

With the advent of the ACA,sometimes known as Obamacare, changes were enacted that required uniformity in the way insurance was written.All policies had to conform to standards set by the ACA. Some of the major changes included that no longer were there exclusions for pre-existing conditions. This popular change meant that an insurance company could no longer deny coverage to an individual who had a serious condition when writing a new insurance policy. Pregnancy and other women’s health requirements were made; tests and screening that were not previously covered were required to be written into all policies. Citing the number of young people who were uninsured, adult children were allowed to remain on a parent’s health insurance plan until age 26. Prescription coverage as part of insurance health plans  improved while cost increases slowed. Insurance marketplaces or exchanges that were set up in many states improved access to underinsured parts of society and support payments made policies affordable. This resulted in a smaller number of people remaining uninsured.

What Is The Right Coverage For You?

If you are employed by a company that offers group health insurance, it is usually your least expensive option. Group insurance covers a pool of individuals and unlike individual health care plans spreads the expense over the group. Individual and family plans while somewhat more costly purchased on your own, are more customizable to meet your individual and family needs. Planning for individual or family health care may be best discussed with an expert to help you make the choice that’s right for you. 

ConsumerCoverage is a source for health insurance information about policies both public and private. We have connections to private insurers that provide individual, family, group and even Medicare Advantage options. Through our portal you can speak to an agent, contact  customer service and you will find us to be a safe secure online source.


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