Individual and family health insurance FAQ

Health insurance is a contract between you and your insurance company in which you pay an annual amount in exchange for coverage. Insurance will be most cost-effective after you've paid your deductible — the cost of your medical expenses you'll cover before your insurance carrier starts covering them.

View our common health insurance terms for more information.

The Affordable Care Act, or ACA, requires everyone to have health insurance. As of Jan. 1, 2019, the tax penalty that enforces that rule is no longer in effect. By having health insurance, you can help protect yourself from medical costs that could drain your finances.

Any U.S. citizen living in the country who's not incarcerated and isn't covered by Medicare can purchase health insurance through the health insurance marketplace.

Employer-sponsored health plans and private insurance companies sell plans that provide minimum essential coverage and may also provide more comprehensive plans as well.

If you have a preexisting condition under the Affordable Care Act and you purchase a:

• Comprehensive health plan, your application can't be rejected.
• Short-term or fixed health plan, your provider can ask questions related to your health that may result in a declined application.

The government has five categories of health insurance plans. The difference between each plan level, also called a metal level, is in how the cost of care is split between you and your provider.

• Bronze: Your plan typically pays 60% of health care costs and you pay 40%.
• Silver: Your plan typically pays 70% of health care costs and you pay 30%.
• Gold: Your plan typically pays 80% of health care costs and you pay 20%.
• Platinum: Your plan typically pays 90% of health care costs and you pay 10%.
• Catastrophic: Your plan pays less than 60% of health care costs. This type of plan is only available to people ages 30 and under or those who qualify for an exemption. It only covers essential health benefits like emergency care.

Generally, but not in all situations, Medicare is the basic health insurance coverage for adults age 65 and over. Marketplace health plans (ACA plans) are for persons under the age of 65. To help you understand your health insurance options and make the right choice for you and your family, consult with a health insurance professional.

COBRA is a federal law that gives you the option to temporarily continue your employer-sponsored health insurance if you lose it because of job loss or a reduction in the number of hours you work, the death of the primary person on the policy or divorce.

You have 60 days after the loss of coverage to obtain health insurance, according to the ACA.

As a veteran, you may be eligible for TRICARE, VA health care, an employer-sponsored health plan and health plans from private insurers or the health insurance marketplace.

If you're able to use the VA health care system, you aren't eligible for health insurance subsidies.