How to Get Health Insurance in 2026: All Your Options

An estimated 28 million Americans remain uninsured in 2026—and BillKarma data shows 60% of them qualify for subsidized or free coverage but haven’t enrolled. Whether you just lost a job, started a new one, aged off your parents’ plan, or simply never had coverage, there is likely a path to affordable health insurance available to you right now. This guide covers all six ways to get covered, with step-by-step instructions for each.

1. 6 ways to get health insurance

The right path to coverage depends on your employment status, income, age, and family situation. Here is a quick overview before we go into detail on each:

2. Employer-sponsored insurance

About 156 million Americans get coverage through an employer. This is the most common path and, for most people with access to it, the best value. Employers typically cover 70–80% of the premium, meaning a plan that costs $700/month in total premiums might only cost you $150–200/month via payroll deduction.

Key things to know about employer-sponsored plans:

• Enrollment windows: New employees typically have 30–60 days from the hire date to enroll. After that, you must wait for the annual open enrollment period (usually in the fall for January 1 effective date).
• Compare the plan options: Most employers offer 2–3 plan tiers. A high-deductible health plan (HDHP) with an HSA is often the right choice for healthy individuals; a PPO or HMO may be better if you have ongoing medical needs or take expensive medications.
• Don’t overlook the network: Verify your current doctors and any specialists you need are in-network before enrolling.
• Check the formulary: If you take prescription medications, verify they are on the plan’s drug formulary at a reasonable tier before choosing the plan.
• Family coverage: Adding a spouse or dependents significantly increases premiums. Compare adding them to your employer plan vs. their own employer plan (if available) vs. the ACA marketplace.

3. ACA marketplace (healthcare.gov)

The ACA marketplace serves self-employed workers, people without employer coverage, and those who lost employer coverage. The marketplace at healthcare.gov (or your state’s own exchange) offers plans from private insurers in metal tiers: Bronze, Silver, Gold, and Platinum.

Open enrollment runs November 1 through January 15. If you enroll by December 15, coverage starts January 1. Enroll December 16–January 15, coverage starts February 1.

Outside open enrollment, you need a qualifying life event (Special Enrollment Period):

• Losing job-based coverage (you have 60 days from the date of loss)
• Getting married or divorced
• Having a baby, adopting a child, or gaining a dependent
• Moving to a new coverage area (new zip code with different plan options)
• Turning 26 and losing coverage under a parent’s plan
• Income change that makes you newly eligible for subsidies

Premium tax credits (subsidies) reduce your monthly premium. You may qualify if your household income is between 100% and 400% of the federal poverty level—and, under current enhanced subsidy rules, even above 400% FPL if the benchmark plan costs more than 8.5% of your income. The 2026 FPL benchmarks for key household sizes:

Cost-Sharing Reductions (CSR): If your income is 100–250% FPL, and you enroll in a Silver plan, you receive additional cost-sharing reductions that significantly lower your deductible, copays, and out-of-pocket maximum. At 200% FPL, your silver plan may have a deductible as low as $300 and an out-of-pocket max under $2,900—essentially platinum-level benefits at a silver price. This is the most underutilized benefit in the ACA.

How to apply on healthcare.gov:

1. Create an account at healthcare.gov (or your state exchange if applicable).
2. Enter your household size, location (zip code), and estimated annual income.
3. Review your subsidy and Medicaid eligibility determination.
4. Compare plans by premium, deductible, out-of-pocket max, network, and formulary.
5. Select a plan and confirm enrollment. You’ll receive an invoice from the insurer to pay your first premium.

4. Medicaid

Medicaid is the federal-state health insurance program for people with low income. Unlike the ACA marketplace, Medicaid has no enrollment windows—you can apply any time of year and coverage begins the month you apply (or the month of eligibility).

In the 40 states that have expanded Medicaid under the ACA, adults with income up to 138% FPL qualify. In the 10 non-expansion states, eligibility is more restricted (primarily to families with children, pregnant women, and people with disabilities). If you are below 138% FPL in an expansion state, Medicaid is almost certainly your best option: $0 premium, very low or no cost-sharing, comprehensive coverage.

Apply at healthcare.gov or directly through your state Medicaid agency. The application takes 10–15 minutes. You’ll need to provide income documentation (recent pay stubs or tax return), Social Security numbers, and immigration status for each household member.

5. Medicare

Medicare is the federal health program for Americans age 65 and older, and for certain people under 65 with disabilities, end-stage renal disease, or ALS. It has four parts:

• Part A (Hospital Insurance): Covers inpatient hospital stays, skilled nursing facility care, hospice. Most people pay $0 premium if they or a spouse worked 40+ quarters paying Medicare taxes.
• Part B (Medical Insurance): Covers outpatient services, doctor visits, preventive care. Standard 2026 premium: $185/month.
• Part C (Medicare Advantage): Private insurance plans that bundle Part A and B, often with drug coverage. May offer lower cost-sharing and extra benefits.
• Part D (Prescription Drug Coverage): Standalone drug plans or included with Medicare Advantage.

If you are approaching 65 and still on employer coverage, you have an 8-month Special Enrollment Period after you or your spouse retires to enroll in Medicare without a late enrollment penalty.

6. CHIP

The Children’s Health Insurance Program covers uninsured children under age 19 in families with income too high for Medicaid but who still cannot afford private insurance. Income limits vary by state but generally reach 200–300% FPL. Like Medicaid, there is no enrollment deadline for CHIP. Apply through healthcare.gov or your state CHIP agency.

7. Other options: COBRA, student, and military

COBRA: When you leave a job (voluntarily or involuntarily) at a company with 20+ employees, you can continue your employer’s health coverage for up to 18 months (36 months in some cases). You pay the full premium—both your share and your employer’s share—plus a 2% administrative fee. Average cost: ~$600/month for individuals, ~$1,700/month for families. COBRA is rarely the cheapest option; compare it to marketplace plans with subsidies first. You have 60 days from the date of coverage loss to elect COBRA.

Student health plans: Most colleges and universities offer student health insurance. Coverage varies widely—some plans are comprehensive, others are very limited. Compare the school plan to marketplace options at your school’s zip code before automatically enrolling.

Military and VA: Active duty service members are covered by TRICARE. Veterans may qualify for VA health care based on service history and income. Apply at va.gov/health-care/apply.

8. How to compare health plans

When comparing plans, look beyond the monthly premium. The five numbers that matter most:

1. Monthly premium: What you pay every month regardless of whether you use healthcare.
2. Annual deductible: What you pay before insurance kicks in. A $7,000 deductible plan with a $200 premium may cost more than a $3,000 deductible plan with a $350 premium if you use medical care.
3. Out-of-pocket maximum: The most you can owe in a plan year for in-network covered services. After this point, insurance pays 100%. The 2026 ACA maximum is $9,450 for individuals.
4. Network: Are your current doctors and preferred hospitals in-network? Call the provider’s office directly—online directories are often out of date.
5. Formulary: If you take ongoing medications, check whether they are covered and at what cost-sharing tier on each plan you’re considering.

Frequently asked questions

Sources

• Healthcare.gov: ACA Marketplace Plan Finder and Enrollment
• KFF: Key Facts About the Uninsured Population
• CMS: ACA Marketplace Enrollment Fact Sheets
• Medicaid.gov: Eligibility and Enrollment
• Medicare.gov: Getting Started with Medicare
• Department of Labor: COBRA Continuation Coverage
• KFF: 2026 Employer Health Benefits Survey