How do you choose health insurance in the United States in 2026?

If you start a US job that offers benefits, ask Human Resources about open enrollment and the new-hire enrollment window. Many employers let you elect medical coverage within a short period after your start date, then again once a year. Compare the Summary of Benefits and Coverage for each option: premium, deductible, network, and out-of-pocket maximum. Employer plans often beat shopping alone, but the employer share varies widely by company and state.

If you do not have job-based coverage, use the Health Insurance Marketplace. In most states you apply on Healthcare.gov. Some states run their own exchange with the same Affordable Care Act (ACA) rules. Marketplace Open Enrollment usually runs from early November into mid-January for the following plan year. Outside that window, you need a Special Enrollment Period after a qualifying life event such as losing other coverage, moving to a new coverage area, marriage, or birth of a child. Healthcare.gov generally gives you about 60 days from the event to act.

Medicaid and CHIP are separate public programs. Eligibility depends on household income, household size, immigration category, and state rules. You can usually apply any time of year, including through the Marketplace application, which screens for Medicaid and CHIP. Do not assume every visa type qualifies.

Start with whether doctors and hospitals you need are in network. Then compare deductible and out-of-pocket maximum, not only the monthly premium. A cheap premium with a high deductible can cost more if you need care early. Check prescription tiers and whether your medicines need prior authorization.

Premium tax credits on the Marketplace can lower the monthly bill based on household income. You estimate income for the coverage year when you apply. Keep a Social Security number (SSN) or Individual Taxpayer Identification Number (ITIN) path ready if the application asks for a tax ID, and keep a US bank account handy for premium autopay once you enroll.

COBRA (Consolidated Omnibus Budget Reconciliation Act) lets some people keep a former employer's group plan for a limited time after job loss or certain other events. You usually pay the full premium plus an administrative fee. Treat COBRA as a bridge while you check Marketplace Special Enrollment or a new employer's plan, not as your default long-term choice.

Confirm whether your employer is offering coverage and the exact deadline to elect it. If not, create a Healthcare.gov (or state exchange) account and check whether you qualify for a Special Enrollment Period after arrival or loss of prior coverage. If income looks low for your state, complete the Medicaid and CHIP screening in the same application.

Save plan documents, member ID cards, and the first premium receipt. Update your address with the insurer when you move between cities or states, because plan networks and Marketplace options are local.