What is the most common type of private insurance?

Introduction

This report presents statistics on health insurance coverage in the United States based on information collected in the Current Population Survey Annual Social and Economic Supplement (CPS ASEC).

Highlights

• In 2020, 8.6 percent of people, or 28.0 million, did not have health insurance at any point during the year.
• The percentage of people with health insurance coverage for all or part of 2020 was 91.4.
• In 2020, private health insurance coverage continued to be more prevalent than public coverage at 66.5 percent and 34.8 percent, respectively. Of the subtypes of health insurance coverage, employment-based insurance was the most common, covering 54.4 percent of the population for some or all of the calendar year, followed by Medicare (18.4 percent), Medicaid (17.8 percent), direct-purchase coverage (10.5 percent), TRICARE (2.8 percent), and Department of Veterans Affairs (VA) or Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) coverage (0.9 percent).
• Between 2018 and 2020, the rate of private health insurance coverage decreased by 0.8 percentage points to 66.5 percent, driven by a 0.7 percentage-point decline in employment-based coverage to 54.4 percent.
• Between 2018 and 2020, the rate of public health insurance coverage increased by 0.4 percentage points to 34.8 percent.
• In 2020, 87.0 percent of full-time, year-round workers had private insurance coverage, up from 85.1 percent in 2018. In contrast, those who worked less than full-time, year-round were less likely to be covered by private insurance in 2020 than in 2018 (68.5 percent in 2018 and 66.7 percent in 2020).
• More children under the age of 19 in poverty were uninsured in 2020 than in 2018. Uninsured rates for children under the age of 19 in poverty rose 1.6 percentage points to 9.3 percent.

There are different types of Marketplace health insurance plans designed to meet different needs. Some types of plans restrict your provider choices or encourage you to get care from the plan’s network of doctors, hospitals, pharmacies, and other medical service providers. Others pay a greater share of costs for providers outside the plan’s network.

Types of Marketplace plans

Depending on how many plans are offered in your area, you may find plans of all or any of these types at each metal level – Bronze, Silver, Gold, and Platinum.

Some examples of plan types you’ll find in the Marketplace:

• Exclusive Provider Organization (EPO): A managed care plan where services are covered only if you use doctors, specialists, or hospitals in the plan’s network (except in an emergency).

• Health Maintenance Organization (HMO): A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won't cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage. HMOs often provide integrated care and focus on prevention and wellness.

• Point of Service (POS): A type of plan where you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network. POS plans require you to get a referral from your primary care doctor in order to see a specialist.

• Preferred Provider Organization (PPO): A type of health plan where you pay less if you use providers in the plan’s network. You can use doctors, hospitals, and providers outside of the network without a referral for an additional cost.

Get more information on what you should know about provider networks (PDF).

Need dental coverage? Visit our Dental coverage in the Marketplace page to learn more about options available to you.

Where do people get private insurance?

Most people get private insurance through their employers. When employers buy insurance for their employees, it is less expensive because the risk of high healthcare costs can be spread out among a large group of people. If people are self-employed, retired or work for a small company, they can buy private insurance on their own, but it is usually more expensive.

What do you do if your employer doesn't offer health insurance? Watch a video.

Module 2: Insurance

Health Insurance Payers and Plans

Healthcare costs are paid for by private payers or public payers. Private payers are insurance companies and public payers are federal or state governments.

Private Payers

A private payer is a private insurance company. There are many private insurance companies in the U.S. Each company offers different types of plans that must meet or exceed basic standards set by the state and federal government.

What are the different types of private health insurance?

Health insurance plans can vary. Generally, lower cost healthcare plans give patients fewer choices in doctors and hospitals. Lower cost plans may also make it more difficult for patients to see a specialist. Types of health plans include:

• Health Maintenance Organization (HMO)
• Preferred Provider Organization (PPO)
• Point of Service (POS)
• Fee for Service (FFS)
• High Deductible Health Plan

What is an important difference between insurance plans? Specialists.

Some insurance plans allow patients to see a specialist anytime. For example, if a patient has a rash they can go directly to a dermatologist. If they have an allergy, they can go directly to an allergist. Other insurance plans require patients to see their primary care doctor first, and then get a "referral" to see a specialist.

What are the trends for types of private insurance?

The chart below shows trends for private health plans. In 1988, conventional insurance was widely used. Now, the most common type of private insurance plan is a PPO. This change is because managed care programs are less expensive.

Source

What is the most common private health insurance?

What is the most common insurance type?

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