US Health Insurance (as of 2026; subject to change)
The US has no single public health insurance. Healthcare costs are the highest in the world, and depending on your insurance, out-of-pocket cost for the same treatment can vary by 10× or more. The Korean idea of "I pay my premium and that's it" doesn't apply — sorting out your insurance is the very first thing to do after arrival.
The four main pathways
| Type | Who it's for | How it works | | --- | --- | --- | | Employer-sponsored | Full-time employees and their families | Employer picks the carrier and pays part of the premium | | ACA Marketplace | Self-employed, freelancers, small-employer staff | healthcare.gov or state exchanges; income-based subsidies | | Medicaid | Low-income | State-run; income limits vary by state | | Medicare | 65+, certain disabilities | Federal. Part A (hospital), B (outpatient), C (Advantage), D (drugs) |
About half the population has employer coverage, roughly a quarter is on Medicaid, and around a fifth on Medicare (rough distribution as of 2026; subject to change).
Key terms (you'll see these on every policy)
- Premium: the monthly cost. Family plans of USD 1,500–2,500/month are common.
- Deductible: how much you pay first before insurance starts paying. USD 1,500–8,000.
- Copay: flat fee per visit (USD 30–60).
- Coinsurance: the percentage you owe (commonly 20% you / 80% insurer).
- Out-of-pocket maximum: annual cap on your spending; insurance covers 100% above this (typically about USD 9,200 individual / USD 18,400 family).
- In-network vs. out-of-network: whether the provider has a contract with your insurer. Out-of-network is essentially uncovered.
Common traps for Koreans
- ER bill shock: going to the ER uninsured for a simple issue often runs USD 5,000+. A broken bone or appendix surgery can be USD 30,000–80,000.
- Surprise billing: an in-network hospital can still send a separate huge bill if, e.g., the anesthesiologist there is out-of-network. The 2022 No Surprises Act helps but doesn't cover everything.
- Drug prices: the same medication is 5–20× the Korean price. Discount cards like GoodRx are essential.
- F-1 student insurance: schools usually require their own plan. Generic student plans tend to have weak coverage — go with the school plan.
Eligibility by status
- F-1 students: essentially excluded from Medicaid; school plan or private student plan.
- H-1B and other work visas: employer plan is standard. After job loss, COBRA continues coverage for 18 months but typically costs USD 2,000+/month.
- Permanent residents: eligible for Medicaid and Medicare (with age) after 5 years of residence. Some states (NY, CA, etc.) waive the wait.
- Citizens: all public coverage available.
ACA Marketplace essentials (as of 2026; subject to change)
- Open Enrollment runs roughly November to January each year.
- Households with income between 100% and 400% of the federal poverty line get a Premium Tax Credit subsidy.
- Four metal tiers (Bronze/Silver/Gold/Platinum) — Silver is the basis for subsidy calculations.
- Outside open enrollment, "qualifying life events" (job loss, marriage, birth) trigger Special Enrollment.
Medicare in brief
- You can enroll starting 3 months before your 65th birthday. Auto-enrollment only if already drawing Social Security.
- Part A (hospital) is free with 40 credits; Part B is around USD 185/month (with IRMAA surcharges for high earners).
- Under the US–Korea Totalization Agreement, Korean work periods can be combined to qualify for Part A.
Useful links
- healthcare.gov — ACA marketplace
- medicare.gov — Medicare enrollment and plan comparison
- medicaid.gov — Medicaid information by state
- ssa.gov/medicare — interaction with Social Security