Medical Expense, Group, and Government-Sponsored Health Coverage
Individual and consumer-driven plans
Individual medical may be comprehensive major medical or a high-deductible health plan paired with a health savings account: tax-deductible contributions, tax-free growth, and tax-free qualified withdrawals, available only with a qualifying HDHP. Flexible spending accounts and health reimbursement arrangements are employer-funded or employee-funded companions.
Group health
Group underwriting looks at the group as a whole; eligibility and open enrollment rules prevent individual selection. The employer often contributes part of the premium, and coverage is typically cheaper per person than individual insurance. COBRA allows continuation after a qualifying event: 18 months for termination or reduced hours, up to 29 months if disability applies, and 36 months for dependents after death, divorce, or loss of dependent status. Conversion allows an individual policy when group coverage ends. HIPAA limits pre-existing condition exclusions for those with prior creditable coverage (group context).
Government programs
Medicare: Part A hospital insurance (premium-free for most, based on work history), Part B medical insurance (premium, income-related), Part C Medicare Advantage (private plans providing Part A and B benefits, often with Part D), Part D outpatient prescription drug coverage. Enrollment windows and late-enrollment penalties matter. Medigap policies are standardized (Plans A, B, C, D, F, G, K, L, M, N in most states; Plans C and F unavailable to those newly eligible after January 1, 2020), sold with a six-month open enrollment and guaranteed issue, and cannot include drug coverage. Medicaid is income-based joint federal-state coverage; CHIP covers children; TRICARE and VA cover military populations.
Trap: assuming Medigap covers prescriptions or that Medicare Part A charges everyone a premium. Rule of thumb: COBRA 18/29/36 months; Medicare open enrollment six months at age 65 for Medigap.