How to Get Health Insurance in the US? Turkish Guide

In the United States, health insurance does not operate through a single public system like it does in Turkey. While employees can be covered through their employers, individuals who wish to purchase insurance can compare plans via the Health Insurance Marketplace under the Affordable Care Act (ACA). Depending on income and family status, Medicaid or CHIP for children are also options.

Insurance Can Be Purchased Through the Marketplace

The most important application point for those seeking individual health insuranceHealthCare.govoperated by the federal Marketplace. Residents of the United States, U.S. citizens or non‑citizens with legal status, and those not incarcerated can apply for plans under the Marketplace. In some states, applications are made through the state’s own Marketplace system.

Important Dates for 2026!

The Marketplace Open Enrollment period for the 2026 plan year ran from November 1, 2025 to January 15, 2026. In the annual calendar, selections made up to December 15, subject to payment of the first premium, are tied to coverage beginning January 1; selections made between December 16 and January 15 are linked to coverage starting February 1.

Is it possible to get insurance right now?

As of August 24, 2026, the annual Open Enrollment period is closed. However, certain life events such as marriage, having a child, adoption, moving, or losing existing health insurance can trigger a Special Enrollment Period. In most cases, a 60‑day window before or after the event is considered for applications during this period.

Medicaid and CHIP alternatives

For low‑income individuals, Medicaid, and for children, Medicaid or CHIP are among the key options. Applications for these programs can be submitted year‑round. Medicaid eligibility varies by state and by factors such as income, age, pregnancy, and disability. CHIP is a program for children whose families earn too much to qualify for Medicaid but struggle to afford private health insurance.

Income changes insurance costs...

The premium that applicants who apply through the marketplace will pay is tied not only to the selected plan but also to household income and family size. The tax credit known as the Premium Tax Credit reduces the monthly premium for eligible individuals. HealthCare.gov notes that the savings eligibility for individuals in 2026 may cause plan prices to vary according to income, and that the exact amount can be viewed during the application process.

What will the average bonus be in 2026?

According to CMS data, the average monthly premium after tax credits for the lowest‑cost Marketplace plan accessed through HealthCare.gov in 2026 is projected to be $50, which is $13 higher than in 2025. CMS also noted that the tax credit is expected to cover on average 91 % of the lowest‑cost plan premium for eligible individuals. It should be remembered that this amount can vary from person to person and does not apply to all applicants.

Support Rules Changed in 2026

The Marketplace premium subsidies that were expanded in 2021 and 2022 expired at the end of 2025. HealthCare.gov notes that individuals who are eligible for savings in 2026 will again be able to receive a tax credit, but they may face higher premiums than in the prior period. Therefore, in choosing a 2026 plan, one must consider not only the monthly premium but also the total annual cost.

Why Is the Federal Poverty Level Important?

The federal poverty level (FPL) is used to determine marketplace subsidies. According to HealthCare.gov, households with incomes between 100% and 400% of the FPL may qualify for a premium tax credit under certain conditions. In states that have adopted Medicaid expansion, the income limit for adults is generally around 138% of the federal poverty level. However, eligibility rules can vary by state and individual circumstances.

When Choosing a Plan, Don't Look Only at Premiums

In the marketplace, plans are divided into four basic categories: Bronze, Silver, Gold, and Platinum. Bronze plans typically have lower monthly premiums, but the amounts paid when services are used are higher. Silver plans offer intermediate premiums and out‑of‑pocket costs, while Gold and Platinum plans have higher monthly premiums and the insured’s share when services are used is usually lower.

Additional Savings Opportunities with Silver Plans

Some low‑ and middle‑income individuals can also benefit from Cost‑Sharing Reductions in addition to the premium tax credit. This support reduces out‑of‑pocket expenses such as deductibles, copayments, and coinsurance. To take advantage of this benefit, eligible people must choose a Silver plan.

What Should Those with Employer‑Sponsored Insurance Do?

In the United States, many employees obtain health insurance through their employer. The premium and coverage of the plan offered by the employer can be compared with Marketplace options. However, a person's access to an appropriate employer plan and its cost are important in terms of the tax credit that can be obtained through the Marketplace. Therefore, the terms of the employer-provided health insurance must be checked before applying individually.

COBRA Option for Those Who Lose Their Jobs

For people who have employer‑based health insurance and lose their jobs, COBRA can provide a temporary solution. According to the U.S. Department of Labor, under COBRA a person and their family can usually keep the employer‑sponsored group health insurance for up to 18 months. In some cases, this period can extend to 36 months. To elect COBRA, there is typically a 60‑day window from the end of employer coverage or from the election notice.

What Documents Are Required for Insurance?

During a Marketplace application, information such as household members, expected annual income, current health insurance, and residence details is requested. For immigrants, documents demonstrating legal status may also be required. Income estimates are especially important because premium assistance is calculated based on the expected household income for the year of application.

Pay Attention to the Tax Credit

Those who use the premium tax credit in advance to lower monthly premiums throughout the year must keep their income estimates up to date. If the actual income at year‑end turns out to be higher, the portion of the credit that exceeds what they are entitled to can be refunded on the federal tax return. If income falls or the household size increases, a larger credit may become available.

Important Point for Turks

Turkish citizens living in the United States must first assess their immigration status, the state they reside in, their household income, and whether they receive health insurance from their employers. Those who are legally present in the U.S. can qualify for the Marketplace under certain conditions, while Medicaid and CHIP eligibility varies by state.

The Correct Application Path

The official HealthCare.gov website can be used to apply for the Marketplace. After entering household information and estimated income on the site, a person can see which programs and how much assistance they qualify for. In some private plans purchased outside the Marketplace, income‑based premium tax credit is not available.

The Next Open Enrollment Period

Within 2026, the next annual Marketplace Open Enrollment period for individuals who do not have special enrollment rights and are not eligible for Medicaid or CHIP will begin on November 1 and run until January 15. Applications submitted by December 15 will take effect on January 1, while those submitted by January 15 will take effect on February 1. The initial premium must be paid at the time of application.