Quick answer
Government health insurance in the U.S. includes Medicare for people 65 and older and some people with disabilities, Medicaid and CHIP for people with low incomes and children, military and veterans’ coverage through TRICARE and the VA, and care for American Indians and Alaska Natives through the Indian Health Service. The government also subsidizes private marketplace plans through premium tax credits.
Key takeaways
- In 2025, 20.1% of people had Medicare and 17.1% had Medicaid at some point during the year.
- Medicare starts at 65, or earlier after 24 months of disability benefits or with ALS or kidney failure.
- Medicaid covers adults up to 138% of the poverty level in 41 states including DC. Many of those adults will face new work requirements starting in 2027.
- Most people get Medicare Part A without a premium; Part B costs $202.90 a month in 2026.
- New Medicaid work requirements begin in most expansion states in 2027.
On this page
The main government programs
| Program | Who it covers | What it costs |
|---|---|---|
| Medicare | People 65 and older, and some younger people with disabilities, ALS or kidney failure | Part A is usually premium-free; Part B is $202.90 a month in 2026 |
| Medicaid | Adults and families with low incomes, pregnant people, people with disabilities, and many seniors in nursing homes | Free or nearly free |
| CHIP | Children in families that earn too much for Medicaid | Low premiums and copays |
| TRICARE | Active-duty and retired military members and their families | Varies by plan and status |
| VA health care | Eligible veterans | Often free or low cost, depending on eligibility |
| Indian Health Service | Members of federally recognized tribes | No cost for eligible services |
Medicare
Medicare has four parts: Part A for hospital care, Part B for doctor visits and outpatient care, Part C (Medicare Advantage) for private plans that combine A and B, and Part D for prescription drugs. Most people pay no premium for Part A because they or a spouse worked and paid Medicare taxes for about 10 years. Others can buy it for $311 or $565 a month in 2026. See who is eligible for Medicare and health insurance for the elderly.
President Lyndon B. Johnson signed Medicare and Medicaid into law in 1965, and former President Harry S. Truman received the first Medicare card.
Medicaid and CHIP
Medicaid is run by states within federal rules, so eligibility varies. In the 41 states (including DC) that expanded Medicaid, adults can qualify with incomes up to 138% of the poverty level. Children qualify at higher incomes through Medicaid or CHIP, up to 255% of the poverty level in the median state. See health insurance for low-income families and health insurance for children.
Under the 2025 tax and spending law, most expansion states must require many adults ages 19 to 64 to show 80 hours a month of work, school or volunteering starting in 2027, and to renew coverage every six months.
Help paying for private coverage
The government also helps people buy private insurance. Premium tax credits lower marketplace premiums for people with household incomes between 100% and 400% of the poverty level. See what Obamacare is.
Before Medicare: retiring early
If you retire before 65, you’re not eligible for Medicare yet. Your options include retiree coverage, COBRA, a spouse’s plan, or a marketplace plan with a tax credit based on your retirement income. See can I get health insurance if I retire early.
Is the U.S. system universal?
No. Government programs cover many people, but not everyone. For how other countries do it, see universal health insurance.
Not eligible for a government program? Compare private plans by ZIP code.
Frequently asked questions
Who qualifies for government health insurance?
People 65 and older and some people with disabilities (Medicare), people with low incomes and many children (Medicaid and CHIP), military members and veterans (TRICARE and VA), and American Indians and Alaska Natives (Indian Health Service).
Is Medicare free?
Part A is usually free. Part B has a monthly premium, $202.90 in 2026, and you pay deductibles and coinsurance unless you have extra coverage.
Can I have Medicare and Medicaid at the same time?
Yes. People who qualify for both are called dual eligibles, and Medicaid can help pay Medicare premiums and costs.
Sources
- CMS: 2026 Medicare Parts A and B premiums and deductibles
- Medicaid.gov: Eligibility
- Medicaid.gov: CHIP eligibility and enrollment
- KFF: Status of state Medicaid expansion decisions
- U.S. Census Bureau: Health insurance coverage in the United States, 2025
- healthinsurance.org: How the One Big Beautiful Bill Act changes health coverage
This article is general information, not legal or insurance advice. Eligibility rules vary by state and program. Last reviewed September 2026.