Health Insurance When Settling in the US in 2026: Comprehensive Financial Protection Solution

Settling in the United States opens up many new opportunities, but it also presents significant challenges in ensuring health security for your family. With healthcare costs ranking among the highest in the world and policy changes in 2026, understanding health insurance has become a key factor helping immigrants protect their finances and access quality healthcare services. This article from Newland USA provides a comprehensive guide on health insurance for US settlement, helping you make informed decisions for your future.

1. Why is health insurance a top priority when settling in the US?

The US healthcare system is highly regarded for its service quality and advanced technology, however, treatment costs are also extremely expensive. A routine doctor’s visit can cost between $250 to $350, while treating a heart attack can cost up to $25,000 or more. For new settlers, not having health insurance means facing an enormous financial burden when unexpected health issues arise.

Health insurance in the US is not just a financial protection tool but also an important factor in the integration process. Having insurance helps settlers access preventive healthcare services, regular health checkups, and timely treatment when needed. Especially in the context of epidemics and health issues that can arise at any time, health insurance becomes an essential “shield” for every immigrant family.

The year 2026 marks important changes in health insurance policies for US settlement, directly affecting the benefits and costs for immigrants. Understanding the new regulations and how they impact different groups will help you plan your finances appropriately and ensure safety for your family.

2. Overview of the US health insurance system

The health insurance system in the US operates on a complex model with many layers and different providers. Unlike many countries with a unified national health system, the US combines both government-managed programs and private insurance packages. This diversity provides many choices but also requires participants to clearly understand their rights and obligations.

For settlers, grasping how the US health insurance system works is an important first step. This system is based on the principle of cost-sharing between participants and service providers. When you have health insurance, you will pay a monthly insurance premium, and when using healthcare services, you only need to pay part of the cost through copayment, coinsurance, or deductible.

Health insurance costs in the US in 2026 are expected to increase higher than previous years due to many factors. The maximum deductible for individual insurance increased to $10,600 (up from $9,200 in 2025), while family insurance has a maximum of $21,200 (up from $18,400). This approximately 15.2% increase poses financial challenges for many families, especially new settlers who are in the process of stabilizing their lives.

Understanding important terms in health insurance helps you compare and choose a suitable insurance plan. Premium is the monthly fee you pay to maintain insurance, whether you use healthcare services or not. Deductible is the amount you must pay out-of-pocket before the insurance company starts paying their share. Copayment is the fixed fee you pay for each doctor’s visit or prescription. Coinsurance is the percentage of healthcare service costs that you must contribute after meeting the deductible.

3. Types of health insurance in the US for settlers

3.1. Insurance through Affordable Care Act (ACA) Marketplace

The ACA Marketplace, also known as the Health Insurance Marketplace, is a platform operated by the federal government helping people search for and compare types of health insurance in the US. This is a popular choice for self-employed people, the unemployed, or those not provided insurance by their employer. The Marketplace offers insurance plans categorized into four metal levels: Bronze, Silver, Gold, and Platinum, helping participants easily assess the balance between monthly premiums and costs when using services.

Health insurance through the Marketplace is particularly attractive because it provides financial assistance to those who qualify. Premium Tax Credit helps reduce monthly insurance premiums, while Cost-Sharing Reductions lower copayments, coinsurance, and deductibles. However, 2026 witnesses significant changes affecting access to these subsidies.

Bronze plans typically have the lowest premiums but high deductibles, suitable for healthy young people who rarely use healthcare services. Starting in 2026, all Bronze and Catastrophic plans are compatible with Health Savings Accounts (HSA), allowing you to save pre-tax money to pay for healthcare costs. Silver plans provide a balance between premiums and costs when using services, and are the only plans that can receive cost-sharing reductions if your income falls within the specified threshold.

Gold plans have higher premiums but lower costs when using services, suitable for those who frequently visit doctors or need regular treatment. Research shows that in 2026, Gold plans often provide better value than Bronze plans, with total costs sometimes even lower than or equivalent to Silver plans but offering more benefits. Platinum plans have the highest premiums but the lowest costs when using services, suitable for people with frequent healthcare needs or chronic illnesses.

3.2. Medicare – Federal health insurance for the elderly

Medicare is a federal health insurance program for people 65 and older, people with disabilities, and people with end-stage illnesses. This program is divided into four parts with different benefits, creating an important health insurance system in the US for the elderly.

Medicare Part A (Hospital Insurance) covers hospitalization costs, care at skilled nursing facilities, home healthcare, and hospice care. Most eligible people do not have to pay premiums for Part A if they or their spouse have paid Medicare taxes for at least 10 years of work. Medicare Part B (Medical Insurance) pays for doctor visits, outpatient care, medical equipment, and preventive services. In 2026, the standard Part B premium is $202.90 per month.

Medicare Part C (Medicare Advantage) are private insurance plans approved by the government, providing all benefits of Part A and Part B, often including additional benefits such as dental, vision, and hearing. In 2026, approximately 67% of Medicare Advantage plans with drug coverage (MA-PD) do not charge additional premiums beyond the Part B premium. Medicare Part D (Prescription Drug Coverage) helps pay for prescription drug costs, with a maximum out-of-pocket cost in 2026 of $2,100 per year.

Medicare health insurance in 2026 has notable changes. Negotiated drug prices for 10 high-cost drugs took effect at the beginning of the year, helping save an estimated $1.5 billion for participants. Insulin continues to be capped at $35 per month without deductible requirements. Adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) continue to be provided free in Part D.

3.3. Medicaid – Support program for low-income people

Medicaid is a health insurance program operated jointly by the federal government and states, supporting healthcare costs for people with limited income and assets. Unlike Medicare, eligibility for Medicaid varies by state. This is an important part of the system of types of health insurance in the US, especially for low-income families and children.

Medicaid health insurance covers many services that Medicare typically does not pay for, such as long-term nursing home care and personal care services. The Children’s Health Insurance Program (CHIP) provides insurance for children in families with incomes too high to qualify for Medicaid.

In 2026, Medicaid policy has significant adjustments. Starting October 1, 2026, only certain groups of immigrants will be eligible for federally funded Medicaid/CHIP assistance, including: lawful permanent residents (after completing the 5-year waiting period), people from Compact of Free Association (COFA) countries residing in the US, and Cuban/Haitian immigrants.

Some states may continue to provide health insurance for children and pregnant women lawfully residing under the Immigrant Children’s Health Improvement Act (ICHIA). As of April 2025, 38 states have adopted the ICHIA option for children in Medicaid. This creates diversity in access to health insurance for US settlement depending on the state of residence.

3.4. Health insurance through employers

Health insurance provided by employers is the most common form in the US, covering over 50% of the population. Companies typically pay part or all of insurance premiums for employees and their families. This is usually the most economical choice because employers contribute significantly to costs, and group insurance plans often have better terms than individual insurance.

When settling in the US and finding employment, immigrants are typically offered health insurance by employers during annual Open Enrollment or within 60 days from the start date. Insurance plans through employers usually include many options with different premium levels and benefits, allowing employees to choose plans suitable for their family’s needs.

Some employers apply the Individual Coverage Health Reimbursement Arrangement (ICHRA) model, allowing employees to choose their own individual health insurance plans in the US and receive reimbursement from the company. In 2026, this model is increasingly popular due to its flexibility and better cost management capability for small businesses. For small businesses, ICHRA allows them to provide health benefits to employees without managing complex insurance plans.

Employees with insurance through employers can still buy health insurance through the Marketplace if they want, but typically will not qualify for financial assistance unless the employer’s insurance plan is not considered “affordable” (costing more than 9.12% of annual household income) or does not meet the “minimum value” standard according to Affordable Care Act regulations.

3.5. Private health insurance purchased directly

Types of health insurance in the US also include private insurance plans purchased directly from insurance companies, agents, or brokers without going through the Marketplace. These plans do not qualify for government financial assistance and may not include all essential benefits like Marketplace plans. However, they may be suitable for some people due to flexibility in benefit design.

In 2026, the off-exchange insurance market is increasingly attracting attention as a flexible and potentially cost-saving alternative. For those who do not qualify for subsidies, insurance plans sold directly by insurance companies may provide better value. Top insurance providers in 2026 include Blue Cross Blue Shield, UnitedHealthcare, Aetna, Cigna, Ambetter, and Oscar.

Health insurance for new immigrants also includes travel and transition insurance plans (immigrant insurance plans), suitable for newcomers and permanent residents. These plans typically range from a few months to two years, covering doctor visits, hospitalization, urgent care, and emergency care. Travel medical insurance costs for visitors to the US in 2026 range from $19 to $172 per month, depending on age and coverage scope.

4. Important changes in health insurance policy in 2026

4.1. Changes affecting immigrants

The year 2026 marks significant changes in health insurance policies for US settlement due to the “One Big Beautiful Bill” Act (H.R. 1). Starting January 1, 2026, lawfully residing immigrants with income below 100% of the federal poverty level will no longer be eligible for premium tax credits if they do not qualify for Medicaid due to immigration status (including lawful permanent residents and others during the 5-year waiting period for Medicaid).

This creates a “coverage gap” for lawfully residing immigrants with low incomes. An estimated 300,000 people will become uninsured due to this change. For people in this situation, they can still buy health insurance through the Marketplace but must pay the full cost without financial assistance, making insurance much more difficult to access.

These changes are estimated to increase the number of uninsured by 900,000 people. For families immigrating through the EB-3 program, understanding these changes is important for appropriate financial planning. Green card holders still retain health insurance benefits, but must complete the 5-year waiting period before qualifying for Medicaid in most states.

4.2. Enrollment periods and deadlines

Open Enrollment for health insurance in 2026 took place from November 1, 2025 to January 15, 2026 in most states. However, an important change is that starting fall 2026, the open enrollment period will be shortened, ending on December 15 instead of extending to mid-January as before. States operating their own exchanges may extend the deadline to December 31.

If you enroll from December 1-15, 2025, your insurance will start January 1, 2026. If you enroll from December 16, 2025 to January 15, 2026, insurance will start February 1, 2026. Missing the open enrollment deadline may require you to wait until the next enrollment season, unless you have qualifying life events such as getting married, having a baby, losing current insurance, or moving to a new state.

4.3. Increasing health insurance costs

Health insurance costs in the US in 2026 are increasing significantly nationwide. Average premiums increased about 11%, but increases vary significantly by geographic region. Some areas like Providence, Rhode Island witnessed Bronze plan premiums increase 28% (from $266 to $340 per month), while Gold plans increased 41% (from $369 to $521). In Wichita, Kansas, Gold plans soared 68.3% (from $451 to $759 per month).

This increase is partly due to the termination of enhanced premium tax credits, applied since 2021 to help millions of Americans pay for health insurance. These subsidies are expected to expire on December 31, 2025, unless Congress acts to extend them. If not extended, the number of Marketplace enrollees is predicted to decrease from 22.8 million people in 2025 to 18.9 million people in 2026.

Seniors aged 60-64 are most heavily affected, with premium increases 25-35% higher than the national average.

On the provider side, some large insurance companies like Blue Cross/Blue Shield and UnitedHealthcare increased premiums 20-30%, while regional companies like Ambetter, Oscar, Molina, and Kaiser typically offer premiums 10-20% lower than large corporations. Aetna has withdrawn from the ACA market, reducing the number of choices for consumers in some areas.

5. Choosing suitable health insurance when settling in the US

5.1. Assessing needs and financial capability

Choosing suitable health insurance for US settlement requires careful consideration of family health needs and financial capability. First, assess the current health status of you and family members. If you or loved ones have chronic illnesses requiring frequent treatment, health insurance plans with lower deductibles and more comprehensive coverage (like Gold or Platinum) may save costs in the long run despite higher monthly premiums.

Estimate total expected healthcare costs for the year, including regular checkups, prescription medications, and anticipated treatments. Add monthly premiums to the maximum out-of-pocket cost to determine total possible costs in the worst-case scenario. In 2026, the maximum out-of-pocket cost for individual insurance is $10,600 and for families is $21,200.

Check whether your preferred doctors and hospitals are in the provider network of the health insurance plan in the US you are considering. Using out-of-network services typically costs much more or is not covered by insurance. The 2026 Medicare Plan Finder tool for the first time includes information about which doctors and providers are included in Medicare Advantage plan networks, making comparison easier.

5.2. Comparing insurance plans

When comparing types of health insurance in the US, don’t just focus on monthly premiums. Consider the entire cost picture, including deductible, copayment, coinsurance. A plan with low premiums but high deductibles may be more expensive if you need to use healthcare services frequently.

In 2026, a smart strategy is to skip Silver plans entirely if you don’t qualify for cost-sharing reductions. Instead, compare the cheapest Bronze plan with the best-value Gold plan to determine which suits your health situation and budget. In many areas, Gold plans provide better value with lower or equivalent total costs to Silver plans but higher benefits.

For families with children, ensure health insurance includes comprehensive pediatric services, regular health checkups, and vaccinations. For seniors, pay attention to prescription drug coverage, especially if you’re taking expensive medications. In 2026, negotiated drug prices for 10 high-cost drugs in Medicare can save significantly for beneficiaries.

Use online tools to compare insurance plans. HealthCare.gov provides a “Browse plans & costs” tool allowing you to preview and compare plans side by side. Enter your ZIP code and household income information to receive premium estimates. Some states like Texas also provide plan comparison tools through state insurance platforms.

5.3. Leveraging available support and resources

If you need help understanding health insurance options, contact the Department of Insurance in your state. They can help you find licensed agents or certified assisters who can review your options. HealthCare.gov provides online resources and connects you with “Navigators” or assistance staff, providing free help, in-person or virtual, with shopping for insurance plans and enrollment.

Community Health Centers provide healthcare services based on your income, even if you don’t have health insurance. They provide care services like dental, mental health, and prescription medications. If you don’t qualify for insurance through the Marketplace, these centers are very important.

For new immigrants, non-profit organizations and community organizations often introduce and explain the health insurance system in the US. They can help explain terms, compare insurance plans, and assist with the enrollment process in native languages. FindHelp.org is a useful resource for identifying community organizations that can help.

5.6. Special cases for new settlers

Lawful permanent residents (green card holders) during the 5-year waiting period for Medicaid but with income below 100% of the federal poverty level will face special challenges in 2026. They cannot receive premium tax credits on the Marketplace and don’t qualify for Medicaid. In this case, health insurance for immigrants (immigrant insurance plans) may be a temporary option until completing the waiting period.

These plans typically include necessary coverage for doctor visits, hospitalization, and emergency care, although they may have waiting periods for pre-existing conditions and don’t include comprehensive preventive care. However, they provide essential health and financial protection during the initial phase of settling in the US.

Green card holders permanently residing in the US qualify for domestic health insurance plans, depending on residence time. Those under 65 may qualify for plans like Blue Cross or Blue Shield, typically after 6 months or more of residence. It’s important to buy temporary health insurance for US settlement until green card holders qualify for domestic insurance plans.

6. Important notes about health insurance for settlers

6.1. Waiting periods and limits

Most domestic health insurance plans in the US, including Medicare and Medicaid, have a 5-year waiting period for green card holders.

During this waiting period, you can still buy health insurance in the US through the Marketplace or through employers. Maintaining continuous insurance is important because healthcare costs can quickly deplete your finances if an emergency occurs. A simple doctor’s visit can cost $250 to $350, while a heart attack can cost at least $25,000.

6.2. Emergency care for uninsured people

Under the Emergency Medical Treatment and Labor Act (EMTALA), hospitals participating in Medicare must provide screening and stabilization services to anyone entering their emergency room, regardless of insurance status. The federal government provides Medicaid funding to reimburse hospitals for part of the cost of providing emergency care to those not eligible for Medicaid due to immigration status.

However, under H.R. 1, funding for this is being cut in states that have expanded Medicaid. Emergency Medicaid will be provided at the state’s regular matching rate, instead of the enhanced ACA 90% Medicaid expansion matching rate, starting October 2026. This may affect access to emergency care for immigrants without health insurance.

7. Conclusion

Health insurance is a crucial foundation for stable and successful life in the US. With high healthcare costs and complex policy changes in 2026, clearly understanding types of health insurance in the US and choosing plans suitable for personal situations is essential. Settlers through programs like EB-3 need to plan finances carefully, accounting for health insurance costs and changes that may affect their access.

Although the health insurance landscape in the US in 2026 is challenging with rising costs and restrictions for some immigrant groups, there are still many options available. Thorough research, comparing insurance plans, and leveraging available support resources will help you find the most suitable health insurance solution for US settlement for your family.

Newland USA, with an experienced team of experts and the motto “Stable settlement – Lifelong prosperity,” is ready to advise and support in preparing documents and accompany you throughout the EB-3 US immigration process. Contact Newland USA immediately via hotline 0785591988 or email: newsletter@newlandusa.asia for detailed and free consultation.

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