Who actually provides your health coverage?
Most people get health coverage from a private insurance company, not from the government. That’s true for job-based plans and for plans sold on the Health Insurance Marketplace (HealthCare.gov or your state’s Marketplace).
Here’s how the pieces fit together:
- Insurance companies create the plans, set the provider networks, and pay claims for covered care.
- The Marketplace is the shopping and enrollment system. It checks whether you qualify for savings and lets you compare plans from different companies in your area.
- The government runs the Marketplace, sets consumer protections, and pays the premium tax credit that lowers your monthly premium if you qualify. It doesn’t run or provide the health plans you choose there.
- Medicaid and CHIP are government programs run by each state. Original Medicare is a federal program, while Medicare Advantage, Part D and Medigap plans are offered by private companies.
Because every plan is a little different, two plans with the same metal level can work very differently for you. That’s where help from a person can make a real difference.
What “Obamacare” means
“Obamacare” is a nickname for the Affordable Care Act (ACA), the 2010 federal law that created the Health Insurance Marketplace and its consumer protections. It isn’t a government plan or an insurance company. We use the name only for ACA-compliant plans, because many people know them by that name. ObamaCare-Enroll.org is run by Health Enrollment, a private, licensed insurance agency. We’re not the government or HealthCare.gov, and this site doesn’t enroll you in anything by itself. We offer ACA plans from the insurance companies we work with, but not every plan in your area.
How a licensed agent helps
A licensed health insurance agent or broker is trained and licensed by your state to sell health insurance. When you work with us, an agent can:
- Review your options with you. We compare plans from the insurance companies we work with in your area and explain the differences in plain language.
- Check your doctors and prescriptions. We look at whether your doctors and hospitals are in a plan’s network and how your medications are covered.
- Explain how the costs work. Premiums, deductibles, copays, coinsurance and out-of-pocket limits all affect what you actually pay. We’ll walk through examples for how you use care.
- Check your savings. We can help you see whether you may qualify for a premium tax credit, lower costs on a Silver plan, or Medicaid or CHIP.
- Help you enroll and follow up. We help you complete the application, pick a plan and understand next steps, like paying your first premium.
- Help when life changes. If you move, marry, have a baby or lose other coverage, we can help you understand a Special Enrollment Period.
Agents can only sell plans from insurance companies they’re appointed with, so ask which companies are available to you. Agents and brokers are usually paid by the insurance company. ObamaCare-Enroll.org does not charge you a fee for using our agency or licensed agents.
A common misconception: “No income means free insurance”
Many people expect that if they have little or no income, their coverage will be free. It isn’t that simple. Eligibility for Medicaid and for help paying premiums depends on your state, your household, the income you expect for the year, your immigration status and other rules. In some states, adults with very low income don’t qualify for Medicaid or for a premium tax credit. A $0 premium plan can still have costs when you use care. Plans outside the ACA, like short-term or fixed indemnity plans, can have their own requirements, including health questions.
A licensed agent can help you understand what you may qualify for and which plans and benefits fit how you use care.
Other free help you can use
You always have choices about how to get help:
- Navigators are trained, unbiased helpers funded by the government. They give free help applying for coverage and understanding your options, but they don’t recommend a specific plan. Find one at HealthCare.gov.
- Certified application counselors work at places like community health centers and hospitals and give free help with applications.
- You can apply on your own at HealthCare.gov or your state’s Marketplace, or by calling the Marketplace Call Center at 1-800-318-2596 (TTY 1-855-889-4325).
Questions to ask before you choose a plan
- Are my doctors, hospitals and pharmacy in the plan’s network?
- How are my prescriptions covered, and what will they cost?
- What’s the deductible, and what do I pay before and after I meet it?
- What’s the most I could pay in a year (the out-of-pocket maximum)?
- Do I qualify for a premium tax credit or extra savings on a Silver plan?
- Is this an ACA plan that covers pre-existing conditions and essential health benefits?
A licensed agent can help you answer each of these for the plans you’re considering. Call 1-877-861-3558 or request a quote, and we’ll go over your options with you.
Last reviewed October 2026. Rules can change and can vary by state; this page is general information, not legal or tax advice.