Government-sponsored health coverage in the United States is a patchwork of federal programs, state agencies, and private plans under contract. These pages explain the whole landscape in plain terms — a good starting point whether you're a member, a caregiver, or new to working in the field.
Learn the landscape
Coverage Basics
Medicare, Medicaid, Medicare Advantage, the Marketplace, and CHIP — what each is, who runs it, and who qualifies.
How Programs Are Governed
Who sets the rules, how the rulemaking cycle works, and where to track regulatory change.
Reference tools
Plain-English Glossary
Searchable definitions for the terms members and professionals actually encounter.
State Medicaid Directory
The official program name and agency website for every state and DC.
The Member Journey
How a person moves through enrollment, care, claims, and appeals — start to finish.
The one framework worth remembering
For any coverage program, three questions cut through most of the confusion:
- Who funds it? Federal, state, or a mix — from taxes, premiums, or both.
- Who administers it? A federal agency directly, states within federal rules, or private companies under contract.
- Who delivers the benefits? The government directly, or private insurers and providers on the program's behalf.
Those three questions separate Medicare from Medicaid from Medicare Advantage from the Marketplace. Coverage Basics walks through each program with that lens.
Medicare, program by program
Hospital Insurance
Inpatient hospital, skilled nursing, hospice, and home health — and benefit periods.
Medicaid, the Marketplace & CHIP
Eligibility, Waivers & Long-Term Care
Pathways, waivers, LTSS, dual eligibility, and why it varies by state.
The Health Insurance Marketplace
Metal tiers, premium tax credits, and Special Enrollment Periods.