Private Insurance

This Data Note includes major findings from the KFF Consumer Survey on consumer experiences with claim denials. Among those who used the most health care over the past year, 27% experienced a denied claim. More consumers with private insurance experienced denied claims compared to Medicaid or Medicare.

With the depletion of the federal-purchased supply of COVID-19 vaccines, treatments and tests following the end of the public health emergency, this resource provides an overview of the implications of these changes for access to people covered by Medicare, Medicaid and private insurance, as well as those who are uninsured.

This analysis uses government data to examine the burden of medical debt, including variations based on state, age, race and ethnicity, and health status. It estimates that people in the United States owe at least $220 billion in medical debt.

This Kaiser Family Foundation documentary explores the financial consequences faced by three people, all privately insured, after being diagnosed with cancer. It was released in conjunction with a joint Kaiser/American Cancer Society report, “Spending To Survive: Cancer Patients Confront Holes in the Health Insurance System.” To download the video, right-click…

This brief presents findings from the 2023 KFF Employer Health Benefits Survey on coverage of abortion services in large employer-sponsored health plans, changes employers made to abortion coverage since the 2022 Supreme Court ruling, and employers’ provision of financial assistance for travel out of state to obtain an abortion.

According to an analysis of responses to KFF’s Employer Health Benefits Survey in 2023, relatively few (8%) large firms (with 200 or more workers) offering health benefits report reducing or expanding coverage for abortion since the U.S. Supreme Court overturned Roe v. Wade with the Dobbs v. Jackson ruling. Since…

The Affordable Care Act does not require businesses to provide health benefits to their workers, but applicable large employers may face penalties if they don’t make affordable coverage available. The employer shared responsibility provision of the Affordable Care Act penalizes employers who either do not offer coverage or do not offer coverage that meets minimum value and affordability standards. These penalties apply to firms with 50 or more full-time equivalent employees. This flowchart illustrates how those employer responsibilities work.

Patient-provider email messaging accelerated early in the COVID-19 pandemic as more patients sought medical care remotely, and the addition of billing codes for digital health services and subsequent changes in insurers’ payment policies have enabled providers to bill insurers and patients for messaging. This analysis examines the typical cost of…

Adult dental care can lead to high out of pocket costs for consumers, especially for those with private insurance coverage. This post analyzes a proposed provision in the HHS Notice of Benefit and Payment Parameters for 2025, and possible implications for consumers who have Marketplace coverage.

Most patients do not know about the new surprise billing protections and likely also do not know of resources available to seek recourse for incorrect medical bills. This brief provides resources to privately insured patients who receive surprise balance bills and also summarizes relevant policies and how they apply to balance billing.