What Health Insurance Actually Looks Like in Every State — A 50-State Guide

A confident woman in her early 30s smirks as she lifts a black knight chess piece across a US-map-shaped chess board from a menacing suited man — the strategic game of health insurance across all 50 states

Here’s a thing that annoys me: insurance websites that say “we’re licensed in X states” and then leave you to figure out what that actually means when you’re the one shopping.

Licensing is one layer. Carrier appointments are another. What the carrier’s actual application will let me quote you is a third. All three have to line up before you get a plan in your name. So let me tell you where I stand today.

The 36 states I’ve personally walked through

As of July 2026, I’ve walked the carrier applications end-to-end in all 36 states where I hold a non-resident health insurance license. That means I’ve gone from ZIP code entry to real quotes at real carriers, and I know exactly what each app will and won’t let me do. Here they are, grouped by what actually shows up in each market:

Broad private market — multiple carriers, most product lines available

Alabama, Arkansas, Arizona, Florida, Georgia, Indiana, Iowa, Kentucky, Louisiana, Missouri, Mississippi, Nebraska, South Carolina, South Dakota, Tennessee, West Virginia.

Multiple carriers, most product lines: real Short-Term Medical (STM), fixed-benefit indemnity, and accident/critical-illness supplemental. HSA-compatible private plans are available in Alabama, Arizona, Florida, South Carolina, and South Dakota. Everywhere else in this group, HSA runs through a Marketplace Bronze plan.

Private market with a state-imposed STM cap or narrower carrier menu

Delaware, Idaho, Maryland, Montana, North Carolina, Ohio, Oregon, Pennsylvania, Texas, Utah, Virginia.

You can still get real coverage. The state just narrows the STM lane — anywhere from 3 months (Delaware, Maryland, Virginia) to 6 months (Idaho, Montana) to 12 months (Ohio, Utah) — and the carrier menu shifts to fit that limit. In some of these, fixed-benefit or Marketplace becomes the sensible primary path instead of STM.

Thin private market — Marketplace is essentially the only path

California, Connecticut, Illinois, Maine, Minnesota, New Hampshire, New Mexico, Vermont, Washington.

Standalone STM is either banned (California, Illinois, New Mexico) or absent from the carriers I work with. The primary path in these states is the Marketplace — Covered California, Access Health CT, Get Covered Illinois, CoverME.gov, MNsure, HealthCare.gov (New Hampshire), beWellnm, Vermont Health Connect, Washington Healthplanfinder. HSA-compatible plans in these states = Marketplace Bronze only.

None of that means I can’t help you — it just means the honest answer might be “let’s compare Marketplace Bronze plans” instead of “let’s stack a private-market plan.” The advice doesn’t change; the recommended path does.

Where I’m not licensed yet

There are 14 states and DC where I don’t currently hold a non-resident health insurance license: Alaska, Colorado, Hawaii, Kansas, Massachusetts, Michigan, Nevada, New Jersey, New York, North Dakota, Oklahoma, Rhode Island, Wisconsin, Wyoming, and Washington DC.

Here’s the thing — that’s not a permanent stop sign. Adding a state is a non-resident-appointment fee away, and I’m happy to add more states as the need arises. If you’re in one of those and it makes sense for me to be your agent, mention it when you reach out. I’ll get the license added.

Why this matters more than a map

A lot of insurance websites will show you a fancy US map and let you click your state to see “what’s available.” Most of those maps show statute-level info — what your state legally allows. That’s not the same as what a specific carrier’s application will actually let me quote you today. Layer 3 (the carrier app) governs your real experience, and that changes when carriers file new products, pause underwriting, or tighten eligibility rules.

The 36 states above I’ve verified across every carrier I’m appointed with. When something changes in a state, I re-walk it. That’s the honest version.

Want to know what’s actually available for you specifically? Book a Healthcare Review and I’ll tell you in the first 15 minutes.

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