OBJECTIVES:   To compare healthcare resource utilization (HRU) among schizophrenic patients in the United States by the type of health insurance and estimate the annual expenditures. METHODS: The 2007 National Health and Interview Survey (NHIS) data were used for this study (150 schizophrenia cases).  Multivariate regression was conducted to compare HRU (hospitalizations, physician visits, ER visits) by type of health of insurance (any private, public only, and none). Additionally, 2008 Medical Expenditure Panel Survey (MEPS) data were linked with the NHIS data (29 of the NHIS cases). Means, SE and 95% confidence intervals of prescription and total healthcare annual expenditures were calculated for schizophrenic patients by insurance type. RESULTS: Multivariate analysis indicated a significant association between the number of hospitalizations, physician visits and ER visits over 12 months and any private insurance (β=-2.06, SE=0.84, p=0.01; -19.69, 8.92, 0.03; -22.35, 9.55, 0.02, respectively) compared to no insurance (referent). These same associations were not significant for the public only insurance (-0.30, 0.44, 0.16;  -5.89, 3.91, 0.13; -7.72, 4.09, 0.06, respectively). Mean, SE [95% confidence interval] prescription expenditures for schizophrenic patients are similar between private insurance holders ($737, 215.3 [312.3-1161.6]) and those without insurance ($718, 237.0 [249.7-1186.3]), but were higher for public insurance holders ($3781, 897.2 [2008.1-5553.0]). Mean total healthcare expenditures for schizophrenic patients are similar between private insurance holders ($4000, 1382.4 [1273.9-6726.7]) and those without insurance ($4318, 2215.4 [0-8696.6]), but were higher for public insurance holders ($12,584, 2452.2 [7739.6-17,428.8]). CONCLUSIONS:  Private insurance HRU for schizophrenic patients is lower than public only insurance holders, followed by those without insurance.  Seemingly contradictory, a higher expenditure among public insurance holders was observed. This observation could be the result of the more severe schizophrenic cases having only public insurance. Caution should be employed in the use of the expenditure calculations due to the small numbers of patients.