How to Get Health Insurance Without a Job

Group health insurance coverage through an employer is common in the US. Almost half of the US population has an employer-sponsored health insurance plan to access medical services. But what happens if you lose coverage because you are unemployed? Please continue reading to find other health insurance options if you are without a job or losing health insurance coverage for another reason.

What is the Special Enrollment Period (SEP)?

The Special Enrollment Period (SEP) allows you to enroll in an individual or family health insurance plan or switch plans outside the annual open enrollment period (the set window of time when you can enroll in ACA-compliant health insurance plans). If you have recently lost your job, you may qualify for SEP. SEP is also valid in the following circumstances:

Loss of job-based health insurance from an employer.
Loss of health insurance through another person’s job.
Change in household size due to a change in marital status, having a baby, or adopting a child.
Change in primary place of living or relocation to a place where the current plan is not offered.
New eligibility for health insurance after lawfully obtaining US citizenship.

People who qualify for the Special Enrollment Period can shop for unemployed health insurance plans offered by health insurance companies on the state exchange. If the health insurance plans offered are unaffordable for you and your desired marketplace insurance plan is compliant with the Affordable Care Act (ACA), you may qualify for subsidies on your health insurance premium.

What is the 60 days COBRA loophole?

Consolidated Omnibus Budget Reconciliation Act (COBRA) insurance allows people to keep employer-sponsored health insurance benefits in certain circumstances, for example:

Termination of employment.
Change in employment status, such as reduction in working hours and disqualification from previous job-based insurance plan requirements.
Divorce or legal separation from a covered spouse.
Death of a covered spouse or parent.
Termination of employment of a covered spouse or parent.
Enrollment of a covered spouse or parent in Medicare.
Loss of dependent status.

You typically have 60 days to decide whether to opt into COBRA benefits. The 60-day COBRA coverage loophole is that no matter when you submit your papers to the health insurance company during this 60-day period, you are covered retroactively from day 1. However, remember that COBRA health insurance coverage can be expensive because you have to pay the full premium from day 1. Therefore, you may prefer to take advantage of the special enrollment period and consider marketplace health insurance plans instead.

Who qualifies for Medicare?

Medicare is not a part of marketplace coverage. It is a federal health insurance program for people aged 65 and older. You can apply for Medicare Part A and B if you are without a job and at least 65 years old. You can also purchase supplemental health insurance plans to fill any coverage gaps in Medicare. If you can’t afford the premiums for Medicare, there are programs to help lower your health insurance cost, including programs that make prescription drugs more affordable.

What is the lowest income to qualify for Medicaid?

Medicaid is a joint federal and state program. It is the single largest health coverage program in the US. Certain groups are included, such as qualified pregnant women and children, low-income families, and individuals who receive Supplemental Security Income (SSI). The Affordable Care Act of 2010 expanded Medicaid coverage for nearly all low-income Americans under the age of 65.

Income eligibility for Medicaid is calculated based on the Modified Adjusted Gross Income (MAGI) methodology. MAGI is also used to determine financial eligibility for the Children’s Health Insurance Program (CHIP), premium tax credits, and cost-sharing reductions on plans available in the health insurance marketplace.

The 2023 Federal Poverty Level (FPL) guidelines in the US are $14,580 for an individual and $30,000 for a family of four. To qualify for Medicaid, you must have income and assets below your state’s maximum income limit. Each state decides Medicaid income eligibility for adults as a percentage of the federal poverty level (FPL). The average in most states is 138% of the Federal Poverty Line. In other words, adults under 65 with income up to 138% of the FPL qualify for Medicaid.

What is the lowest income to qualify for Obamacare?

If your individual or household income disqualifies you from CHIP or Medicaid, you can shop for traditional health insurance. A federal marketplace plan (ACA-compliant or Obamacare plan) will allow you to get health insurance without a job. These plans offer comprehensive benefits, including mental health services and dental coverage.

Your monthly premium payment for marketplace health insurance plans depends on your household income. Households with incomes between 100% to 400% of the Federal Poverty Level receive subsidies to lower their health insurance costs.

You can take advantage of advance premium tax credits, which are available to anyone who earns up to 400% of the federal poverty level (FPL). You may also qualify for a subsidy on your health insurance premium, such as the American Rescue Plan Act (ARPA), which eliminated the subsidy level through 2025. This means that even if you earn over 400% of the FPL, you can still get a reduced premium for a marketplace health insurance plan and save money through the premium tax credit.

What is the Children’s Health Insurance Program (CHIP)?

The Children’s Health Insurance Program (CHIP) is a federal program for families whose income is too high to qualify for Medicaid but who cannot afford a traditional health care policy. CHIP is administered at the state level. The costs and medical coverage vary from state to state. However, in all states, CHIP includes comprehensive coverage for children, including immunizations, glasses and vision care, dental benefits, emergency services, and more. Together, Medicaid and CHIP provide low-cost coverage or free health insurance to millions of Americans.

What are average private health insurance costs in the US?

ACA plans are categorized into metal tiers - bronze, silver, gold, and platinum. Bronze plans have the lowest monthly costs but the highest out-of-pocket expenses when you access care. Gold and platinum plans have the highest monthly premiums but the lowest out-of-pocket costs when you receive care.

Some indicative monthly premiums for unsubsidized ACA plans on the health insurance marketplace and health insurance exchanges are as follows:

For an individual aged 21 years:

$313 per month for a Bronze plan.
$410 per month for a Silver plan.
$450 per month for a Gold plan.

For an individual aged 40 years:

$401 per month for a Bronze plan.
$526 per month for a Silver plan.
$578 per month for a Gold plan.

For an individual aged 60 years:

$850 per month for a Bronze plan.
$1,115 per month for a Silver plan.
$1,225 per month for a Gold plan.

What are some other options for health insurance without a job?

Short-term health insurance

This limited health insurance coverage is valid for a few months. It is useful when you are not eligible for the special enrollment period under the ACA and cannot get any other type of plan. In such cases, a short-term health insurance plan can bridge the coverage gap until the annual open enrollment period begins. A short-term health insurance policy can last as long as you need, but it must be less than a year. This is the best health insurance if you want quick coverage, a flexible coverage period, and options for deductibles.

Catastrophic health insurance plans

Catastrophic insurance plans provide coverage for serious health events such as unexpected illnesses or accidents (worst-case scenarios). They have low monthly premiums but very high deductibles. These plans do not cover routine health care. They are an option if you are losing coverage due to unemployment and are under 30 or over 30 with a hardship or affordability exemption.

Joining a family member’s plan

If you are looking for health insurance without a job, check if you are eligible to join a family member’s health plan. A spouse, children under the age of 26, and other dependent relatives can be added to an existing plan.

What happens if you can't afford health insurance coverage in America?

If you cannot afford private health insurance and do not qualify for Medicaid and/or the Children’s Health Insurance Program, you can go to community health centers in your area that may offer health care on a sliding scale and charge what you can afford.

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