Employment not only offers a source of income but frequently includes the added benefit of valuable health insurance. However, the question arises: How does one secure health insurance when faced with unemployment?
Several avenues exist, encompassing private health insurance, COBRA, Affordable Care Act plans, public health insurance such as Medicaid, and short-term health insurance. Determining the optimal choice for you hinges on factors such as eligibility, costs, and your specific coverage preferences.
Health Insurance Options for the Unemployed
Options for getting health insurance if you’re unemployed include both public and private health plans.
ACA Plans
The Affordable Care Act marketplace at HealthCare.gov offers health insurance coverage, which allows you to compare options in your area in one place. ACA plans offer comprehensive coverage, including the 10 essential health benefits, such as emergency, doctor visits, outpatient care, maternity, hospitalizations, mental health and prescriptions.
ACA plans provide premium tax credits and subsidies to those who qualify based on household income. If you have a household income that’s under 400% of the federal poverty level, you can save through tax credits to help pay for health insurance. You may also save if your household income is above that threshold. ACA plans are the only health insurance policies that have this advantage.
If you don’t qualify for those tax credits, an ACA health insurance marketplace plan can be much more expensive than an employer plan. A 40-year-old with an unsubsidized ACA plan pays $6,108 on average annually for health coverage. That’s just for single coverage. If you cover both you and your spouse, you can expect to pay double that amount.
Another option is to buy health insurance coverage directly through a health insurance company. These policies don’t have to offer the same level of coverage found in an ACA plan, so you may find a cheaper plan with limited coverage.
COBRA health insurance
Are you uninsured because you lost a job where you had health insurance? You may qualify for COBRA insurance if you recently lost employer-sponsored health insurance, such as getting laid off. COBRA lets you keep the employer’s health coverage, including all of the benefits. There is a significant drawback, though: COBRA is expensive because you’ll pay the full premiums yourself (plus possibly a small administrative fee).
Employers typically pay well over half of health insurance premiums for their health plans, but they usually don’t typically contribute to premiums for a COBRA plan.
The Kaiser Family Foundation estimates that single coverage costs $8,435 annually for an employer-sponsored health insurance plan. Employers pay slightly more than $7,000 of that premium on average, with employees saying the remaining $1,400.
Companies with 20 or more employees that offer health insurance must offer COBRA, but you may also qualify for COBRA if you work for a smaller company. States often require “mini-COBRA” plans for smaller companies.
A Spouse’s Plan
If your spouse gets health insurance through an employer, check with the company’s benefits department about being added to the coverage. Not all employers allow spouses on health plans.
You will typically qualify for a special enrollment period on a spouse’s plan if you lose your health insurance. You’re able to sign up for new health insurance during that special enrollment period and don’t have to wait until the plan’s open enrollment period.
Being added to a spouse’s plan will generally increase premiums significantly but that is still likely cheaper than buying COBRA coverage. Kaiser Family Foundation estimates that family coverage costs employees an average of $6,575 annually for those with group health insurance.
Catastrophic Health Insurance
Catastrophic health insurance is an option for people under 30 and those facing severe financial problems like homelessness. You can buy a catastrophic policy through the ACA marketplace at HealthCare.gov.
Catastrophic health plans have lower costs than ACA plans while offering similar coverage. One drawback is that catastrophic plans have much higher deductibles and out-of-pocket costs, so you pay all the costs when you need care until you reach the plan’s deductible.
Catastrophic health insurance doesn’t have coinsurance, so once you reach your deductible, the plan picks up the rest of the costs for healthcare services for the year.
Catastrophic coverage costs an average of $3,120 annually for a 27-year-old. If you’re a 40-year-old who qualifies, the average jumps to $3,804 a year.
Medicaid
Medicaid is a low-cost option, if you qualify. The federal/state health insurance program for low-income people offers comprehensive health insurance at little to no cost based on your household income.
Eligibility differs by state and situation. The ACA’s Medicaid expansion lets states cover people with incomes at up to 138% of the federal poverty level. Not all states have expanded to that level, though.
States may also have higher percentages for certain situations. For instance, children and pregnant women may have less strict eligibility requirements than a single adult. An example is California, which has eligibility of 261% of poverty level for children 18 and under; 208% for pregnant women and 138% for other adults.
See your state’s Medicaid eligibility rules at Medicaid.gov.
Medicare
Medicare is a federal health insurance program for people 65 and over, those with disabilities and people with end stage renal disease or Lou Gehrig’s disease (amyotrophic lateral sclerosis, or ALS). If you qualify, Medicare can be a low-cost option with excellent coverage.
Short-Term Health Insurance
Short-term health insurance is another low-cost option but with much less coverage. The federal government allows people to have short-term health plans for one year with the option of extending coverage to three years. Short-term plans aren’t allowed in all states and some states restrict the length.
Short-term health insurance isn’t technically health insurance under the ACA, since it doesn’t offer the essential health benefits required for other health plans. Short-term plans come with limited benefits and coverage limits. For instance, you may have trouble finding a short-term health plan that covers prescriptions, mental health and pregnancy.
Short-term coverage costs slightly over $2,000 annually on average for a 30-year-old. Though these plans have their limitations, you may prefer the low-cost option to help bridge a coverage gap until you can get standard health insurance again.
There are ways to get health insurance without a job. Here are avenues to consider:
- Check with your spouse’s employer about whether you can be added to your spouse’s plan.
- If you are uninsured because you recently lost a job, find out about potential COBRA options from your former employer and look closely at costs.
- Enter your household income information at the ACA health insurance marketplace website at HealthCare.gov to see how much you might pay for an ACA plan.
- See if you qualify for Medicaid in your state.
- Look into short-term health insurance, which offers limited coverage at low costs.
- If you qualify, explore catastrophic health insurance that you can buy through the ACA marketplace.
