Can I Get Health Insurance Without a Job?

Losing a job often raises concerns about health insurance. However, various options exist to maintain coverage without employer-sponsored benefits. Several programs and plans can bridge coverage gaps or provide long-term solutions, ensuring access to necessary medical care.

Health Insurance Marketplaces and Medicaid

The Health Insurance Marketplace provides a platform for individuals to compare and enroll in health insurance plans. Losing job-based coverage is a qualifying life event, triggering a Special Enrollment Period (SEP) that allows enrollment outside the annual Open Enrollment Period. This SEP typically grants 60 days to select a new plan. Marketplace plans are categorized into metal tiers—Bronze, Silver, Gold, and Platinum—indicating the percentage of healthcare costs they cover.

Financial assistance is available through the Marketplace to reduce premiums and out-of-pocket expenses. Premium Tax Credits lower monthly payments, while Cost-Sharing Reductions decrease deductibles, co-payments, and co-insurance. Eligibility for these subsidies depends on household income relative to the Federal Poverty Level (FPL) and family size. Individuals with incomes between 100% and 400% of the FPL may qualify for Premium Tax Credits. Those between 100% and 250% of the FPL can receive Cost-Sharing Reductions, which are only available with Silver plans.

Medicaid is a joint federal and state program offering health coverage to individuals and families with limited income and resources. Eligibility requirements vary by state, but generally, adults with incomes up to 138% of the FPL are eligible in states with expanded Medicaid programs. Specific groups, such as pregnant individuals, children, and adults with disabilities, often have different or higher income thresholds for eligibility.

Continuing Coverage from a Former Employer

The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a federal law allowing individuals to continue group health coverage after leaving employment or experiencing other qualifying events. This option is available if the former employer had 20 or more employees and offered a group health plan. COBRA coverage serves as a temporary bridge, ensuring continuity of care during transitions.

COBRA coverage lasts for 18 months following job loss or reduction in hours. Spouses and dependents may be eligible for up to 36 months of coverage in certain situations. An extension to 29 months may be possible for individuals determined to be disabled by the Social Security Administration within the first 60 days of COBRA coverage.

COBRA is costly, as individuals pay the full premium previously subsidized by the employer, plus a small administrative fee, up to 102% of the total cost. Average individual COBRA premiums can range from $400 to $700 per month. Employers must notify former employees of their COBRA rights, providing at least 60 days to decide whether to enroll.

Private and Temporary Health Plans

Individuals can explore private health insurance plans purchased directly from insurance companies outside the Health Insurance Marketplace. These plans are generally ACA-compliant, offering comprehensive benefits. However, premium tax credits and cost-sharing reductions are only available for plans purchased through the official Marketplace, not directly from an insurer.

Short-term health insurance plans offer a temporary solution for coverage gaps, often with lower monthly premiums. These plans are not ACA-compliant; they typically do not cover pre-existing conditions and may exclude essential health benefits. Federal rules limit their initial term to three months, with a maximum total coverage period of four months including renewals. These plans are suitable for very short-term needs but lack the consumer protections and comprehensive coverage of ACA-compliant options.

Students enrolled in higher education might be eligible for student health plans. If an individual has a spouse, job loss is a qualifying life event, allowing enrollment in their spouse’s employer-sponsored health plan outside the regular enrollment period. Limited-benefit plans or discount cards are also available, but these are not comprehensive health insurance and should not be relied upon for major medical needs.