Can You Get Insurance Without a Job?

Losing health insurance coverage when employment ends can be unsettling. Many individuals wonder how to maintain access to necessary medical care without employer-sponsored benefits. Fortunately, several avenues exist to secure health coverage, offering various solutions depending on individual circumstances. This article guides you through the different options available to ensure you remain covered during periods of unemployment.

Continuing Coverage from Prior Employment

When you leave a job, you may continue health coverage through the Consolidated Omnibus Budget Reconciliation Act, or COBRA. This federal law allows eligible employees and their families to maintain their group health coverage for a limited time after certain events, such as job loss or reduction in work hours. COBRA coverage is typically available for up to 18 months, though it can extend to 29 or 36 months in specific circumstances, such as disability.

To be eligible for COBRA, your former employer must have offered a group health plan and had 20 or more employees in the prior calendar year. You must also have been covered by the employer’s health plan before the qualifying event. While COBRA allows you to keep the same coverage, you will be responsible for the full cost, plus an administrative fee of up to 2%. This can make COBRA more expensive than the premiums you paid as an active employee.

Upon a qualifying event, your employer notifies the plan administrator, who provides an election notice. This notice outlines premium amounts and payment due dates. You typically have 60 days from the notice date or the date your coverage would end, whichever is later, to elect COBRA coverage. To elect, complete and return the required forms and make your initial premium payment within the specified timeframe.

Beyond federal COBRA, some states have their own continuation laws, often called “mini-COBRA” laws. These state laws provide continuation coverage for employees of smaller businesses not subject to federal COBRA. The terms and conditions, including eligibility and duration, vary by state, but they provide similar protections for a period after employment separation.

Health Insurance Marketplace Plans

The Health Insurance Marketplace, established by the Affordable Care Act (ACA), allows individuals to purchase health insurance. Losing job-based coverage is a “qualifying life event” (QLE), which triggers a Special Enrollment Period (SEP). This allows you to enroll in a Marketplace plan outside of the annual Open Enrollment Period. You have a 60-day window from the date you lose your coverage to select a new plan. If you have advance notice of your coverage loss, you can apply for the SEP up to 60 days in advance.

Eligibility for Marketplace plans requires you to be a U.S. citizen or legal resident, not incarcerated, and not eligible for Medicare. The Marketplace offers financial assistance, which can reduce the cost of monthly premiums and out-of-pocket expenses. This assistance comes in two forms: Premium Tax Credits and Cost-Sharing Reductions.

Premium Tax Credits lower your monthly premium payments, based on your estimated household income and household size. For 2025 coverage, these credits are available to individuals and families whose household income falls between 100% and 400% of the Federal Poverty Level (FPL), depending on the benchmark plan cost. A provision extended through 2025 ensures individuals will not pay more than 8.5% of their modified adjusted gross income (MAGI) for a benchmark plan, even if their income exceeds 400% of the FPL.

Cost-Sharing Reductions (CSRs) further reduce your out-of-pocket costs, such as deductibles, copayments, and coinsurance. To receive CSRs, you must enroll in a Silver-level plan, and your income must be below 250% of the FPL.

Marketplace plans are categorized into “metal tiers”: Bronze, Silver, Gold, and Platinum. These tiers indicate how you and the plan share costs, but not the quality of care. Bronze plans have the lowest monthly premiums but the highest deductibles and out-of-pocket costs. Silver plans offer moderate premiums and out-of-pocket costs, and they are the only plans eligible for Cost-Sharing Reductions. Gold and Platinum plans have higher monthly premiums but lower out-of-pocket costs when you receive care.

Applying for a Marketplace plan involves visiting HealthCare.gov or your state’s specific marketplace website. You will create an account, provide details about your household size and estimated income, and then compare available plans. The system will determine your eligibility for financial assistance based on the information you provide. After selecting a plan, you will complete the enrollment process and make your first premium payment. Coverage typically begins on the first day of the month after your job-based insurance ends, if you enroll within the SEP timeframe.

Medicaid and Children’s Health Insurance Program (CHIP)

Medicaid and the Children’s Health Insurance Program (CHIP) offer government-funded health coverage for low-income individuals and families. Eligibility for Medicaid is determined by household income relative to the Federal Poverty Level (FPL) and varies by state. In states that have expanded Medicaid under the Affordable Care Act, adults often qualify with incomes up to 138% of the FPL. In non-expansion states, eligibility for adults is more restrictive, though children and pregnant individuals often have higher income thresholds for qualification.

Beyond income, other factors such as age, disability status, and pregnancy can also influence Medicaid eligibility. Individuals over 65, those with certain disabilities, or pregnant women may qualify even if their income is slightly higher than the standard FPL thresholds. These programs provide comprehensive health benefits, including doctor visits, hospital care, prescription drugs, and preventive services, with little to no out-of-pocket costs for eligible individuals.

CHIP provides low-cost health coverage for children in families who earn too much to qualify for Medicaid. Some states also extend CHIP coverage to pregnant women. Like Medicaid, CHIP eligibility thresholds vary by state, often extending to higher FPL percentages than adult Medicaid programs.

You can apply for Medicaid and CHIP through your state’s Medicaid agency or through the Health Insurance Marketplace. When applying, you will need to provide documentation to verify your income, household size, and state residency. This information helps the state determine your eligibility for either program. The application process often allows for online submission, telephone applications, or in-person assistance.

Other Individual and Family Health Insurance Options

When traditional employment-based coverage is no longer an option, several other avenues can provide health insurance or access to care. Joining a spouse’s employer-sponsored health plan is one alternative. If your spouse has health coverage through their job, losing your own job-based insurance often qualifies as a special enrollment event, allowing you to be added to their plan outside of the regular open enrollment period. Similarly, individuals under the age of 26 may remain on a parent’s health insurance plan.

Another option is to purchase a health plan directly from an insurance company, outside of the Health Insurance Marketplace. These are often referred to as “off-Marketplace” or “direct private plans.” While these plans offer flexibility, they generally do not qualify for the Premium Tax Credits or Cost-Sharing Reductions available through the Marketplace. Therefore, the full premium cost would be your responsibility, which can be higher without subsidies.

Short-term health insurance plans can serve as a temporary bridge during brief gaps in coverage. These plans provide limited benefits for a short period, typically from three months up to a year, though some states may allow longer durations. Short-term plans are not regulated by the Affordable Care Act; they often do not cover pre-existing conditions, may have benefit caps, and do not include all essential health benefits required of ACA-compliant plans. They are not available in all states and are a temporary solution.

For those pursuing higher education, student health plans offered by colleges or universities can be a viable option. These plans cover the health needs of students and may be a more affordable alternative than individual plans, often including access to on-campus health services. Eligibility requires enrollment in a degree-seeking program. Community health centers and free clinics also provide affordable medical care and prescription services, particularly for low-income or uninsured individuals. While not a substitute for comprehensive health insurance, these centers offer essential primary care and preventive services on a sliding scale or at no cost.