7 Options If You Don’t Have Health Insurance From an Employer
Having health insurance is important.
Without health insurance, one visit to the emergency room could easily cost you over $1,000 or, in some cases, $10,000 or more.
Unfortunately, many people rely on their jobs to provide health insurance.
But what happens if you work for an employer that doesn’t offer health insurance?
What if you quit, get fired or get laid off from a job that you had your health insurance through?
While each person’s circumstances are unique, there are a few options you should consider if you don’t have health insurance from your employer.
1. COBRA Health Insurance
If you recently left your job, got fired or got laid off, you may qualify to get insurance through your old employer through COBRA (Consolidated Omnibus Budget Reconciliation Act).
If you qualify, your employer is required to offer this coverage after you leave the company in certain cases.
Your insurance will remain the same, but the cost will likely be different.
When you work for an employer, they generally pay part of your health insurance premiums as a perk.
However, the company does not have to help pay for the cost of the health insurance plan with COBRA. This may cause a price shock for many people.
The good news:
You can usually continue using the same health insurance you had at your employer for up to 18 months after you elect coverage.
You won’t have to worry about pre-existing conditions, either. You just have to be able to afford the potentially higher premium.
2. Marketplace Health Insurance
A healthcare marketplace health insurance plan can be purchased by anyone that:
- Lives in the United States
- Is a U.S. Citizen or lawfully present and
- Isn’t incarcerated
This insurance option can work great for stay at home parents or someone between jobs.
Generally, you can apply for health insurance through your state’s health insurance marketplace or Healthcare.gov during open enrollment each year.
While this period may change from year to year, it typically starts in November and runs through sometime in December.
If you don’t sign up during open enrollment, you may not be able to apply for traditional health insurance coverage through the marketplace.
You may qualify for an exception called a special enrollment period.
Thankfully, you can qualify for a special enrollment period in one of many ways. These require you to have a qualifying life event and can include:
- Getting married
- Getting divorced or legally separated and losing health insurance coverage
- Having a baby
- Adopting a child
- Certain changes in residence
- Loss of health insurance from
- Losing job-based coverage
- Losing coverage for a plan or policy you bought yourself
- Losing eligibility for Medicaid, CHIP or Medicare
- Losing coverage through a family member
There may be other ways to qualify for a special enrollment period, as well.
If you do qualify for one of these periods, you have to choose a new plan within 60 days of the qualifying event. If you miss this window, you have to wait until open enrollment comes around again.
3. Your Parents’ or Spouse’s Health Insurance Plan
Many employers allow a person to add spouses and children to their health insurance plans.
This is a great option for stay at home parents, children that haven’t found jobs yet or even a spouse between jobs.
An employer does not have to subsidize coverage for family members even if they subsidize coverage for their employees.
The additional cost to add a spouse or child to a policy could be much different than the premium for the employee only.
A spouse or child can be added during the plan’s annual open enrollment period.
If you lose coverage due to a qualifying event, you may be able to get health insurance from your spouse or your parents during the year, too.
Your spouse or parent can inquire with their company’s HR department to see what options they have. If you’re trying to qualify for insurance through a qualifying event, act fast.
Qualifying events may only allow you to make changes for 30 days. This can be different from marketplace health insurance.
Those under age 26
People under age 26 may be able to get coverage through their parents’ health insurance plans.
Law allows those under age 26 to sign up for health coverage through their parents’ health insurance plans as part of the Affordable Care Act.
If you’re under age 26 and lose coverage, ask your parents if you can be added to their health insurance. This will likely increase their premiums, sometimes significantly.
Consider paying them the difference in price if you’re able to.
Medicare may be an option for your health insurance needs. Medicare is usually for retirees. That said, certain other people can qualify, as well.
In general, you have to be:
- Age 65 or older
- A U.S. citizen or permanent legal resident that has lived in the U.S. for at least five years and
- You worked long enough to qualify for Social Security or railroad retirement benefits
Additionally, you may qualify before age 65 if:
- You have Lou Gehrig’s disease
- You’ve been entitled to benefits for Social Security Disability for 24 months or more or
- You have permanent kidney failure that requires dialysis regularly or that requires a kidney transplant and you or your spouse have paid Social Security taxes for a certain length of time that depends on your current age
Of course, there are exceptions and other ways to qualify as with many other government programs.
Believe it or not:
Medicaid is the single largest source of health coverage in the United States.
It is a free or low-cost health insurance option.
Specifically, Medicaid can cover some families and children, pregnant women, parents, the elderly and people with disabilities.
Federal law requires coverage for low-income families, but other groups may qualify depending on your state’s Medicaid program.
It’s important to note:
Each state has its own rules regarding how Medicaid works in that state.
These rules include how to qualify. In general, your income must be below a certain level based on your family size.
Check your state’s Medicaid website to see if you qualify for coverage. If you do, your coverage can start immediately.
6. Off-Market Health Insurance Plans
While your state’s healthcare marketplace offers plans that conform with the Affordable Care Act, other health insurance plans exist.
It’s important to note, these plans won’t always meet the same standards as Affordable Care Act plans. Still, they can still provide some coverage.
One option is a short-term health insurance plan.
In general, you can apply for these plans at any time. There are no open enrollment windows or special qualifying events.
These plans typically cost less than traditional health insurance, but they don’t offer the same coverage.
Many of these plans don’t cover common medical expenses such as:
- Preexisting conditions
- Mental healthcare
- Pregnancy and childbirth
- Preventative care
- Prescription drugs
These plans can be extremely short. Sometimes they’re as short as three months.
When the plan expires, you’ll have to reapply if your state allows you to.
Make sure to read up on your state’s laws surrounding short-term health insurance and the details of the policy before you apply.
You need to completely understand what you’re getting and how it works.
7. Healthcare Sharing Ministries
First, it’s important to note that healthcare sharing ministries are not health insurance. That said, they work similarly to health insurance in some ways.
The major differences are they do not guarantee to cover your medical expenses and they aren’t regulated like health insurance.
In a healthcare sharing ministry, people submit monthly payments to the ministry. The ministry then reallocates that money to other members that have healthcare costs.
The major healthcare sharing ministries include:
- Christian Healthcare Ministries
- Samaritan Ministries
- Liberty Healthshare
To join a healthcare sharing ministry, you must usually agree to abide by their standards.
Requirements can include attending church on a regular basis or agreeing to a statement of faith.
These plans can also require you to not smoke or not drink excessively.
Additionally, the plans can reject you for any reason, including pre-existing conditions. They can deny the ability to pay for any service they wish, including certain lifestyle choices or injuries from dangerous activities.
Do not consider a healthcare sharing ministry unless you’ve done extensive research about how they work.
For many people, they are not a good fit.
Picking the Right Option for You
If you’ve found yourself without health insurance, you should investigate all of your options.
You may find you only have one option to get the coverage you need. In this case, you have to decide whether that option is worth the cost.
In other cases, you may find you have several options that meet your needs. If you’re lucky enough to be in this situation, make sure you fully understand each option first.
Then, compare your options.
In particular, you should look at:
- What is covered
- Where you can go for service
- The costs for
- Any other costs
Once the comparison is complete, choose the plan that best fits you or your family’s needs.
Beyond health insurance, always remember to build an emergency fund that can help you handle situations where you cannot cover essential healthcare needs without insurance.