Health Coverage Options If You’re Unemployed

If you're unemployed, you can still access affordable health insurance through the Health Insurance Marketplace®, with potential savings based on your income and household size. You may also qualify for free or low-cost coverage through Medicaid or the Children’s Health Insurance Program (CHIP). Your eligibility and the amount of financial assistance you receive depend on your household size and income, not your employment status.

Lost Your Job and Job-Based Insurance?

If you've recently lost your job and the health insurance that came with it, you're eligible for a Special Enrollment Period (SEP). This allows you to enroll in a Marketplace plan outside the standard enrollment period. You typically have 60 days from the day your job-based coverage ends to sign up. Learn how to apply for a Special Enrollment Period.

Medicaid and CHIP, on the other hand, have no limited enrollment period. If you qualify for these programs, you can enroll at any time of the year. Your eligibility will be determined when you complete your Marketplace application.

Your Options Depend on Your Household Income

When applying for coverage through the Marketplace, you will need to estimate your income for the current year. This can be challenging if you’re unemployed, but it’s important to provide the most accurate estimate possible, considering all current and expected income sources.

Types of Income to Include:

• Unemployment benefits from your state
• Income from all household members
• Additional income, such as interest, capital gains, and alimony
• Most withdrawals from traditional IRAs and 401(k)s (refer to IRS guidelines for specifics)

Be sure to update your income information with the Marketplace if your financial situation changes during the year. This will ensure you receive the correct amount of savings based on your new annual income estimate.

Medicaid, CHIP, and Marketplace Insurance Plans

When you complete a Marketplace application, you’ll discover if you qualify for:

• Marketplace Insurance Plan: Depending on your household size and income, you may be eligible for premium tax credits and savings on out-of-pocket costs. Those with lower incomes might even pay minimal premiums. Learn more about reducing costs on Marketplace plans.

• Medicaid: This program offers coverage to individuals with limited income or disabilities. Many states have expanded Medicaid to cover all residents below specific income levels. Learn more about Medicaid and how to apply.

• Children’s Health Insurance Program (CHIP): CHIP provides health coverage for children and, in some states, pregnant women in families with incomes too high for Medicaid but too low to afford private insurance. Learn more about CHIP.

After completing your Marketplace application, you’ll receive an eligibility determination that outlines the coverage options available to you and your household.

COBRA Coverage and the Marketplace

When you lose your job-based health insurance, your former employer may offer you COBRA continuation coverage. This allows you to maintain the same health plan for a limited time, but at your own expense. Before making a decision, it's essential to understand your rights and options under COBRA, which you can learn about from the U.S. Department of Labor.

Considering COBRA or a Marketplace Plan?

If you haven’t signed up for COBRA yet, you might want to explore Marketplace plans as an alternative. Losing your job-based coverage qualifies you for a Special Enrollment Period (SEP), giving you 60 days to enroll in a Marketplace health plan, even if it’s outside the annual Open Enrollment Period. You can compare Marketplace plans and prices to see if they offer a better option than COBRA.

Already Enrolled in COBRA?

If you're already on COBRA, you still have options in the Marketplace depending on your situation.

Switching from COBRA to a Marketplace Plan:

• If your COBRA coverage is ending: You can switch to a Marketplace plan. This qualifies you for a Special Enrollment Period.
• If you want to end COBRA early: During Open Enrollment, you can switch to a Marketplace plan. However, outside of Open Enrollment, you'll have to wait until your COBRA coverage ends or another qualifying event occurs.
• If your COBRA costs change: If your former employer stops contributing or you lose a government subsidy and must pay the full cost, you qualify for a Special Enrollment Period and can switch to a Marketplace plan.

Understanding these options can help you make the best decision for your health coverage needs.

Next Steps: Coverage Options if You’re Unemployed

1.Explore Your Coverage Options: Learn how to apply for Marketplace coverage and check if you qualify for Medicaid, the Children’s Health Insurance Program (CHIP), or reduced costs on a Marketplace insurance plan.

2.Report Income and Household Size Accurately: Ensure you report your income and household size correctly to receive the appropriate amount of financial assistance for your coverage.

3.Understand Exemptions: Familiarize yourself with the 2018 exemptions from the penalty for being uninsured. Note that exemptions are not needed for plan years 2019 and beyond.

4. Access Affordable Care: Discover community health centers where you can receive medical services based on your income.

5. Get Local Assistance: Find local help to assist you with completing your application.

6. Contact Customer Service: If you have questions or need help with your application, call our customer service center for support.