Get Health Insurance When Unemployed

You need to keep yourself and your family healthy, even if you've lost your job. It can be difficult to get health insurance when you're unemployed because finances will be restrictive and your options may be limited. However, even if you are unemployed, you have several possible options for getting health insurance, including through the Affordable Care Act, through Medicaid, or through COBRA coverage.

Steps

Preparing to Apply for Insurance or Medicaid

1. Know your household size. In order to qualify for health insurance through the Affordable Care Act or Medicaid, you must know your household size. Household size is important because different income limits apply to different household sizes: a larger household may be able to qualify for Medicaid or reduced cost-insurance under the Affordable Care Act with more income than a smaller household.
   • A household typically includes the person who files taxes, that person’s spouse, and any dependents.
   • For insurance purposes, "dependent" includes anyone that you would list as a "dependent" on your tax records. Typically, minor children will qualify and in some cases, you will be able to list your parents as dependents.
2. Calculate your income. In addition to your household size, your income determine whether you are eligible for Medicaid or discounted health insurance through the Affordable Care Act. Include the following income sources in your calculation of annual income:
   • Any unemployment compensation that you receive.
   • Any income earned by members of your household, including your spouse or any dependents.
   • Any alimony payments, interest income, income from capital gains.
   • Withdrawals from a 401k account or a Roth IRA.
3. Prepare to fill out an application for insurance. Under the Affordable Care Act, insurance applications are available on the “healthcare.gov” website. Usually, you can only enroll in health insurance during an “open enrollment period,” which is a specified enrollment time. However, because you have lost your job, you are eligible to fill out an application and get health insurance through “special enrollment,” even if the open enrollment period has ended. Before you are ready to fill out an application, you will need the following information:
   • Information about your income and your household size (as discussed above).
   • Home and mailing addresses for anyone applying for coverage.
   • Basic information about everyone who needs coverage, such as the relationships of those people to you. For example, if you want to apply for coverage for both you and your spouse, you will need to enter basic information about him or her.
   • The social security numbers of everyone who needs healthcare.
   • Information about any professionals who will help you complete the application. While you can fill out the application completely on your own, some people choose to have an attorney or accountant help. If this applies to you, the professional will be required to submit information about themselves with your application.
   • Immigration information for anyone applying, if there is anyone who is not a citizen of the United States.
   • Information on how you file your taxes. This includes whether you file jointly with a spouse, or if you are single with no dependents.
   • Any insurance policy numbers, if anyone in your household currently has a health insurance policy.
   • Information on employers. You need information on the employers of anyone living in your household, even if the employer does not provide health insurance.

Filling out an Application to Determine Eligibility for Discounted Insurance

1. Visit the federal online marketplace. Once there, you will be prompted to start the application process. To start the process, create an account by selecting the state you live in and creating a username and password.
2. Gather the required documents. When you apply for health coverage, the federal marketplace will ask you to verify certain information with documentation. The federal website offers a checklist of documents to gather and includes:
   • Information about your household;
   • Your address;
   • Your Social Security number;
   • Tax filings;
   • W-2 forms;
   • Income estimates; and
   • Information about your current health plan.
3. Follow the on-screen instructions. When you start the application process, the website will prompt you to answer a number of important questions. Follow the instructions on the screen and answer every question completely and honestly. While the questions will vary depending on how you answer them, you will generally be asked to provide:
   • Your estimated income;
   • Your age and health history; and
   • Your tax information.
4. Understand marketplace plans. Understanding the different types of marketplace plans can help you choose the right insurance. Here are examples:
   • Exclusive Provider Organization (EPO): A managed care plan where services are covered only if you use doctors, specialists, or hospitals in the plan’s network (except in an emergency).
   • Health Maintenance Organization (HMO): A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won't cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage. HMOs often provide integrated care and focus on prevention and wellness.
   • Point of Service (POS): A type of plan where you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network. POS plans require you to get a referral from your primary care doctor in order to see a specialist.
   • Preferred Provider Organization (PPO): A type of health plan where you pay less if you use providers in the plan’s network. You can use doctors, hospitals, and providers outside of the network without a referral for an additional cost.
5. Choose the coverage that fits your need. When you are done answering the questions, you will be offered a number of plans you are eligible for. Read through the plans and choose the best one. The option overviews will give you an idea of the monthly premium, the deductible, and the maximum out-of-pocket total.
   • For example, you could choose a plan that featured a low monthly premium and higher deductible or a plan where you paid a higher monthly fee and a reduced annual deductible.
   • Additionally, depending on your income, you may be able to receive a tax credit for part of the premium, thus lowering the monthly cost.

Applying for Medicaid

1. Determine your state requirements. After the Affordable Care Act became law, states had the choice to expand Medicaid coverage to provide coverage for more residents, or leave coverage rules the same. Whether or not your state expanded Medicaid can have an effect on eligibility requirements for coverage.
   • If your state did choose to expand Medicaid, you can qualify based on your household size and income. To determine whether you qualify based on your income and household size, see https://www.healthcare.gov/qualifying-for-lower-costs-chart.
   • If your state did not expand the Medicaid program, you will need to meet your state’s existing eligibility requirements for Medicaid. Typically, to apply for Medicaid under the old rules, your income must be below 100% of the poverty level. Currently, this would mean that for one person, annual income must be below $11,670 to qualify. For a family of four, the income cutoff is $23,850.
2. Fill out a marketplace application online, over the phone, through the mail, or in-person. To determine whether you are eligible for Medicaid, you can fill out the same application that you would fill out to get insurance under the Affordable Care Act. You can apply for Medicaid at any time, regardless of any “open enrollment periods.”
3. Fill out a Medicaid application through your state. Although you can apply for Medicaid coverage through filling out a marketplace application, you can also apply directly through your state.
   • State applications will vary depending on the state, so it is likely easier to fill out a marketplace application.
   • To fill out a state application, visit https://www.healthcare.gov/medicaid-chip/eligibility and select your state from the dropdown menu.
4. Enroll in Medicaid. If you are eligible for Medicaid, you can be enrolled through the marketplace or through your state agency. After enrollment, you will receive a Medicaid card in the mail: you will use this card when receiving medical care or filling prescriptions.
   • If you have any questions about your coverage, you should contact your state Medicaid agency.

Getting Health Insurance through the COBRA program

1. Understand COBRA. COBRA is a program instituted by the department of labor that allows an employee who has lost his or her job to maintain health insurance for a certain amount of time. Under COBRA, an employee who is eligible is required to pay the full cost of the health plan out of pocket, with no contribution from the employer.
   • Because most employees do not pay full price for an employer’s group health care plan, COBRA can be extremely expensive. However, if you are deciding between getting insurance through the Affordable Care Act or through COBRA, you should price both plans to see which one would be cheaper for you.
   • Even if you are eligible for COBRA coverage, you may want to see if you can get cheaper insurance through the Affordable Care Act or Medicaid.
2. Determine whether you are eligible for COBRA coverage. In order to be eligible for COBRA coverage, your insurance plan and your circumstances must meet the following requirements:
   • Your plan must be covered under COBRA: health plans provided by employers who have employed 20 or more employees during the past year are covered by COBRA. To calculate the number of employers, count part-time employees as well as full-time employees. Part-time employees are counted as a fraction of a full-time employee, based on the hours worked (for example, 2 part-time employees who each work 20 hours a week will count as 1 full-time employee).
   • To qualify, you must not have been fired from your job for “gross misconduct.” Therefore, if you were fired from your job for a reason other than your own “gross misconduct,” you will still be eligible. Because there is no official definition for “gross misconduct,” consult with a local attorney if you are denied COBRA coverage due to your former employer claiming “gross misconduct” on your part.
3. Elect COBRA benefits. Under COBRA, covered insurance plans must provide you notice of your COBRA rights as long as you qualify. Your notice will contain information on how to get COBRA coverage, and how to continue the coverage up to the maximum amount of time offered.
   • Once you receive a notice, you will have 60 days to decide whether you want to take advantage of COBRA coverage.
   • If you have dependents, such as a spouse or minor children, who were covered under your insurance plan, they can elect to receive COBRA benefits along with you, and anyone who could be covered should get a notice.
4. Keep your insurance coverage. If you elect to receive COBRA benefits, your insurance coverage will be identical to your coverage while you were employed. Additionally, you will have the same rights that you had under your previous plan, such as the right to appeal a claim denial.
   • If you were fired or laid off from your job, you can receive COBRA coverage for a maximum of 18 months.

Tips

• If you cancel your COBRA coverage early, you will not be eligible to enroll in insurance through the marketplace, so make sure you look at all available options before committing.

Related Articles

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Sources and Citations

See also

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• Verify Health Insurance
• Get a Wheelchair Through Medicare
• Add a Spouse to Health Insurance
• Add a Baby to Health Insurance

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