Part-time workers are not required to receive health insurance through an employer and end up having less access to affordable health insurance options as a result. It can be costly for the employer to offer comprehensive coverage to all their employees as a small business. The best health insurance options for part-time employees include HRAs, Concierge Medicine, and Care Memberships, and more.
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Best Health Insurance Options for Part-Time Employees
The best health coverage option will be the one that is within budget and offers coverage on relevant health services. Employers are not required to provide health insurance to part-time employees, even if they provide health coverage to their full-time workers leaving part-time workers to find options for themselves. A study found that 85 percent of full-time workers have health insurance compared to 24 percent of part-time workers.
Following are the best health coverage options available for an employer to offer or even as individual coverage.
- Best for Employee Flexibility: HRAs
- Best for Alternatives to Primary Care: Concierge Medicine
- Best for Specialty Care: Health Insurance PPO Plan
- Best for Emergency Care: Catastrophic Coverage
- Best for Affordable Alternatives: Care Membership
Best for Employee Flexibility: HRAs
Health reimbursement arrangements (HRAs) are a group health plan for employers to help employees pay for medical expenses. Employees have flexibility in choosing a health insurance plan to most closely meet their needs with financial assistance from their employer.
Small businesses that don't offer group health coverage can help their employees pay for medical expenses through a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA). Employers with 50 or more employees are required to offer health insurance, but for a small business can be a costly expense. A QSEHRA can help pay for the cost of health care expenses such as premiums and coinsurance to employees with an individual marketplace plan with minimum essential coverage.
With a QSEHRA, small employers can decide what they'll contribute to their employees’ health care costs, up to an annual maximum set by the IRS. Employees pay their provider or insurance company for their health care costs, then submit proof of payment to be reimbursed by the QSEHRA. Reimbursement is tax-free. The QSEHRA amount provided to employees affects the premium tax credit employees are eligible to receive with their Marketplace health plan.
Employers can utilize a federal program called the Individual Coverage Health Reimbursement Arrangement (ICHRA) to offer part-time employees a monthly tax-free allowance to purchase an individual health insurance plan. Additionally, health benefit memberships provide an alternative form of medical coverage that is affordable to both the employer and employee while providing basic medical coverage.
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Best for Specialty Care: PPO Health Insurance Plan
If you are searching for health insurance through the Marketplace, you will have the option to choose between different types of health insurance plans, such as a PPO, but will be presented with other options such as Point of Service (POS), Exclusive Provider Organization (EPO), and Health Maintenance Organization (HMO). A preferred provider organization (PPO) health insurance plan is designed to give you flexibility in choosing your health care providers.
You get the greatest flexibility with a PPO because you can usually visit specialists without a referral, including that out-of-network. Still, it is cheaper to see doctors in your insurance provider’s network, despite having higher monthly premiums and out-of-pocket costs. A PPO plan is one of the most common health plans, especially for employer-sponsored health insurance. Metal tier plans can also be paired with a PPO, and if opting for a silver plan where your insurance covers 70 percent of the costs and you cover 30 percent, you may also be eligible for extra savings. These savings are called cost-sharing reductions and are dependent on your income.
Best for Emergency Coverage: Catastrophic Insurance
Catastrophic health insurance plans help with emergency medical needs if you get seriously sick or injured, but these plans have low monthly premiums and very high deductibles. For 2020, the deductible for all Catastrophic plans was $8,150.
Most routine medical expenses are not covered under catastrophic plans, but enrollees are covered for three primary care visits each year, even before the deductible is met. Catastrophic plans also cover certain preventive services at no cost. Those eligible for catastrophic plans are people under 30 or people of any age with a hardship exemption or affordability exemption (based on Marketplace or job-based insurance is unaffordable).
Best Alternative for Primary Care: Concierge Medicine
Primary Care Medicine Plans, also known as concierge medicine,” provides primary care services offered directly from doctors to patients without dealing with health insurance companies as the middleman. Fees are range between $100 to 250 per month, a cheaper option than a monthly health insurance premium without a deductible. With Concierge Medicine, a pre-agreed list of services and exams are covered, and there is no eligibility requirement.
A Concierge program allows patients to have more quality time with their physician because instead of seeing over 5,000 patients in a traditional practice, there may only be 600 patients. Members may also have their doctor’s phone number for 24/7 availability. As of 2019, only about 12,000 physicians offer concierge medicine but are prominent in major cities throughout the United States. Concierge Medicine can work as a stand-alone option or in addition to health insurance to help offset the costs of the services not covered under the agreed-upon plan.
Best for Affordable Alternatives: Care Membership
A care membership plan is an affordable alternative to traditional health insurance. Mira is a care membership plan that provides individual, family, or employer plans for low-copays on primary, behavioral, and urgent care services. Mira also provides highly discounted rates on over 1,000 prescriptions and essential lab screenings. Monthly payments average to either $25, $45, or $60 to change the cost of copay for goods and services, but copayments do not exceed $99 for urgent care or other essential lab testing services.
If you pay out-of-pocket (OOP), Mira will highly discount any lab tests or prescriptions ordered to make the visit cheaper. With Mira, you still get access to primary care, mental health, and urgent care services, but the customer service team will find you the most affordable rates on specialty care in your area to ensure you get the best rate for OOP care.
Part-Time Health Insurance Frequently Asked Questions (FAQs)
When searching for an employer that offers part-time insurance or understanding your options as an individual, consider the following questions regarding health insurance for part-time workers:
Can I join my spouse’s plan if I am a part-time worker?
Yes. If your spouse has a health insurance plan either as an individual or through their employer, you would be able to join their health insurance plan. If you are recently married, marriage is a qualifying life event for enrolling in a health insurance plan. If you wait more than 60 days after your marriage license agreement, you will have to wait until the Open Enrollment Period.
Is there a penalty if an employer or if an individual does not have health insurance?
A policy known as the individual mandate under the Affordable Care Act (ACA) required most people to obtain health insurance or pay a tax penalty. The individual mandate was eliminated in late 2017, and healthcare consumers will no longer face penalties for not acquiring health insurance. Without health coverage, consumers may face the challenges of paying out-of-pocket for the high costs of healthcare services.
What are health insurance options for freelancers or contractors?
Freelancers or contractors can enroll in the options previously listed, such as concierge plans with primary care physicians, care membership plans such as Mira, or their health plans through the marketplace. Employers that want to offer health benefits to contracted workers have specific rules to follow.
What companies offer health insurance for part-time workers?
Many big companies such as retailers and food chains offer health benefits to their part-time workers. Some of those big-name companies include:
- Home Depot
- JP Morgan Chase
- Trader Joe’s
Offering health insurance as a small business can be expensive, but having health benefits helps retain and attract workers. Understanding your budget and medical needs will help you know what is best for you as a part-time worker or an employer looking to offer benefits for your part-time employees. Consider alternatives or reimbursement options for affordable ways to keep yourself and your business healthy!
Mira offers an affordable health coverage option for full-time, part-time, and contracted workers. Rates are as low as $25 per month for access to low-cost urgent care visits, virtual primary care, and telebehavioral health. Members get access to up to 80 percent discounted rates on thousands of prescriptions and preventative lab screenings with Mira. Join today!