How To Get Health Insurance Without a Job
If you do not have a job, there are other ways to get insurance without relying on an employer. If eligible, you can sign up for a Marketplace plan or participate in federal health insurance programs such as Medicare or Medicaid. Alternative options such as care membership plans or short-term health insurance options may also suit your needs.
Mira offers an affordable health coverage alternative for just $45 per month. No more expensive monthly premium. With Mira, you get access to doctor’s offices and urgent care visits for just $99 and up to 80 percent discounted rates on over 1,000 prescriptions. Try Mira today!
How to Get Health Insurance Without a Job in 4 Steps
Whether you are unemployed, a freelancer or nomad, an individual with disabilities, or are pregnant without health insurance; you have options outside of relying on an employer-provided health plan. You can apply for health insurance through the Marketplace, which will also determine your eligibility for federally-funded programs such as Medicare and Medicaid, or consider alternatives to insurance.
Alternatives to health insurance such as short-term coverage, fixed-indemnity plans, or care memberships may provide you with supplemental coverage, or a means to access preventative care. You may also consider Association Health Plans, which provide group health insurance to those sharing a common interest, such as freelancers or those of religious affiliations.
Step 1: Apply for Marketplace Plans
The Affordable Care Act, also known as Obamacare, created a Marketplace where anyone can sign up for a health plan. Marketplace insurance offers quality coverage as they provide the same categories of essential health benefits under the Affordable Care Act but cannot exclude people based on pre-existing conditions. Monthly premiums may vary depending on the state in which you live.
To sign up, you have to enter your zip code, which will then navigate you to your state’s health insurance marketplace, where you will be asked a few questions such as date of birth, frequency of medical care, prescription needs, and income level. A personalized list of health insurance plans with estimated costs will be generated based on these questions. Remember that registration depends on whether you qualify for a Special Enrollment Period; otherwise, you will have to wait until the Open Enrollment Period.
The Federal Open Enrollment period lasts between November 1 to December 15 each year, with plans beginning January 1st. Certain events may qualify you for Special Enrollment, such as marriage, divorce, the birth of a child, job loss, also known as qualifying life events.
Health Insurance Plan Types
When comparing health plans, you will often find plans categorized by either metal tier, price, or type of health plan such as HMO, PPO, POS, EPO, etc. The type of health plan indicates the flexibility you have in choosing your healthcare providers and requiring a referral to seek a specialist. Metal tiers can have plans of any network provider type, for example, a silver PPO plan. Below is the defined list of health insurance plan types: HMO, PPO, POS, and EPO plans.
- Health Maintenance Organizations (HMOs): typically have lower insurance premiums and out-of-pocket costs because they require a primary care physician (PCP) referral before seeking specialty care. When employees sign up for an HMO plan, they should choose a trusting PCP since they will be the gatekeeper of their other health needs.
- Point of Service Plans (POSs): Like an HMO, a POS plan requires a referral from a primary care physician before seeing a specialist. These plans usually have higher premiums than HMOs because they cover out-of-network doctors and higher expenses for in-network care.
- Preferred Provider Organization (PPOs): PPOs typically have higher premiums than HMOs or POS plans, but enrollees can freely seek specialists and out-of-network physicians, with no referral needed. These plans are an excellent option for those requiring frequent and various care and can afford higher premiums.
- Exclusive Provider Organization (EPO): EPO’s are lesser-known and only cover in-network services, but the network is generally more extensive than HMOs, so they may not require a referral from a primary care physician. The premiums for EPOs are higher than HMOs but lower than PPOs.
Metal Tier Plans
Bronze plans tend to offer the most coverage for the least amount for individuals requiring moderate and preventative care. Gold and Platinum plans work best for people often needing care and are willing to pay more each month for greater coverage. Below is a breakdown of the shared costs associated with metal tier plans.
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If you do not find the estimated monthly premiums and deductibles for the suggested plans match your budget or health needs. In that case, Suppose you may find that you are eligible for federal assistance. Upon applying, you will see whether you qualify for Advanced Premium Tax Credits to help reduce the cost of your premium or whether stated Medicaid programs are eligible to you.
Step 2. Determine Eligibility for Federal Insurance Programs
Another option for getting health insurance without a job is through federal and state health programs providing health coverage, if eligible. While Medicaid is for individuals with income limits with the national poverty level, you may find it suitable for Medicare. States administer their own Medicaid with varying income requirements.
Medicare provides a federal health insurance program typically for individuals above 65, those with specific disabilities, or individuals experiencing permanent kidney failure requiring intensive care. Medicare is divided into different parts, each focusing on a type of coverage Medicare provides.
When you enroll, if eligible, you have two options on how to get your coverage, through the original Medicare or with Medicare Advantage. The Original Medicare requires a deductible and about a 20% coinsurance; however, the original plan only includes Part A and Part B, and often consumers enroll in Medigap for supplemental coverage. Medicare Advantage (Part C) is a bundled plan including parts A, B, and usually D.
When you apply for retirement or disability benefits from Social Security, this also serves as your application for Medicare. Once approved, you will automatically receive Part A coverage premium-free. When you are approaching age 65, you have seven months to sign up for Medicare, beginning the three months before turning 65 to the three months after, called your Initial Enrollment Period. If you miss this day, you may have to wait until the General Enrollment Period and have to pay a late enrollment penalty.
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Medicaid is a federal and state-funded health insurance option provided to 1 in 5 Americans; however, children account for 43 percent of Medicaid enrollees and cover nearly half of all births in the typical state. To apply for Medicaid, you will have to visit your state’s Medicaid website to determine your eligibility and estimated costs.
Eligibility for Medicaid depends on income or citizenship and is provided to those living within 138 percent of the federal poverty level (FPL) in most states where Medicaid eligibility was expanded. The FPL for individuals in 2021 is $12,880. You may also be eligible for tax subsidies if your income falls between 100 to 400 percent of the FPL. If your income is below 138 percent of the FPL and you live in a state with Medicaid expansion, you qualify for Medicaid solely based on your income.
3. Consider Short-Term Health Insurance
If you are between jobs or only need health coverage for a specified period, you may want to consider short-term health coverage. Short-term health insurance typically lasts for about six months and covers basic health needs, emergency care, or more expensive full-coverage plan options but does not cover preexisting conditions, maternity care, or mental health. Many major health insurance providers also offer short-term health insurance plans. Speak with a health insurance representative to determine plan offerings.
COBRA (Consolidated Omnibus Budget Reconciliation Act) is a short-term health insurance option for individuals previously covered under a group or an employer-sponsored health insurance plan that wish to continue coverage after termination of employment. If you no longer have a job but recently left a job with employer-sponsored insurance, then your employer should provide you with information on how to enroll in COBRA.
If you elect to use COBRA, you are now the sole financier plus, and you must pay an additional 2 percent administrative fee. You may consider COBRA as a short-term option but understand that your costs will likely increase significantly, as the cost of your healthcare is no longer shared with your employer unless otherwise stated.
4. Understand Alternatives Options to Health Insurance
Should you find marketplace plans insufficient for your needs, or you are ineligible for a Marketplace health insurance plan, you have additional options you may consider. Below are alternatives to health insurance that you may wish to consider.
Care Membership Plan
Mira offers a new healthcare coverage option perfect for freelancers. While Mira is not insurance, it provides flexible and affordable health coverage, offering discounted urgent care and primary care visits at just $99. You also receive discounted rates for over preventative lab screenings and over 1,000 prescriptions. There is also no employment necessary.
Not only is Mira an excellent option for freelancers or unemployed individuals as a sole coverage option, but 1 out of 5 members use Mira in addition to a high deductible or catastrophic health plan. You may end up saving over $1,000 a year on medical expenses by using Mira for your primary healthcare needs. It’s also simple. You could sign up right now and be covered by the end of the day.
Fixed-Indemnity Health Insurance
Fixed-indemnity health insurance is a type of supplemental health plan also called fee-for-service plans. These plans pay you a fixed rate for a particular service, such as $100 for an urgent care visit. With these types of plans, you can make your own health choices by visiting almost any hospital, primary care physician, or specialist you prefer. Still, indemnity plans do not have to cover all essential health benefits, nor are they considered minimum basic coverage.
Indemnity plans are recommended as an additional layer of health coverage and are used primarily with a more traditional insurance plan because they are not ACA compliant. However, these plans may be best for relatively healthy people looking for the freedom to choose the doctors or hospital to receive care.
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A Parent or Spouse’s Plan
Without a job, a Parent or Spouse’s plan may also be an option for you. Under the Affordable Care Act, if you are under the age of 26, you may be eligible to be added to your parent's plan. If your parents have insurance, talk to them about whether this would be an affordable option, as it will likely increase their monthly premium.
Similarly, you may be able to be added to your spouse’s or domestic partner’s plan.
Suppose you are a full-time student without a job; in that case, your college or university may offer health insurance to cover medical services provided to you at campus facilities, as well as prescriptions provided in-network. Often, these plans do not transfer between universities or if you reduce your college credit hours to part-time status. Check with your college or university to determine plans available and your eligibility.
How to Get Health Insurance Without a Job Frequently Asked Questions (FAQs)
Navigating health insurance can be daunting and confusing, with limited transparency. Here are a few frequently asked questions answered to help you understand your coverage options.
What are health insurance subsidies, and who is eligible?
Health insurance subsidies may also be available for individuals who cannot afford a health plan but do not qualify for Medicaid. If this is the case for you, you may be eligible for a health insurance subsidy, lowering the cost of healthcare for individuals below 400% of the federal poverty level. Two types of subsidies are available: Advanced Premium Tax Credits (APTC) or Cost-Sharing Reductions (CSR). When you apply through the Marketplace, you will find out if you qualify for APTC or CSR.
What is the risk of not having health insurance?
The risk of not getting health insurance is unknown, as it varies between people and families, but no one likes paying high monthly premiums for health insurance. Despite regularly engaging in healthy lifestyle habits, your health may not always be in your control, and your circumstances may unknowingly change tomorrow. Acquiring a reliable health coverage option that you can afford is a sound investment in your health and the outlook of your future.
How do I know which health insurance plan or alternative is right for my family and me?
It is all entirely up to you. There are pros and cons to every plan, but at the end of the day, you are the one in charge of evaluating different plans and determining which you think will best suit you and your dependents’ needs. Some factors to guide your evaluation include the size of your family, cost of plans, and overall relative health of your family. Consider speaking with a health insurance representative to determine which plan may be best for your medical needs and budget.
Without an employer, you may feel that your health coverage options are limited. Depending on your income and where you live, you may be eligible for federal and state-based health programs like Medicare or Medicaid. While typically costly, an individual marketplace plan is also available to you, in addition to alternative coverage options and short-term plans.
Mira offers an affordable health coverage alternative or even supplemental coverage. For just $45 per month, you get access to affordable, preventive lab screenings, doctor’s office, and urgent care visits, including x-rays, COVID-19 testing, physical exams, and more. Better yet, with Mira, you receive up to 80 percent discounted rates on over 1,000 prescriptions. Try Mira today.
Ashley Brooks works in Healthcare Consulting and graduates with her MPH in September of 2022 from George Washington University, but graduated with her B.S. in Health Science from James Madison University in 2019. Ashley has been with Mira since June of 2021 and shares the passion for creating affordable healthcare coverage for all!