If You Can’t Get Health Insurance at Work
Coverage under the Affordable Care Act (also called Obamacare)
Under the health care law, people looking for health coverage will be able to compare plans and select the best one for them from online health insurance Marketplaces in each state. Your state’s Marketplace will collect information from you to find out if you qualify for Medicaid (or if your child is eligible for your state’s Child Health Insurance Program, called CHIP) or financial help to pay for coverage. Visit healthcare.gov or CuidadoDeSalud.gov for your state’s information.
You might also want to consider the different types of health plans that are offered on the Marketplace. There are HMO plans, which may offer you a fixed set of services from a single group or facility, and at the other extreme, Point of Service plans that allow you more choice of health providers. You can read about the different types of plans in Types of Health Insurance Plans.
Gather the information you’ll need to apply for Marketplace coverage
First, get your updated income estimates and household information together and be sure they’re correct. (Visit the Marketplace website first to see what other information you will need to apply through the Marketplace and to learn whether you qualify for Medicaid or CHIP. Or you can call 1-800-318-2596 to find out.)
After you get your information together, call the number above or go to the Marketplace online at healthcare.gov to re-apply. Find out what kind of plan you can get and when the new coverage will start.
If you don’t have Internet access, you can get Marketplace information and sign up by phone. For the phone number of your state marketplace, call 1-800-318-2596.
What You Need to Know About the Marketplace
Individual insurance policies
You can buy individual insurance plans outside the marketplace to cover yourself and your family. Most plans will meet the requirements for sufficient coverage so that you avoid the penalty at tax time, but some won’t. Be sure to ask whether it meets the minimum requirement. An independent insurance broker may be able to help you find a reasonable benefit package.
If you are employed, before you leave your job, find out if you can convert your group insurance to an individual plan. Some group plans have a clause that allows people to convert to individual plans, but premiums are often much higher. You usually must apply for these individual plans within 30 days of leaving a job. (This is different from COBRA, which lets you keep group insurance for a limited time.)
What You Need to Know About Individual Health Insurance
Consolidated Omnibus Budget Reconciliation Act (COBRA)
If you have been covered under your work health insurance plan for at least one day you should be able to keep your medical insurance through COBRA. Your employer must tell you, in writing, about your COBRA option. For more information, please see COBRA If COBRA is too costly, you might still qualify for a special enrollment period to buy a Marketplace plan.
What You Need to Know About COBRA
Medicare or Medicaid
Look into Medicare, which covers most people who are 65 or older, as well as those under 65 who are disabled—including children--and who have been getting Social Security disability benefits (SSI or SSDI) for 2 years.
If you are in a low-income bracket or are unemployed, find out if you or your family are eligible for Medicaid, or if your children qualify for CHIP. CHIP programs vary from state to state, as does eligibility. They usually cover children up to age 19. The family must be below certain income levels.
What You Need to Know About Medicare
What You Need To Know About Medicaid
Last Medical Review: November 17, 2015 Last Revised: March 1, 2016