Jane Dotson
If you're unemployed or have no income, you may still be able to get affordable health insurance. In the US, you can apply for coverage through the Health Insurance Marketplace, which offers a range of options at different costs, depending on factors such as income, family size, and location. You can also apply for Medicaid, a federal and state program that provides health insurance to people with limited resources and low incomes. Eligibility for Medicaid varies by state, but it typically offers free or low-cost coverage for individuals, families, children, pregnant women, and people with disabilities. Additionally, if you've recently lost your job, you may be able to get health insurance through the Consolidated Omnibus Budget Reconciliation Act (COBRA), which allows you to maintain your employer-sponsored health insurance for a period of time.
| Characteristics | Values |
|---|---|
| For people with no income | Healthcare.gov is a good place to start. |
| People with low income may qualify for a Medicare Savings Program (MSP) that pays for Medicare premiums. | |
| People 65 and older with low income can apply for Medicare Savings Programs for help with Medicare premiums and out-of-pocket costs. | |
| The Affordable Care Act (ACA) set up a health insurance marketplace where you may review, compare, and buy health insurance plans for yourself and your family. | |
| The marketplace offers a range of options at different costs, depending on factors such as coverage, income, family size, and location. | |
| Subsidies and tax credits could lower your premiums if you qualify. | |
| The American Rescue Plan (ARPA) is a law signed in 2021 that provided additional financial help toward monthly premiums for ACA health insurance plans. | |
| In some states, CHIP covers pregnant women. | |
| Medicaid is a federal and state program that provides health insurance to people with limited resources and low income. | |
| Eligibility for Medicaid depends primarily on income, and for those who qualify, it provides free or low-cost health coverage for individuals, families, and children, pregnant women, the elderly, as well as those with disabilities. | |
| If you've lost your job, the Consolidated Omnibus Budget Reconciliation Act (COBRA) might be the quickest and easiest way to get health insurance without a job, especially if you liked your employer's health plan. |
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What You'll Learn
Medicare Savings Programs for over 65s
Medicare Savings Programs (MSPs) are free government benefits for individuals over 65 with limited resources and incomes. MSPs are a subset of Medicaid, a health insurance program for people with low incomes. MSPs help cover out-of-pocket Medicare costs, such as Part A and Part B premiums, deductibles, coinsurance, and copayments. Medicare Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care. Most people don't pay a premium for Part A if they or their spouse paid Medicare taxes while working. Medicare Part C, a private health plan approved by Medicare, combines Part A and Part B benefits and often includes additional benefits like prescription drug coverage, dental, vision, and wellness programs.
There are four types of Medicare Savings Programs, each with different income and resource eligibility limits. The first is the Qualified Medicare Beneficiary (QMB) Program, which covers Medicare premiums (Part A, if applicable, and Part B), deductibles, copayments, and/or coinsurance. To qualify, individuals must have an income of less than 100% of the Federal Poverty Level (FPL) and resources under $9,660 if single and $14,470 if married. The second is the Specified Low-Income Medicare Beneficiary (SLMB) Program, which helps pay for Part B premiums and provides extra help for prescription drugs (no more than $12.15 per drug). The third is the Qualified Disabled and Working Individuals (QDWI) Program, which helps pay for Part A premiums. Finally, enrollment into MSPs automatically qualifies individuals for the Medicare Part D Low-Income Subsidy (LIS/Extra Help), which helps pay for prescription drugs and is estimated to have an annual value of $6,200.
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Medicaid for under 65s
If you have no income, you may be able to get an affordable health insurance plan through the Marketplace, with savings based on your income and household size. You can apply for coverage in several ways.
Medicaid is a federal-state program that provides free or low-cost health coverage to certain low-income individuals and families who fit into an eligibility group recognized by federal and state law. Eligibility for Medicaid depends primarily on income, and for those who qualify, it provides free or low-cost health coverage for individuals, families, children, pregnant women, the elderly, as well as those with disabilities.
Eligibility for Medicaid is based on Modified Adjusted Gross Income (MAGI). To be eligible for Medicaid, individuals must also meet certain non-financial eligibility criteria. They must be residents of the state in which they are receiving Medicaid and either citizens of the United States or certain qualified non-citizens, such as lawful permanent residents.
Certain Medicaid eligibility groups do not require a determination of income by the Medicaid agency. This coverage may be based on enrollment in another program, such as SSI or the breast and cervical cancer treatment and prevention program. Children for whom an adoption assistance agreement is in effect under title IV-E of the Social Security Act are automatically eligible. Young adults who meet the requirements for eligibility as a former foster care recipient are also eligible at any income level.
States have the option to establish a "medically needy program" for individuals with significant health needs whose income is too high to otherwise qualify for Medicaid. Medically needy individuals can still become eligible by “spending down” the amount of income that is above a state's medically needy income standard. Once an individual's incurred expenses exceed the difference between the individual's income and the state's medically needy income level (the "spenddown" amount), the person can be eligible for Medicaid.
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Affordable Care Act (ACA) health insurance marketplace
The Affordable Care Act (ACA) Health Insurance Marketplace provides more accessible health insurance options. There is no income limit to be eligible to enroll in health coverage through the Marketplace, and you can find out if you qualify for a Marketplace plan by submitting one application. The Marketplace offers a range of plans to choose from, covering medical, dental, and vision care.
Each state's Marketplace has its own enrollment instructions, and you can find your state's Marketplace at Healthcare.gov. During the open enrollment period, you can change your coverage if you experience a life event, such as moving or having a baby. You may also qualify for a special enrollment period if your household income is below a certain amount.
If you have Marketplace coverage and are offered a job-based health plan, you can choose to keep your Marketplace plan and continue to receive any savings based on your household income. However, you may not qualify for cost savings if the job-based plan is considered "affordable," which is determined by whether your share of the monthly premium is less than a certain percentage of your household income.
When applying for Marketplace coverage, you will need to provide income information, including your monthly and annual income estimates for the year you are seeking coverage. This includes unemployment benefits, household members' income, and additional income sources such as interest income, capital gains, and alimony. It is important to report any changes in your circumstances, such as income or family size, as they may impact your advance payments of the premium tax credit.
The American Rescue Plan (ARPA), extended through 2025 by the Inflation Reduction Act, provides additional financial assistance for ACA health insurance plans, making coverage more affordable for many. Depending on your location, you may pay as little as $0 or $1 in monthly premiums for an individual or family ACA plan.
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Consolidated Omnibus Budget Reconciliation Act (COBRA) continuation coverage
The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a federal law that allows individuals to maintain temporary health coverage after their employment ends, they lose coverage as a dependent, or due to another qualifying event. COBRA is applicable in cases of voluntary or involuntary job loss, reduction in hours worked, transition between jobs, death, divorce, and other life events. It is important to note that COBRA coverage is often costly since your employer is no longer contributing to the cost of the health plan.
Under COBRA, individuals may be required to pay up to 102% of the premium for their health coverage. This includes the monthly premium, as well as other costs such as deductibles, copayments, and coinsurance. COBRA typically applies to health plans sponsored by employers with 20 or more employees, or by state and local governments. However, some states have similar continuation coverage laws for individuals covered by group health plans sponsored by employers with fewer than 20 employees.
Qualifying events for COBRA include the loss of benefits coverage due to the death of the covered employee, involuntary or voluntary termination of employment, reduction in hours, divorce or legal separation, and a dependent child reaching the age where they are no longer covered. COBRA imposes different notice requirements on participants and beneficiaries, depending on the specific qualifying event. It is important to note that COBRA does not apply if the employer has terminated the health plan altogether or gone out of business.
The duration of COBRA coverage varies depending on the circumstances. In most cases, COBRA allows for coverage of up to 18 months. However, if the individual is deemed disabled by the Social Security Administration, coverage may be extended up to 29 months. In the event of divorce or the death of the former employee, coverage for the former spouse or widow may continue for up to 36 months.
Employees and dependents also have the option to choose a lesser form of coverage under COBRA. For example, they may opt for a plan that only covers the employee and not their dependents or a plan that only provides medical and hospitalization coverage. It is important for individuals to make timely payments of premiums to maintain their coverage. Additionally, employers are required to inform employees and dependents in writing at least 15 days before the coverage ceases.
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State-specific programs, e.g. Minnesota's MNsure
State-specific programs can provide insurance options for people with no income. These programs vary from state to state and are designed to assist those who cannot afford private insurance or do not qualify for other forms of coverage. Here is an example of a state-specific program:
Minnesotans can access health insurance through MNsure, which is Minnesota's health insurance marketplace. MNsure offers a range of plans, including private and public options. It is a one-stop shop for individuals and families to find and compare health insurance plans, and it provides information on financial assistance and eligibility for programs like Medicaid and the Children's Health Insurance Program (CHIP). MNsure also has a dedicated call centre and a network of expert assisters to help Minnesotans navigate the complex world of health insurance and find the best option for their needs and budget.
Now, let's explore some general principles and options regarding state-specific programs for those without an income:
Each state has its own Medicaid agency, and eligibility requirements vary. Some states have expanded their Medicaid programs to cover all individuals below a certain income level, while others have specific criteria. To find out if you qualify for Medicaid, you can check with your state's Medicaid agency or visit Healthcare.gov, which will provide information based on your state. This website will also inform you about potential eligibility for the Children's Health Insurance Program (CHIP), which offers coverage for children in families with incomes too high to qualify for Medicaid but insufficient to purchase private insurance. CHIP qualifications differ in every state, so it is essential to refer to your specific state's guidelines.
Additionally, some states have their own health insurance marketplaces, such as Covered California or Washington Healthplanfinder, which offer a range of plans with different premiums and cost-sharing requirements. These marketplaces often provide tools and resources to help individuals understand their options and determine eligibility for savings or subsidies based on income and household size.
Finally, it is worth noting that if you have recently lost your job, you may be eligible for COBRA (Consolidated Omnibus Budget Reconciliation Act) continuation coverage. This federal law allows you to maintain your previous employer's health coverage temporarily, although you will be responsible for the full cost of the premiums.
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Frequently asked questions
If you have no income, you can look into Medicaid, a federal and state program that provides health insurance to people with limited resources and low income. You can also look into Medicare Savings Programs (MSP) that help with Medicare premiums and out-of-pocket costs. If you are 65 or older, you can apply for Medicare Savings Programs.
You can apply for insurance with no income by visiting Healthcare.gov or your state marketplace, or by going directly through your state Medicaid agency. You can also contact your state's health department for more information.
When applying for insurance with no income, you will need to provide information such as your ZIP code, state, the number of people in your household, and your household income. You will also need to estimate your monthly and annual income, including any unemployment benefits, additional income sources, and withdrawals from retirement accounts.
Yes, if you have recently lost your job, you may be eligible for the Consolidated Omnibus Budget Reconciliation Act (COBRA) which allows you to maintain your employer-sponsored health insurance for a period of time after leaving your job. You can also look into low-cost health care options at community health centers or consider the Affordable Care Act (ACA) health insurance marketplace to compare and buy health insurance plans.
