Health Insurance for Unemployed or Self-Employed People
Health insurance is an essential aspect of healthcare that offers numerous benefits to individuals and their eligible dependents. It can help cover medical costs that may arise due to a sickness or an injury that could lead to debt and high stress. However, getting health insurance coverage can be challenging, especially for unemployed or self-employed individuals. Read on to learn about different options that may be available to obtain health insurance coverage.
The Importance of Health Insurance
To start, it’s important to understand why someone needs health insurance in the first place. Health insurance coverage is crucial because it provides a safety net that typically covers some medical costs that someone may not be able to afford otherwise. Many medical services are expensive. The average cost per day of a hospital stay is $2,882 and surgeries alone typically exceed $100,0001. But for many people, these medical services are life-saving and essential care.
Without health insurance coverage, a patient may not be able to access the medical care they need, and if they do, they may end up with a lot of medical debt and resulting stress. Health insurance generally provides a way for people to receive the medical care they need without accumulating unbearable amounts of debt.
Health insurance is also important because it can help people maintain their overall health by giving them access to preventive care, including certain screenings and vaccinations. Without health insurance coverage, some people may choose to forgo recommended screenings or other primacy care services, which could eventually lead to health issues.
Having health insurance coverage can help give people peace of mind, knowing that they have some financial protection in the case of a medical emergency.
Non-Employer-Sponsored Health Insurance Options
Fortunately, there are health insurance options available to most individuals who are unemployed or self-employed. Read on to learn about some of the common options for obtaining health insurance coverage that may be available to unemployed or self-employed individuals.
Medicare, Medicaid, and CHIP
There are several government programs that help provide health insurance coverage to qualifying individuals. Generally, Medicare is a federal health insurance program that provides coverage to people aged 65 and older. Medicaid provides health coverage to eligible low-income individuals, pregnant women, elderly adults and people with disabilities. Eligibility for Medicaid coverage may vary by state.
The Children's Health Insurance Program (CHIP) provides health coverage to eligible uninsured children whose parents or guardians earn too much to qualify for Medicaid but not enough to afford private health insurance. CHIP typically covers doctors’ visits, emergencies, vaccinations, and even dental care and glasses.
COBRA
The Consolidated Omnibus Budget Reconciliation Act (“COBRA”) was passed in 1985 to provide coverage to people who lost their employer-sponsored health insurance coverage and their eligible dependents. COBRA is a federal law that allows eligible individuals to maintain their employer-provided health insurance for a limited period. This coverage can last for up to 18 months but can be extended in some cases. Some states have also enacted “mini-COBRA” laws.
Qualifying events are events that cause an individual to lose their group health coverage. These may include:
- Termination of employment
- Reduction in the number of hours
- Divorce or legal separation from a covered spouse
- Death of a covered spouse
- Loss of dependent status
It’s important to note that while COBRA allows eligible individuals to maintain health insurance coverage, it does not require employers to pay a portion of the premium. COBRA coverage will typically cost more than employer-sponsored health coverage, and depending on the cost, it could be worth considering other options.
Health Insurance Marketplace
The Affordable Care Act (“ACA”) established health insurance marketplaces where eligible individuals can enroll in individual health insurance plans that meet their needs and budget. Health insurance plans sold through the Health Insurance Marketplaces are required to cover the following categories of services:
- Pregnancy, maternity and newborn care
- Preventive services
- Outpatient services
- Emergency services
- Hospitalization
- Prescription drugs
- Mental health and substance use disorder services
- Laboratory services
- Pediatric services, including oral and vision care
- Rehabilitative and habilitative services and chronic disease management
Whether a specific service or prescription drug is covered, depends on the plan an individual enrolls in.
There are premium tax credits that many people qualify for that can help make plans purchased through a Health Insurance Marketplace more affordable. Eligibility for premium tax credit is based on income and other factors.
Purchasing Individual Health Insurance from Insurer
An individual may purchase individual health insurance coverage directly from an insurance company or through an insurance broker. This option offers more flexibility and selection of health insurance plans than employer-sponsored health insurance, but it can be more expensive. The premiums are not subsidized, but individuals can choose plans that meet their healthcare needs.
Joining a Family Member's Plan
If an individual has a family member who is enrolled in health insurance coverage, they may be able eligible for coverage as a dependent. Eligibility for dependent coverage may depend on state law. For eligible dependents, this can be one of the most affordable ways to get health insurance coverage.
Conclusion
In conclusion, health insurance is an essential aspect of healthcare. The insured can receive preventive care that can help them manage their health and, potentially, avoid future health problems. It can also provide a safety net in case of a medical emergency.
While many people get health insurance coverage through their employer, there may be options available for individuals who are unable to obtain health insurance coverage through an employer. From government programs like Medicaid and Medicare to private individual health insurance plans, most individuals can find health insurance coverage that meets their needs.
It can be overwhelming to know where to start and how to find health insurance coverage. Acrisure and our Agency Partners are here to help. Acrisure can help you find the health insurance solution that's right for you. Contact us to learn more about health coverage options available to you.
1 https://www.debt.org/medical/hospital-surgery-costs/
2 https://www.irs.gov/affordable-care-act/individuals-and-families/the-premium-tax-credit-the-basics