What to do if Your Employer Doesn’t Offer Health Insurance
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If you don’t have insurance through your employer, you’re not alone. Only about half of all employers offer any health benefits to their employees. On top of that, self-employed and unemployed people often have to find their own coverage.
Instead of going to Google to look for an insurance plan, you can start by checking to see if you’re eligible for a low-cost program. Depending on your income, family size and other demographics, you may even qualify for free care or a tax credit that brings your premium down to $0 a month.
Four Places to Look for Affordable Health Insurance Plans
If you need to find an insurance plan, the best place to start is by looking into federal and state programs. If you’re not eligible, there are still ways to find an affordable plan and/or reduce your monthly bill. We recommend starting from the top of this list and working your way down:
1. Public Health Insurance
If you have little or no income or a qualifying disability, you may be eligible for a free or low-cost public healthcare plan. These include:
- Medicare: For people 65 and older, or people under 65 who have certain long-term disabilities.
- Medicaid: It may be known by another name in your state, but Medicaid programs provide medical coverage based on income, family size and disability status.
- The Children’s Health Insurance Program (CHIP): Formerly known as the State Children’s Health Insurance Program (SCHIP), this state-sponsored program covers low-income children who don’t qualify for Medicaid. Like Medicaid, CHIP may go by a different name in your state.
2. Insurance Marketplaces
If you don’t qualify for a public insurance plan, the next place to look is through an insurance marketplace.
When you go through a marketplace you choose a plan from a public insurance provider, but you can also find out if you qualify for income-based assistance with the cost. Depending on your income and family size, you may qualify for a federal tax credit that drops your monthly premium as low as $0.
Just keep in mind that you may owe some money at tax time. If you underestimate your annual income and receive too high a credit, you may have to pay back the difference to the IRS.
3. A Family Member's Plan
If you have a family member with an employer-sponsored insurance plan, you may be able to join their plan. People who can join generally include:
- Spouses, whether by traditional or common law marriage.
- Children up to the age of 26.
Before joining, check to see how much it will cost and make sure the policy is more affordable and/or comprehensive than other options you qualify for on our list.
If the employer provides a Flexible Spending Account (FSA) or Health Savings Account (HSA), your family member will also want to look into adjusting their FSA or HSA contribution in order to help cover your healthcare costs.
4. By Affiliation
You may be able to qualify for free or reduced-cost medical insurance based on your affiliation with a specific group. Here are some examples:
- TRICARE: A healthcare program for active duty members of the military, their families, and retired service members.
- Indian Health Service (IHS): Healthcare for indigenous Americans who live on or near reservations or who live in certain Urban Indian communities.
- Health Care Sharing Ministries (HCSMs): Insurance plans for members of specific religious groups.
- Group Health Insurance: Plans for members of certain unions and professional associations, including for self-employed people.
Other Ways to Make Medical Insurance Affordable
If you’re looking for more ways to reduce or offset the cost of medical insurance, keep these tips in mind:
- Low-premium plans: HMO plans and Bronze and Silver marketplace plans typically have the lowest premiums. Out-of-pocket costs can be high, so these plans are best for people with a minimal need for medical care.
- Health Savings Accounts (HSAs): If you have a High Deductible Health Plan (HDHP) you can open an HSA, and contributing to your HSA helps you cover premiums and other medical expenses while reducing your tax bill.
- Employer assistance: If your employer doesn’t provide insurance but does have a QSEHRA or an ICHRA, they’ll give you a monthly reimbursement for part of your health insurance premium.
If you still can’t find a way to afford an insurance plan, you may want to consider a healthcare membership, which gives you access to a variety of medical services for a monthly or annual fee. You may also be able to get care at a Federally Qualified Health Center (FQHC) in your area, such as a free clinic or a school-based facility.
What Should You Look for in a Health Insurance Plan?
A low insurance premium isn’t the only thing to consider when you’re looking for an affordable healthcare plan. If the premium is low, it’s likely because the out-of-pocket costs are high or the plan has other limitations. Here are a few questions to ask yourself before choosing a plan:
- Which services do I use most and how much will I pay for them?
- How affordable is emergency care?
- How easy is it to find and book an appointment with an in-network doctor?
- How accessible are the in-network facilities?
Is There a Penalty for Not Having Insurance?
Going without health insurance can be risky for your health and your wallet, but as of 2018, there is no federal tax penalty for not having coverage. Most states don’t have a penalty either, with these exceptions:
- California: Minimum fee of $850 per adult and $425 per dependent child under 18.
- The District of Columbia (D.C.): Either $745 per adult and $372.50 per child (up to $2,235 per family) or 2.5% of family income that exceeds the federal tax filing threshold, whichever is greater.
Meeting your state’s requirement can be tricky, since many insurance plans have a limited-time, special enrollment period each year. However, you can enroll outside of the special period if you have a “qualifying event,” such as a change in your household size or the loss of a job.
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