Individuals who have lost job-based health benefits may be eligible to purchase a qualified health plan that meets the requirements of the Affordable Care Act (ACA) during a Special Enrollment Period (SEP). SEPs provide individuals with the opportunity to purchase health benefits outside of the annual Open Enrollment Period (OEP). To determine eligibility for a SEP, individuals should review their job-based health benefits and confirm that they have been lost.
How Can I Get Individual Health Insurance?
You can get individual health insurance for individuals through a Special Enrollment Period (SEP). An SEP gives you 60 days to enroll in a comprehensive health insurance plan — for you only, or you and your family — after a qualifying life event. You can enroll as soon as your qualifying event occurs. There are several qualifying life events that can make you eligible for an SEP, including:1
- Job loss
- Adopting/having a baby
- Moving to a new ZIP code
- Loss of employer-sponsored health coverage
- Becoming a U.S. citizen
How Much Is Health Insurance Without a Job?
Individuals who are not employed may be eligible for subsidies to help cover the cost of health insurance plans under the Affordable Care Act (ACA). Subsidies can be used to lower the cost of monthly premiums and out-of-pocket expenses. There are two main types of subsidies available to individuals who qualify: premium tax credits and cost-sharing reductions. Premium tax credits can be used to reduce the amount of monthly premiums, while cost-sharing reductions can be used to reduce the amount of out-of-pocket expenses associated with a health insurance plan. Individuals who are interested in purchasing an ACA health insurance plan should take the time to research their eligibility for subsidies in order to maximize their savings.
- A premium tax credit is a type of subsidy that can help lower your monthly premiums, if you’re eligible. You can choose to have the credit paid directly to your health insurance provider to be applied toward your premium,2 or you can claim your premium amount when you file your income tax return.3
- A cost-sharing reduction (CSR), also called “extra savings,” is a type of subsidy that can help lower your out-of-pocket costs, including deductibles, copayments, and coinsurance. If you qualify, you have to enroll in a Silver plan to get the extra savings.
You can check your eligibility for these subsidies online.