Many workers today get health insurance through their employers. Companies often offer group health plans that make coverage more affordable. If you lose your job or work for an employer that does not offer health insurance, it may seem that you are out of options. The good news is you can get health insurance outside of your job, and there are several options to secure coverage that fits your health and financial needs.
Why Look for Health Insurance Outside of Work?
Employer-sponsored health insurance is an important employee benefit, but it is not always available or the right fit for everyone. Individuals and families may look for alternatives for a number of reasons, including the following:
- Self-employment: Freelancers, small business owners, and contractors must find their own health coverage.
- Job transitions: If you have recently resigned, been laid off, or retired early, you may need new coverage.
- Part-time or gig work: Many gig platforms and part-time jobs do not offer health benefits.
- Better options: Some families and individuals find marketplace plans or private policies that provide better networks and offer more flexibility.
What Are the Main Options for Health Insurance That is Not Employer-Sponsored?
Individuals and families may have any of the following options for health insurance outside of work:
Health Insurance Marketplace (Affordable Care Act Plans)
Created under the Affordable Care Act (ACA) the Health Insurance Marketplace is a popular choice for individuals without employer-sponsored coverage. Plans are categorized in tiers (Bronze, Silver, Gold, and Platinum) based on cost sharing. Marketplace plans are required to cover essential health benefits, such as emergency services, prescription drugs, and preventive care.
Depending on your household income, you may qualify for premium tax credits that reduce your monthly cost. Open Enrollment for Marketplace plans begin on November 1 and end on January 15 of the following year. December 15 is the last day to enroll in a plan that starts January 1. Certain life changes, such as job loss or marriage, may qualify you for a Special Enrollment Period.
Medicaid or CHIP
Medicaid provides free or low-cost health insurance for eligible low-income families and individuals. Eligibility can vary, as each state has its own income guidelines. Children may qualify for low-cost health coverage under the Children’s Health Insurance Program (CHIP) even if their parents are not eligible for Medicaid.
Medicare
Individuals ages 65 and older or with certain disabilities may be eligible for Medicare. Under Parts A, B, C, and D, it offers hospital, medical, and prescription drug coverage, along with Medicare Advantage (private) plan and Medigap (Supplemental Insurance) options.
Other Options for Health Insurance
For those not covered by employer-sponsored health insurance, other options include:
- COBRA (Consolidated Omnibus Budget Reconciliation Act) coverage, which allows you to temporarily continue your previous coverage, although you typically pay the full premium plus an administrative fee
- Short-term health insurance is designed to cover temporary gaps in coverage
- Private health insurance plans, which may provide more flexibility than Marketplace plans
Our friendly agents at Pacific Way Insurance Services are well-versed in all available health insurance options. Contact us at (310) 277-4939 for help finding health insurance outside of work.