If you’re unemployed you may be able to get an affordable health insurance plan through the Marketplace, with savings based on your income and household size. You may also qualify for free or low-cost coverage through Medicaid or the Children’s Health Insurance Program (CHIP).
Your household size and income, not your employment status, determine what health coverage you’re eligible for and how much help you’ll get paying for coverage.
- If you just lost your job and your job-based insurance
If you have just left your job for any reason and lost your job-based health coverage, you qualify for a Special Enrollment Period. This means you can enroll in a Marketplace insurance plan any time of year. You usually have 60 days from the day you lose your coverage to enroll. Learn how to apply for a Special Enrollment Period.
There is no limited enrollment period for Medicaid or CHIP. If you qualify, you can enroll in these programs any time of year. You’ll find out if you qualify when you fill out your Marketplace application.
Your options depend on your household income
When you apply for Marketplace coverage you’ll estimate your income for the current calendar year.
- How to estimate your income if you’re unemployed
It’s hard to predict your annual income if you’re unemployed. Still, it’s important to make your best estimate based on all current or expected sources of income for the year.
Types of income to include on your application:
- Unemployment compensation
- All household members’ income (not just yours)
- Additional types of income, including interest income, capital gains, cash support, and alimony
- Most withdrawals from traditional IRAs and 401ks. (But see IRS Form 8606 instructions (PDF) for information on non-deductible contributions, and IRS Publication 590-B (PDF) for information on Roth accounts.)
Learn about income sources the Marketplace considers for everybody.
Note: It’s very important to immediately update your income information with the Marketplace if your income changes during the year. This will ensure you get the right amount of savings based on your new annual income estimate.
Medicaid, CHIP, and insurance plans through the Marketplace
When you fill out a Marketplace application, you’ll find out if you qualify for any of these types of coverage:
- A Marketplace insurance plan. You may qualify for premium tax credits and savings on deductibles, copayments, and other out-of-pocket costs based on your household size and income. Some people with low incomes may wind up paying very small premiums. Learn about getting lower costs on a Marketplace insurance plan.
- Medicaid. Medicaid provides coverage to millions of Americans with limited incomes or disabilities. Many states have expanded Medicaid to cover all people below certain income levels. Learn more about Medicaid and how to apply.
- Children’s Health Insurance Program (CHIP). CHIP provides coverage for children, and in some states pregnant women, in families with incomes too high for Medicaid but too low to afford private insurance. Learn more about CHIP.
After you finish your Marketplace application, you’ll get an eligibility determination that tells you what kind of coverage you and others in your household qualify for.
- Does unemployment compensation count as income?
Yes. You’ll need to report your expected unemployment compensation when applying for health coverage through the Marketplace.
- When you complete a Marketplace application, you’ll need to predict your income for the coverage year the best you can. The application will help you make this estimate.
- Learn about how to estimate your income.
- If I make withdrawals from my IRA or 401k, does this count as income?
It depends on the kind of account you’re withdrawing from. Generally, the amount of your income from a retirement account distribution depends on the type of retirement account, how much you contributed to it, and whether you were already taxed on the amount you contributed.
- Withdrawals from a traditional IRA or SEP-IRA generally count as income. (If you made only tax-deductible contributions, all of it is considered income. If you made non-deductible contributions, see IRS Form 8606 (PDF).
- Roth IRAs are different. Qualified withdrawals from a Roth IRA are not considered income. For more information, see IRS Publication 590.
- Withdrawals from a 401k plan are generally counted as income (your pre-tax contributions, an employer’s matching contributions, as well as earnings, are included in income). But qualified distributions from a designated Roth account in a 401(k) plan are not considered income. For more information, see IRS Publication 575.
- If I’m unemployed, do I have to pay the fee for not having coverage?
Like other Americans, you must have qualifying health coverage or pay a fee. This is true regardless of your employment status.
- There are several exemptions from the fee that may apply to people who have no income or very low incomes. See the full list of exemptions. If you have an exemption, you don’t need to pay the fee for being uncovered.
- What if my spouse has job-based insurance?
If you’re eligible for coverage under a family member’s job-based plan, even if you don’t enroll in it, you may not be able to get lower costs on Marketplace coverage based on your income. This will depend on whether the job-based insurance that’s offered to you is considered affordable and meets certain minimum standards.
- You can learn whether the plan is considered affordable and meets minimum standards by asking the employer to fill out an Employer Coverage Tool (PDF). Use information from this completed form to fill out your application.
- If your family member’s job-based coverage isn’t offered to spouses or dependents, you can qualify for lower costs on a Marketplace plan. If this is the case, only the person with the job-based coverage won’t qualify for lower costs.
- Note: Having access to job-based coverage doesn’t affect your eligibility for Medicaid.
- What if I get a job after I have Marketplace coverage?
- If you get a job and are offered a job-based health plan you should tell the Marketplace as soon as possible. You can cancel your Marketplace plan or keep it. But you may not be able to get lower costs based on your income. This will depend on whether the job-based plan is considered affordable and meets certain minimum standards. If you enroll in the job-based plan, you can’t get any savings on Marketplace insurance.
- If your new job doesn’t offer insurance, you can keep your Marketplace plan. You may qualify for lower costs based on your household size and income.
When your situation changes, update your Marketplace information immediately. Learn how to report household and income changes to the Marketplace.
- What if I lose my job outside of Open Enrollment?
Losing job-based coverage qualifies you for a Special Enrollment Period. This means you’ll be able to apply for coverage through the Marketplace outside the Open Enrollment Period.
- If you’re eligible for your spouse’s job-based coverage, you may not be able to get lower costs on a Marketplace plan based on your income. This will depend on whether the job-based plan is considered affordable and meets certain minimum standards. If you enroll in the job-based plan, you can’t get any savings on Marketplace insurance.
- How can I get health care if I have no insurance and no income?
The health care law has expanded funding of community health centers, which provide primary care to millions of Americans on a sliding scale based on income. Learn about community health centers.