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 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. You can start an application with a Special Enrollment Period right now.
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.
When you apply for Marketplace coverage you’ll estimate your income for the current calendar year.
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:
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.
When you fill out a Marketplace application, you’ll find out if you qualify for any of these types of coverage:
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.
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.
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.
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.
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.
Having access to job-based coverage doesn’t affect your eligibility for Medicaid.
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.
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.
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.