Employer Health Coverage
If you lose your job, you will be eligible to enroll in a marketplace health plan. You will have 60 days to enroll in marketplace coverage following a qualifying life event, like a job loss. If your income falls to Medicaid eligibility levels, you can enroll in Medicaid at any time of the year.
After a job loss, you also have the right to continue on your existing insurance for up to 18 months through a longstanding law called COBRA. But generally you will have to pay more for coverage than when you were employed, so it may be more cost effective for you to seek Medicaid or marketplace coverage. If you enroll in COBRA coverage through your former employer, but later change your mind, you will need to wait until the next marketplace open enrollment period to switch to a marketplace plan.
If you need financial help with medical costs, you may be able to get additional support through the Ryan White HIV/AIDS Program.
Does insurance coverage through an employer differ from coverage provided through other sources (such as purchased through a marketplace/exchange)?
Health plans offered by employers may vary from other types of coverage or new coverage available through the marketplaces established by the Affordable Care Act (or ACA). Coverage offered through marketplaces or expanded Medicaid provides a core set of required benefits, known as Essential Health Benefits (EHB). Employers are not required to provide these essential benefits, though insurance provided through an employer plan can sometimes be more comprehensive than many private insurance plans. More on essential health benefits.
Yes. All U.S. citizens and legal residents have a right to purchase insurance from a health insurance marketplace in their state. If you have access to insurance through your job, however, you may not be eligible for financial help to buy insurance in the marketplace.
If you chose to give up your employer insurance, you are giving up what your employer pays, and in many situations you will not be eligible for a tax credit. Only if your employer-based coverage is unaffordable and doesn’t reach a certain standard under the law will there be an option for financial help to buy your own coverage in the marketplace. In those cases, depending on your income, a tax credit could be available to reduce the amount you pay each month for your premium and for medical costs paid from your own pocket.
Starting in 2015, employers with 50 or more workers will be required to provide affordable insurance options to full-time workers. However, some employers may opt to take the penalty and not offer coverage, so check with your employer to see what it offers.
Most people in the United States get their health insurance through their jobs or a family member’s job. If your employer doesn’t offer health benefits, you can apply for coverage in the marketplace, and depending on your income, you may qualify for financial help. To get an estimate of your eligibility for subsidies in the marketplace, use the Kaiser Family Foundation subsidy calculator.