Unemployed On Obamacare: What If I Am Unemployed But My Spouse Works
Im uninsured and unemployed but my spouse works. Can I still enroll in Obamacare to get health insurance?
Your household income is used to determine whether you qualify for Medicaid, CHIP, or lower costs on Marketplace coverage. So youll need to count your spouses income when you fill out your application.
Information about any job-based coverage that is available to you and your family also affects whether you qualify for lower costs on Marketplace coverage.
If youre eligible for coverage under a family members plan but dont 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 is considered affordable and meets certain minimum standards.
You can learn whether the plan is considered affordable and meets minimum standards by filling out an Employer Coverage Tool. You can use information from this completed form to fill out your application.
Having access to job-based coverage doesnt impact your eligibility for Medicaid.
If your family members job-based coverage isnt offered to spouses or dependents, you can qualify for lower costs. Only the person with the job- based coverage wont qualify for lower costs on Marketplace insurance.
Unemployed: What The Affordable Care Act Means For You
The bottom line is simply this: thanks to the Affordable Care Act, If it is outside of open enrollment, 2017Is ObamaCare Free? Obamacare FactsJun 07, Learn how to apply for Marketplace coverage and find out if you qualify for Medicaid, Thats due in part to the Affordable Care Act, Recent events have changed this fine, You can qualify for Medicaid in New York if you earn up to 133 percent of the federal poverty level, according to
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Access to telehealth services can be a lifesaver for anyone dealing with unemployment. Not only does virtual care save you the time and cost of getting to a doctors office, but you can also even get remote treatment for some minor ailments without having to pay for an in-person visit. Cigna includes $0 telehealth visits with all of its individual plans through partnerships with MDLive and Amwell, two of the largest telemedicine providers in the United States.
Virtual health visits arent the only advantage to purchasing health insurance from Cigna. In-house customer service is available 24 hours a day to answer questions and provide assistance. The company also places a $25 monthly out-of-pocket cost limit on insulin regardless of your coverage level.
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Unemployed Applicants Should Use State Or Federal Marketplace
An unemployed person can apply for health insurance on the federal or state exchanges. They may find affordable low-premium options based on family income. Should they not find an affordable option, they may qualify for an exemption, Medicaid, or the CHIP.
Many states offer assistance to low-income families to help them qualify for affordable health insurance including payment assistance. If income is below the minimum needed for Obamacare, then applicants can seek coverage under the applicable state Medicaid program or CHIP for minors.
Where To Get Help
You can call 211 and ask for help to be connected with local health insurance experts.
Experts called navigators help people sign up for health insurance and find the best plans that fit their needs.
Covering Wisconsin, a program based out of the University of Wisconsin-Madison, has navigators on staff to help people through the process. Their services are free. People wanting help can call 608-261-1455 or 414-400-9489 to set up an appointment.
A range of other organizations also have people who offer help often for free with enrolling in health coverage. That includes community health centers, such as:
“There’s many, many different resources out there to help them. They don’t have to navigate this process through the HealthCare.gov website because it can be complicated and kind of confusing for folks,” said Isabell, of Milwaukee Health Services.
Find more organizations that can help and their contact information at coveringwi.org/enroll.
Why Is It Risky To Go Without Affordable Health Insurance
Do you have enough savings to cover your living expenses AND any medical expenses you may need for 4 months, 6 months, 9 months, a year or longer while you remain unemployed?
Most people do not. A recent study widely reported in January 2016, including in Fortune magazine, by Bankrate.com from a study done by Princeton Survey Research Associates International in December 2015 showed that:
- 63% of Americans do not have enough money in savings to cover an unexpected $1,000 medical event.
If you are one of that majority, then you need to consider taking action to protect yourself and your family. And remember, while you are looking for work, you probably also will be depleting any savings you do have that otherwise could be used for unexpected medical expenses.
That is why short term health insurance can be so important for unemployed people.
Who Is Eligible For Unemployment
The unemployment-based subsidies are available to anyone who has received or been approved to receive unemployment compensation at any time this year.
Eligibility for the unemployment-based subsidies includes people whose income is under the federal poverty level, as long as theyre not eligible for Medicaid. People with income under the poverty level are normally not eligible for subsidies, which means theres a coverage gap in the states that have refused to accept federal funding to expand Medicaid. But a person who would otherwise be in the coverage gap can receive a full premium subsidy and full cost-sharing reductions in 2021, if they receive unemployment compensation at any time during the year.
CMS has confirmed that the full premium subsidies are only available if its a taxpayer who is receiving the unemployment compensation. If its a dependent who is receiving it, the household is eligible for the cost-sharing reductions , but not the full premium subsidies.
Even if you only received unemployment compensation for one week of 2021, youre potentially eligible for the enhanced subsidies for the entire year. But subsidy eligibility would end if and when you become eligible for employer-sponsored health coverage , or premium-free Medicare Part A.
The ARP has not fixed the family glitch, so family members would also lose access to any subsidies in the exchange if they become eligible for employer-sponsored coverage thats considered affordable for the employee.
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Potential Aca Subsidy Repayment Caps For Fiscal Year :
Maximum Clawback Repaymentin 2022:
|MAGI Income % of Federal Poverty Level||Single Tax Filer|
|Entire Subsidy||Entire Subsidy|
If the subsidy mandate reverts back to pre-2021 rules, you can expect these guidelines to be similar, but not the exact same, for the taxes you pay in 2022 and beyond.
These general guidelines do not apply in a few special circumstances. If you are recently divorced, filing separate returns, sharing a plan between families, received subsidies from two different tax families during the year, did not receive a subsidy that you should have qualified for, or have other tax questions, then youll want to read IRS Form 8962 and accompanying Publication 974 closely to understand your special situation.
What You’ll Need To Sign Up
You do not necessarily need to provide proof of unemployment to take advantage of the savings, VanSpankeren said. However, it helps to have proof handy in case you need to submit verification.
For people already enrolled in a marketplace health plan, the process could be as simple as resubmitting your application to receive the savings. If you already listed unemployment income, you will automatically receive the savings when you resubmit, said Chang, of Progressive Community Health Centers.
Those enrolling in a marketplace plan for the first time and working with a navigator or other helper may be asked to bring proof of current income and other documents, such as a picture ID or your most-recent tax returns.
Ask what you should bring to an appointment if you are working with a navigator or other helper.
However, VanSpankeren stressed that missing documents should not stop people from trying.
“You could come to a navigator with virtually nothing, and we can figure it out. We can help you,” he said.
Covering Wisconsin is holding most appointments remotely, he said, meaning clients could locate any necessary documents while talking to a navigator from home.
Sarah Volpenhein is a Report for America corps reporter who focuses on news of value to underserved communities for the Milwaukee Journal Sentinel. Email her at . Please consider supporting journalism that informs our democracy with a tax-deductible gift to this reporting effort at JSOnline.com/RFA.
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How Can I Get Individual Health Insurance
You can get individual health insurance for individuals through a Special Enrollment Period . 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
- Moving to a new ZIP code
- Loss of employer-sponsored health coverage
- Becoming a U.S. citizen
Aca Plans Provide Comprehensive Longer
Even if youre unemployed, you may have a choice of affordable health plans that offer essential benefits required by the Affordable Care Act of 2010. Does your family need a wider range of benefits? Planning to work independently? Your income level and where you live could make ACA health coverage your best optionand well help find the plan you need.
Special enrollment period: Extended to August 15th.
How Many People Enrolled In An Obamacare Plan For 2020
People who enroll in an ACA plan often do so because they do not have access to affordable health insurance from an employer. For that reason, the number of Obamacare enrollees can shed light on the general state of health insurance coverage in the United States.
Obamacare enrollment has decreased every year since President Trump took office. This isnât very surprising since the Trump administration has sought to roll back Obamacare since his election. For example, in 2017, the Centers for Medicare and Medicaid Services , which administers Obamacare, shortened Open Enrollment by about two weeks. The agency also cut federal funding for the Navigator program, which helps people sign up for marketplace plans.
The individual mandate, which required people to buy health insurance, was also suspended in 2019. Although anyone who didnât buy health insurance wouldâve been charged a penalty, the individual mandate also kept overall costs down.
The Premium Assistance Tax Credit
Furthermore, if they earn at least an amount equal to the Federal Poverty Level currently $11,490 for an individual, $15,510 for a married couple, or $23,550 for a family of four they may be eligible for the Premium Assistance Tax Credit, which applies to incomes as high as $45,960 for individuals, $62,040 for married couples, and $94,200 for a family of four .
Those whose income is below certain thresholds may be eligible for health insurance through Medicaid, though eligibility varies by state.
To estimate the amount of premium tax credit you would be eligible for, you can check out the on HealthcareACT.com, or to get a more specific quote based on your exact income and circumstances, including the cost of health insurance in your state, go through the sign-up process at Healthcare.gov to see what your cost of health insurance would be.
If your income is lower for the year due in part to unemployment itself you may find yourself eligible for a very significant credit.
And notably, unlike many other tax credits, the premium assistance tax credit is not merely claimed when you file your tax return at the end of the year. Instead, its actually advanced to your health insurance company to help pay for your premiums if you purchase through the marketplace.
For instance, if your premium tax credit was $200 per month and your insurance cost $300 per month, you will simply pay the difference $100 per month for your health insurance in the first place.
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What Is Cobra Insurance And Is It Worth It
The Consolidated Omnibus Budget Reconciliation Act, commonly known as COBRA, is a federally mandated program through which you can retain your employer’s policy for up to 18 months. If you do elect COBRA coverage, be prepared to pay significantly higher monthly premiums youll be required to cover the amount your employer was contributing plus a 2% administration fee. Oftentimes COBRA isnt worth it, as most unemployed individuals can find a much more affordable policy on the marketplace.
Ease Your Health Insurance Worries With Help From An Expert
Heres the truth: Trying to figure out your health insurance can be really overwhelming, especially if youre unemployed. Why not take the stress out of it and let an independent insurance agent guide you? Having an agent step in to make sense of it all is really helpful.
Among other details, an independent agent will know your particular states laws vs. federal policies. Even better? Theyll be able to save you money by knowing how and when to apply the perks of the American Rescue Plan.
Ready for some good advice and peace of mind from trusted insurance experts in your area? Start the process today by talking with an Endorsed Local Provider .
About the author
Ramsey Solutions has been committed to helping people regain control of their money, build wealth, grow their leadership skills, and enhance their lives through personal development since 1992. Millions of people have used our financial advice through 22 books published by Ramsey Press, as well as two syndicated radio shows and 10 podcasts, which have over 17 million weekly listeners.
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Affordable Care Act Subsidized Plans After Medicaid
Special Enrollment Status: If you lose your Medicaid health coverage, a Special Enrollment Period opens up for you. During an , you can obtain full-featured health insurance known as an Affordable Care Act plan.
The SEP is only a 60-day window, so you have to act quickly. Tools like HealthCare.com help you determine which plan is best for your needs and budget.
Without a Special Enrollment Period, you can enroll in a health plan only during the annual Open Enrollment Period, which generally lasts from November 1 through December 15. Once the window closes, you will be unable to enroll in healthcare coverage until the next open enrollment period.
For example, if your Medicaid is canceled as of March 1, you will have 60 days to enroll in a health plan through Obamacare. If you dont enroll by the end of that 60-day window, you will have to wait until the next open enrollment period, and the coverage would not be effective until January 1 of the following year.
If you know when your Medicaid plan ends, you can sign up in advance. Health insurance plans are generally effective the first day of the following month after you apply, but a new application may take some time to process.
ACA Discounts for Low and Moderate Incomes: The cost of health insurance premiums can be intimidating, but help is available. Depending on your income level, you might receive a subsidy for ACA coverage.
Finding Economic Hardship Exemptions
Persons that fail to keep coverage throughout the year can get an economic exemption for 1-2 months. These exemptions were intended to bridge a short period of economic hardship with triggering the uninsured tax penalty for the full year.
When the economic hardship persists beyond a short period, applicants can file for an exemption from the individual mandate and penalty.
These exemptions include bankruptcy, foreclosure, unpaid medical expenses, ad many other indicators of financial hardship.
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Spouses Or Parents Health Insurance Plan
We saved this option for last for a reason. Sometimes, being on your spouses plan isnt the most cost-effective option in typical circumstancesthats why you arent already on the same plan! And most people dont actually want to put their health care burden on a parent. But lets face itit could be the right move for a season.
If youre unemployed and married and your spouse has health insurance through their employer, you can be included on their policy in most cases. Or if youre under 26 years old, youre legally eligible to be included on your parents insurance policy.4
Selecting The Best Fit For Unemployed Applicants
Costs and budgeting may be a high priority for unemployed persons. It is important to update application figures to reflect unemployment and future earnings. Comparison shopping is an ideal method for assessing the features of plans that matter most. These might be facilities, in-network services, or locations.
For those seeking to lower costs, the degree of out-of-pocket expenses may be the most important factor. Comparison shopping is a tool for the consumer to get the best plan for their individual or family situation.
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