How do I get health insurance?
Figuring out how to get a health plan for you and your family doesn't have to be daunting.
In this post
Is there a penalty for not having health insurance?
What are my health plan options?
What are my family’s options?
Health plans explained
🚨 Read before proceeding
This post is NOT guidance and I am NOT an expert. This is my best attempt to consolidate information across a variety of sources, which I’ve linked throughout the post.
Things are always changing, so DOUBLE CHECK the information before continuing. If you see any corrections or updates that need to be made, please let me know in this feedback form.
Here is HealthCare.gov's Glossary for your reference if any of the terms are confusing.
This post is specific to the USA. If you’re not based in the USA, swipe left.
Figuring out how to get health insurance is daunting. It’s difficult enough to select a plan when annual enrollment rolls around. Here’s my best attempt to consolidate the information you need to get covered.
Is there a penalty for not having health insurance?
You don't have to pay a FEDERAL tax penalty for not having health insurance.
The fee for not having health insurance (aka “Share Responsibility Payment” or “mandate”) no longer applies to plans starting 2019. Unless you’re 30 or older and want a “Catastrophic” health plan. Then you’ll be required to apply for a hardship or affordability exemption.
If you live in California, the District of Columbia, or Maryland, your STATE has their own mandate, which may require you to pay a fee. They also have their own exemptions processes.
Check your state for more information:
California - Covered California
District of Columbia - DC Health Link
Maryland - Maryland Health Connection
What are my health plan options? In no particular order…
Extend your existing plan by enrolling in COBRA.
Apply for a “no out-of-pocket cost” plan, including Medicaid.
Buy a private plan from an insurance company
If you’re under 26, get on your parent’s health plan.
What are my family’s options?
1-4 above plus one only for children and pregnant individuals, depending on the state
Apply for CHIP.
Health plans explained
1. Extend your plan by enrolling in COBRA
COBRA (Consolidated Omnibus Budget Reconciliation Act) allows you and your family to continue your existing health plan with your previous employer for up to 18-36 months. By staying on the same plan, you can continue to receive the same benefits and to see the same doctors.
Even if you choose not to enroll, your dependents are still eligible to enroll.
This FAQs on COBRA is a super helpful resource.
💰 COST: You may be required to pay the entire premium out of pocket and a 2% administrative fee
✅ ELIGIBILITY: Individuals and families
⏰ ENROLLMENT PERIOD: You have 60 days after your employer-sponsored coverage ends to apply. Even if your enrollment is delayed, you’ll be covered starting the day your previous coverage ended. You don’t have to stay on COBRA the entire 18-36 months and can enroll temporarily while you search for other health plans.
✏️ APPLY:
Review the Election Notice - Your previous employer will send you a COBRA Election Notice within 45 days, which will tell you how much the premium will cost and how to apply.
Enroll - Within 60 days (or your special enrollment period), follow the instructions in your Election Notice to enroll in COBRA.
Pay Your Premiums - Pay your monthly premium within 45 days to avoid cancellation.
2. Apply for a no out-of-pocket cost plan
States provide health plans with no out-of-pocket cost or lower month premiums, including Medicaid. You have to apply to see if you qualify for one of these plans. Each state will either have its own Health Insurance Marketplace (or “Marketplace”) or expand Medicaid.
💰COST: If you qualify, you will have no out-of-pocket cost.
✅ ELIGIBILITY: Individuals and families
⏰ ENROLLMENT PERIOD:
Marketplace - Marketplaces have Open Enrollment Periods when you can apply. If you are outside these periods, you can still apply if you qualify for a Special Enrollment Period. Losing your job-based coverage qualifies you for a Special Enrollment Period.
Medicaid - Apply whenever. Medicaid does not have an Open Enrollment Period.
✏️ APPLY:
Apply yourself - Use this HealthCare.gov tool to navigate to your state and apply.
Get help - Agents, Brokers, and Assisters can guide you through the process. Use HealthCare.gov’s Find Local Help tool to find someone based on your zip code.
3. Buy a private plan from an insurance company
You can purchase a plan from an insurance company. The plans vary based on company, state, etc. so you’ll need to compare plans.
💰COST: Depends on health plan
✅ ELIGIBILITY: Individuals and families
⏰ ENROLLMENT PERIOD: Apply whenever. Insurance companies do not have an Open Enrollment Period.
✏️ APPLY:
Finder tool - Use HealthCare.gov's Finder tool to find and compare plans.
Comparison tool - A variety of companies like NerdWallet or LendingTree provide tools..
Insurance company - Directly contact health insurance companies or search their sites to find a list of health plans.
Get help - Agents, Brokers, and Assisters can guide you through the process. Use HealthCare.gov’s Find Local Help tool to find someone based on your zip code.
4. If you’re under 26, get on your parent’s health plan
If your parent’s health plan covers dependents, you may be able to be added to their plan and stay on it till you turn 26.
💰COST: Depends on health plan
✅ ELIGIBILITY: Individuals and families
⏰ ENROLLMENT PERIOD: Your parent’s can add you to their plan during the plan’s annual Open Enrollment Period or during a Special Enrollment Period. Losing your job-based coverage qualifies you for a Special Enrollment Period.
✏️ APPLY: Your parent needs to check with the plan or their employer’s benefits department for directions.
5. Apply for CHIP
CHIP (Children’s Health Insurance Program) provides low cost coverage for children up to the age of 18. Each state offers CHIP and works closely with its Medicaid program. If you apply for Medicaid, you will find out if your children qualify for CHIP.
💰COST: Depends on the state but never more than 5% of you family’s income for the year.
✅ ELIGIBILITY: Children and (depending on the state) pregnant individuals
⏰ ENROLLMENT PERIOD: Apply whenever. CHIP, like Medicaid, does not have an Open Enrollment Period.
✏️ APPLY:
Apply yourself - Use this Medicaid.gov tool to navigate to your state and apply.
Get help - Agents, Brokers, and Assisters can guide you through the process. Use HealthCare.gov’s Find Local Help tool to find someone based on your zip code.
Figuring out how to get covered is difficult. Hopefully this information helps you. Remember to DOUBLE CHECK the information before you proceed.
Feedback? If you see any corrections or updates that need to be made, share it here.