What do I do if I lost my job, don’t have a job, and cant pay premiums? I don’t know when I might be working again.


When you lose a job you qualify for a 60 day special enrollment period. You can get a Marketplace plan and report that you don't plan on having any income, and report the income you did make this year. Then you will qualify for cost assistance based on total Modified Adjusted Gross Income for a calendar year. When you start to work again, let the marketplace know so you can adjust cost assistance. If you get access to an employer plan before the end of the year, make sure to cancel your marketplace coverage when you switch back to an employer plan. You'll have to pay back some portion of assistance based on income you earn in that calendar year if you make more income than you project, so make sure you read up on advanced tax credit repayment limits. Lastly, in states that didn't expand Medicaid, some people will fall in "the Medicaid Gap" where they don't qualify for Medicaid or cost assistance and thus they should look into short term health plans. Lastly, if you lose your job and you qualify for COBRA, you can take that instead and then use special enrollment when COBRA coverage is set to end.

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Steven Folden on

I hurt my back and was out of work for about three weeks.
I was fired and lost my medical insurance.
I have no income.
What are my choices?

ObamaCareFacts.com on

You should enroll via special enrollment unless you have worker’s comp or COBRA options you have access to. Then you can consider all those options.

Clay on

There appears to be NO Coverage available for a single male who loses job and has not savings or income. Guess we fall into the hole of no insurance options. Great. The Marketplace plans make it hard to find a doctor who will accept insurance….it can take weeks and the doctor may be so busy it’s close to impossible to get an appointment. While on the surface the idea seems good in practice you can end up paying $200 per month for a plan that no one accepts. Better to save the $200. The insurers publish a list of doctors they have in network with SOME of their plans and the insured has to spend time calling only to find the doctor does not accept marketplace plans. The insurers are making out like bandits….collecting premiums and providing a list of doctors who do not accept insurance.

Jim Male on

I got laid off and can’t afford Cobra.

Kendra on

This Obama care is bullcrud! I can barely live on my unemployment and now I’ll be penalized for being too poor! If I was Mexican or Muslim or on welfare I’d get a free ride. It doesn’t pay to be a single white middle aged female.

ObamaCareFacts.com on

Nothing you said is true, although we are all allowed our frustration and our opinions.

1. Religion and race have nothing to do with access to assistance or rights in general (minus a few specific tax exemptions and rights for religious reasons).

2. The ACA expanded Medicaid and cost assistance generously to single adults, some GOP led states rejected Medicaid, but generally the left is pro-women’s rights in rhetoric and action. So actually Obama specifically has done a ton for low-income middle aged females.

This list is telling: http://pleasecutthecrap.com/obama-accomplishments/

Jesus on

Im Mexican with Muslim friends and we all pay health insurance,so where do you collect you info?

Amy on

My brother-in-law lost his job and health care. They qualified for medical assistance and then he took a job. 2 month waiting period to start health insurance, living on smaller income trying to catch up on bills from being out of work. As they file their taxes the find out they are penalized for the 2 months that he was working until the health insurance kicks in.

Now they have health insurance, but the copayment is so high, they can’t afford to go to the doctor.

Mary on

Does the 60 day period start the day of the loss of a job, or the last day of medical coverage (which usually is at the end of that month)?

Sue Stephens on

This does not clearly state whether or not I will get a subsidy if I am no longer earning a salary and unable to pay. It states based on TOTAL Modified Adjusted Gross Income for a calendar year – what does this mean – no salary is the adjusted gross income or is it based on the salary I have already earned. If based off of salary I already earned, does this mean I may not get a subsidy for healthcare even though I no longer have any income? It’s not clear.

Michael on

“And here’s where it gets crazy” :
I had been unemployed for almost a year, applied for assistance, reported “0” income for this year and “0” expected income. I was first asked to provide a W2. FROM WHERE? i AM UNEMPLOYED!!!! I submitted my app and was immediately “rejected for assistance” and told my premiums would be $325 / month. The only source of household income was my wife’s SS. I resubmitted my app with the ONLY change being that I added my wife’s SS income which is way less than $19k/yr. “BING” – “Welcome to the marketplace. You qualify for $300/month assistance so your OOP will be $25/month”. Huh? I had “0” income so I didn’t qualify for ANY assistance but I have a little income so I qualify for ALOT of assistance? I DARE anyone to explain how that works.

Mike on

Your household income is above the threshold the Marketplace deems as Medicaid elligible, thus receiving the premium tax credit.

upset American on

So from what I am reading I am finding that I lost my job, my insurance, and have a family of 5. But because my wife has a job and we don’t live of welfare I don’t qualify for anything. So at tax time I will pay a penalty for not having insurance for a year, when in all actuality I will only not have coverage for three months. We can’t afford the premiums in the marketplace and continue to put food on the table and a roof over our heads. My wife’s salary is only $30,000 but because I am drawing unemployment that throws our household income over $39,000. This is ridiculous, we work our a*$$e# off and when something out ofour control happens we get penalized for it. Only to have the money that we did work our butts of go to people on welfare sitting at home eating bon bons.

[email protected] Erin on

You don’t pay the fee for the whole year, you only pay 1/12 (aka the annual fee for not having insurance is divided by 12 months and then you pay for each month without insurance). In addition, everyone has a three month short term exemption every single year. So if it was only 3 months, you’re fine. If it was more, you will owe 1/12 of the annual fee X each month you went without insurance and also didn’t have an exemption. There are other exemptions as well. If the insurance your offered costs more than 8.13% of your families income, you are completely exempt from having to have insurance or from paying the fee for not being insured. That one you have to fill out an application for through healthcare.gov.

sue on

“So if it was only 3 months, you’re fine.” This isn’t true. If there was a gap of three CONSECUTIVE months, you’re not fine, unfortunately. It can only be two consecutive months. Do further research at the healthcare.gov site if you doubt this.

ObamaCareFacts.com on

To clarify: it must be “less than three consecutive months”. It is in the 8965 exemption form. The wording results in confusion sometimes.

So it is a monthly fee, you can claim exemptions for “less than three in a row”, but no, you can’t spread them out… so one might end up owing a fee for an odd month (as calculated on form 8965). Also here I’ll note, coverage for even one day in a month counts.

Dan on

Tell me again how this is great. I lost my job – was making pretty decent wage plus contributing to 401 k – I worked my way up to 86K with Base pay plus bonus. Now I lost my job and on my yearly income tax -it will show that I made with 401 k taken out – more than I am actually worth.
I have been out of work now for about 3 months – trying to find job that matched or close to my old pay. It is hard considering I was with the company for well over 10 years and earned yearly increases.
Now I will get penalized because I have no insurance and I will have to pay for insurance without having a job.
Again, tell me how Obama Care Act is helping me?

ObamaCareFacts.com on

Unless you have a preexisting condition, or get one down the road and would have been priced out of coverage, or lose your ability to work or some income and need assistance, it isn’t helping much. I won’t pretend that it is. There are some real problems that have gotten worse over the years. I really wish Congress would do something about this personally.

Mike on

Using your information I show a $200 Deductible, $15 office visit, $600 max out of pocket plan for $108 a month for you and your spouse. Kids use Medicare.
There is no penalty for not having insurance for 2 months or less. You may need to contact an insurance agent and a good tax person.

agent1159 on

Quit a job in march. Started self employed/part time work. Applied for insurance in July. Why in the hell should my estimate include income from a job I no longer have? I naturally based it on how much self employment I expected to make. This really is a half assed system. Now I’m getting penalized for taking too much of a subsidy in which I STILL had to pay $70 a month! Not to mention my premiums shot up 60% and I had to switch to a crappier plan that pretty much means I’m filing for bankruptcy whether I had insurance or not.

J on

I was laid off in November. I am losing my umemployment in a few weeks. My health insurance plan is private, can I get a reduced rate since I won’t have income? Or can I apply for Medicaid?

ObamaCareFacts.com on

If you don’t have a marketplace plan, there is no way to get cost assistance. If however your income dips low enough, then Medicaid may be an option. With that said, if you are losing your insurance plan for any reason other than non-payment, you should qualify for special enrollment in the marketplace. So check that out: https://obamacarefacts.com/special-enrollment-period/

Roxana on

I lost my employment June 2016, but I was paid my salary until May 2017 which made it possible to continue paying for private health insurance. We have very limited income now. Can I apply for health insurance through the exchange now?

ObamaCareFacts.com on

You can switch from your plan to a marketplace plan via open enrollment rather easily if you shop by Dec. 15. Otherwise you’ll have to go through a special enrollment process. You might not qualify for special enrollment given your situation (I’d need a few more specifics to know for sure), so it makes a lot of sense to take advantage of open enrollment!

dace on

I am 57 lost my job but have $1 million in the bank which is supposed to be used for my retirement. What type of insurance can i get now.

ObamaCareFacts.com on

Under the Affordable Care Act cost assistance is tied to total wealth, just income. So I would contact healthcare.gov ASAP and try to enroll in special enrollment (since we are outside of open enrollment).

Patricia Mignone on

My husbands company is going out of business and we will be left without insurance and we both have diabetis and he we will loose insurance when enrollment period is not open what do we do? I am so worried financially don’t know what we will do. We are so confused and scared and no one knows how to direct us.

ObamaCareFacts.com on

You should contact healthcare.gov because this is almost certainly a qualifying life event that would result in you being eligible for special enrollment.

steven tobin on

I was fired without cause in 2017. Lost insurance but got the State plan 2 months later. Why would I be getting hit with a penalty for those two months, wasn’t my fault?

ObamaCareFacts.com on

If you had less than a 3 month gap in coverage and got covered by a marketplace plan or Medicaid after losing employer insurance then you should not be subject to the fee. It could be that you didn’t file the 8965 form the claim the exemption or that something got messed up with your 1095-a or 1095-b. You should check all of this as you likely shouldn’t owe the fee.

Jerry Saad on

I am self-employed – but due to COVID, my self-employment earnings for 2021 were only $2,750. I have been on Obamacare for several years. My business is starting to recover and I expect to earn more than $15,000 in 2022. Will i be able to keep my Obamacare coverage?

ObamaCareFacts.com on

If you mean those figures as annual and you are on Medicaid, you can stay on Medicaid. If you mean those numbers as monthly, you won’t qualify for cost assistance but can keep your plan.