author-img
Insurance and Healthcare Consultant

Tammy Burns is an experienced health insurance advisor. She is ACA-certified for health insurance and other ancillary, life, and annuity product.

Health insurance premiums are too expensive for some individuals and families. But going without health insurance is risky. If you were to face an unexpected illness or injury, the medical bills could be overwhelming, especially if you need ongoing care.

What’s the answer if you can’t afford the health insurance you need?

Today more than ever, there are free or low-cost health coverage options for low-income households, says Kimberly Liddell Jones, an insurance agent for Jayman Insurance in Sanford, Fla., an exclusive provider of Florida Blue plans.

“The government is helping so many people with tax credits and offering different plans,” Jones says. “Insurance companies have also restructured plans to be more inclusive and open up more doors. I can’t tell you how many policies I write where six or seven plans are offered at zero dollars because the tax credits cover that much.”

What You Should Know About Health Insurance for Low Income

  • Medicaid: Depending on your income and other qualifications, you may be eligible for Medicaid.
  • Subsidized insurance: If you don’t qualify for Medicaid, you can get an income-based subsidy for Health Insurance Marketplace plans.
  • Free health insurance: You may have additional options for free health insurance, including employer-based income, using a parent’s insurance plan, or Medicare.

What is Medicaid?

Medicaid is a government health care program that offers insurance to adults, children, pregnant women, adults over age 65, and those with disabilities. You must qualify based on income limits, which vary by state. States administer Medicaid programs based on federal guidelines. As of January 2021, 73.8 million Americans were enrolled in Medicaid. Medicaid includes the Children’s Health Insurance Program (CHIP) for qualifying families with low income.

What does Medicaid cover?

Medicaid coverage depends on the state in which you live, but federal law mandates some benefits. Some of those mandatory benefits for health care services include:

  • Inpatient and outpatient hospital services
  • Physician services
  • Laboratory and x-ray services
  • Home health services

You can add optional benefits like prescription drug coverage, case management, physical therapy, and occupational therapy.

Beyond those essential mandatory benefits, Medicaid offers the following benefits:

  • Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services
  • Nursing facility services
  • Rural health clinic services
  • Family planning services
  • Certified Pediatric and Family Nurse Practitioner services
  • Freestanding birth center services when licensed or recognized by the state
  • Transportation to medical care
  • Tobacco cessation counseling for pregnant women

Optional benefits states can offer aside from prescription drugs, physical therapy, and occupational therapy include:

  • Clinic services
  • Speech, hearing, and language disorder services
  • Respiratory care services
  • Diagnostic, screening, preventive, and rehabilitative services
  • Podiatry services
  • Optometry services
  • Dental services
  • Dentures
  • Prosthetics
  • Eyeglasses
  • Chiropractic services
  • Hospice
  • Case management
  • Services for those age 65+ in an institution for mental disease
  • Services in an intermediate care facility for individuals with intellectual disability
  • State plan home and community-based services
  • Self-directed personal assistance services
  • Community First Choice Option
  • TB related services
  • Inpatient psychiatric services for individuals under age 21
  • Health Homes for Enrollees with Chronic Conditions

How do you qualify for Medicaid?

You may qualify for Medicaid if you have low income and belong to at least one of the following groups:

  • Families with children
  • Qualified pregnant women
  • Those receiving Supplemental Security Income (SSI)

Some states include additional groups, such as children in foster care. With the Affordable Care Act of 2021, states can opt to offer expanded Medicaid to nearly all low-income Americans under age 65.

You can qualify for Medicaid based on Modified Adjusted Gross Annual Income (MAGI). MAGI is also used for tax credits and cost-sharing reductions on the Health Insurance Marketplace. You also have to meet other non-financial criteria, such as living in the state that will provide the care.

If you search for health insurance on the marketplace, which will require you to provide your household income, you automatically will be directed to Medicaid if your MAGI qualifies you. Or, you can work with an insurance agent who will direct you to Medicaid health insurance options if you meet federal and state qualifications.

How does Medicaid vary from state to state?

Medicaid plans must meet federal requirements, but states administer Medicaid plans, which is why coverage and eligibility can vary depending on where you live. For example, Alabama has not expanded its coverage to include adults with low income like many other states have, and eligibility levels can range.

Following are state Medicaid resources so you can find out about plans where you live.

Can You Qualify for Marketplace Assistance?

If you do not qualify for Medicaid, the Affordable Care Act (ACA) marketplace at HealthCare.gov provides affordable health care options. Because of the American Rescue Plan Act of 2021, you might qualify for lower-priced health insurance. The federal health care marketplace offers a tool to help you figure out if your income qualifies you for additional premium tax credits.

When you create a marketplace account and submit an application, you can view all available health insurance policies. There are plenty of affordable and even free options once premium tax credits are applied.

You’ll create a marketplace account, then gather some basic information so you can prepare to fill out an online application. The marketplace asks for:

  • Home and mailing address
  • Basic information about applicants, including their relationship to you
  • Social Security numbers for all applicants
  • Immigrant documentation, if applicable
  • Whether you file taxes jointly or independently, and whether you have dependents
  • Employer and income information
  • Estimated household income
  • Health care coverage information if anyone in the household has a plan
  • Employer Coverage Tool information if anyone in the household has an option to get employer health insurance
  • Health Reimbursement Arrangement (HRA) notice if anyone in the household has one

After you apply, you’ll immediately find out if you qualify for a premium tax credit on a low-cost or no-cost health insurance plan or coverage through Medicaid or CHIP.

Premium tax credits

Premium tax credits are based on income and household information you fill out on the marketplace application. These premium tax credits subsidize your monthly health insurance premiums and have been extended to more people than ever before.

“Credits vary, and it doesn’t cost you any money to find out if you qualify,” Jones says. “Also, prices for health insurance are lower this year than in previous years, and open enrollment was extended to August 15.”

There are also federal poverty levels (FPLs) tax credits if your income is between 100% and 400% below the FPL. If your income is higher than the 400% FPL, you can still qualify for premium tax credits for a 2021 marketplace plan.

State Health Coverage Qualification and Costs

Do you qualify for Medicaid? How much does it cost? What does an unsubsidized marketplace plan cost? Find answers to these questions for your state in this table.

State* Average marketplace
premium amount
Medicaid income limit Medicaid premium*
Alabama Bronze: $401
Silver: $549
Gold: $583
Single: $12,880
Married: $17,420
Married, 1 child: $21,960
Married, 2 children: $26,500
Married, 3 children: $31,040
Married, 4 children: $35,580
0
Alaska Bronze: $435
Silver:$673
Gold: $608
Single: $22,204
Married: $30,042
Married, 1 child: $37,881
Married, 2 children: $45,719
Married, 3 children: $53,557
Married, 4 children: $61,396
0
Arizona Bronze: $342
Silver: $418
Gold: $553
Single: $17,774
Married: $24,039
Married, 1 child: $30,304
Married, 2 children: $36,570
Married, 3 children: $42,835
Married, 4 children: $49,100
0
Arkansas Bronze: $322
Silver: $387
Gold: $499
Single: $17,774
Married: $24,039
Married, 1 child: $30,304
Married, 2 children: $36,570
Married, 3 children: $42,835
Married, 4 children: 49,100
Up to 5% of household income
California Bronze: $323
Silver: $400
Gold:$444
Single:
Married:
Married, 1 child:
Married, 2 children:
Married, 3 children:
Married, 4 children:
0
Colorado Bronze: $236
Silver: $346
Gold: $383
Single:
Married:
Married, 1 child:
Married, 2 children:
Married, 3 children:
Married, 4 children:
0
Connecticut Bronze: $368
Silver: $523
Gold: $489
Single:
Married:
Married, 1 child:
Married, 2 children:
Married, 3 children:
Married, 4 children:
0
Delaware Bronze: $400
Silver: $522
Gold: $517
Single: $17,774
Married: $24,039
Married, 1 child: $30.304
Married, 2 children: $36,570
Married, 3 children: $42,835
Married, 4 children: $49,100
0
Florida Bronze: $339
Silver: $447
Gold: $489
Single: $12,880
Married: $17,420
Married, 1 child: $21,960
Married, 2 children: $26,500
Married, 3 children: $31,040
Married, 4 children: $35,580
0
Georgia Bronze: $348
Silver:$443
Gold: $463
Single: $12,880
Married:$17,420
Married, 1 child: $21,960
Married, 2 children: $26,500
Married, 3 children: $31,040
Married, 4 children: $35,580
0
Hawaii Bronze: $314
Silver: $467
Gold: $314
Single: $20,451
Married: $27,655
Married, 1 child: $34,858
Married, 2 children: $42,062
Married, 3 children: $49,266
Married, 4 children:$56,469
0
Idaho Bronze: $330
Silver: $492
Gold: $526
Single:
Married:
Married, 1 child:
Married, 2 children:
Married, 3 children:
Married, 4 children:
0
Illinois Bronze: $337
Silver: $415
Gold: $478
Single: $17,774
Married: $24,039
Married, 1 child: $30,304
Married, 2 children: $36,570
Married, 3 children: $42,835
Married, 4 children: $49,100
0
Indiana Bronze: $333
Silver: $400
Gold: $592
Single: $17,774
Married: $24,039
Married, 1 child: $30,304
Married, 2 children:$36,570
Married, 3 children: $42,835
Married, 4 children: $49,100
Up to 5% of household income
Iowa Bronze: $311
Silver: $481
Gold: $443
Single: $17,774
Married: $24,039
Married, 1 child: $30,304
Married, 2 children: $36,570
Married, 3 children: $42,835
Married, 4 children:$49,100
Up to 5% of household income
Kansas Bronze: $373
Silver: $470
Gold: $501
Single: $12,880
Married: $17,420
Married, 1 child: $21,960
Married, 2 children: $26,500
Married, 3 children: $31,040
Married, 4 children: $35,580
0
Kentucky Bronze: $ $342
Silver: $455
Gold: $579
Single: $17,774
Married: $24,039
Married, 1 child: $30,304
Married, 2 children: $36,570
Married, 3 children: $42,835
Married, 4 children: $49,100
0
Louisiana Bronze: $410
Silver: $502
Gold: $614
Single: $17,774
Married: $24,039
Married, 1 child: $30,304
Married, 2 children: $36,570
Married, 3 children: $42,835
Married, 4 children: $49,100
0
Maine Bronze: $348
Silver: $435
Gold: $494
Single: $17,774
Married: $24,039
Married, 1 child: $30,304
Married, 2 children: $36,570
Married, 3 children: $42,835
Married, 4 children: $49,100
0
Maryland Bronze: $222
Silver: $342
Gold: $327
Single:
Married:
Married, 1 child:
Married, 2 children:
Married, 3 children:
Married, 4 children
0
Massachusetts Bronze: $277
Silver: $353
Gold: $419
Single:
Married:
Married, 1 child:
Married, 2 children:
Married, 3 children:
Married, 4 children:
0
Michigan Bronze: $255
Silver: $340
Gold: $370
Single: $17,774
Married: $24,039
Married, 1 child: $30,304
Married, 2 children: $36,570
Married, 3 children: $42,835
Married, 4 children: $49,100
Up to 5% of household income
Minnesota Bronze: $251
Silver: $295
Gold: $362
Single:
Married:
Married, 1 child:
Married, 2 children:
Married, 3 children:
Married, 4 children:
0
Mississippi Bronze: $407
Silver: $458
Gold: $543
Single: $12,880
Married: $17,420
Married, 1 child: $21,960
Married, 2 children: $26,500
Married, 3 children: $31,040
Married, 4 children: $35,580
0
Missouri Bronze: $347
Silver: $467
Gold: $530
Single: $12,880
Married: $17,420
Married, 1 child: $21,960
Married, 2 children: $26,500
Married, 3 children: $31,040
Married, 4 children: $35,580
0
Montana Bronze: $330
Silver: $445
Gold: $483
Single: $17,774
Married: $24,039
Married, 1 child: $30,304
Married, 2 children: $36,570
Married, 3 children: $42,835
Married, 4 children: $49,100
Up to 5% of household income
Nebraska Bronze: $439
Silver: $645
Gold: $631
Single: $17,774
Married: $24,039
Married, 1 child: $30,304
Married, 2 children: $36,570
Married, 3 children: $42,835
Married, 4 children: $49,100
Married, 4 children:
0
Nevada Bronze: $280
Silver: $383
Gold: $472
Single:
Married:
Married, 1 child:
Married, 2 children:
Married, 3 children:
Married, 4 children:
0
New Hampshire Bronze: $247
Silver: $325
Gold: $363
Single: $17,774
Married: $24,039
Married, 1 child: $30,304
Married, 2 children: $36,570
Married, 3 children: $42,835
Married, 4 children: $49,100
0
New Jersey Bronze: $319
Silver: $388
Gold: $661
Single:
Married:
Married, 1 child:
Married, 2 children:
Married, 3 children:
Married, 4 children:
0
New Mexico Bronze: $236
Silver: $328
Gold: $324
Single: $17,774
Married: $24,039
Married, 1 child: $30,304
Married, 2 children: $36,570
Married, 3 children: $42,835
Married, 4 children:$49,100
0
New York Bronze: $430
Silver: $588
Gold: $709
Single:
Married:
Married, 1 child:
Married, 2 children:
Married, 3 children:
Married, 4 children:
0
North Carolina Bronze: $350
Silver: $503
Gold: $518
Single: $17,774
Married:$17,420
Married, 1 child: $21,960
Married, 2 children: $26,500
Married, 3 children: $31,040
Married, 4 children: $35,580
0
North Dakota Bronze: $273
Silver: $464
Gold: $432
Single: $17,774
Married: $24,049
Married, 1 child: $30,304
Married, 2 children: $36,570
Married, 3 children: $42,835
Married, 4 children: $49,100
0
Ohio Bronze: $280
Silver: $360
Gold: $428
Single: $17,774
Married: $24,039
Married, 1 child: $30,304
Married, 2 children: $36,570
Married, 3 children: $42,835
Married, 4 children: $49,100
0
Oklahoma Bronze: $367
Silver: $504
Gold: $502
Single: $17,774
Married: $24,039
Married, 1 child: $30,304
Married, 2 children: $36,570
Married, 3 children: $42,835
Married, 4 children: $49,100
0
Oregon Bronze: $318
Silver: $426
Gold: $458
Single: $17,774
Married: $24,039
Married, 1 child: $30.304
Married, 2 children: $36,570
Married, 3 children: $42,835
Married, 4 children: $49,100
0
Pennslyvania Bronze: 306
Silver: $439
Gold: $427
Single:
Married:
Married, 1 child:
Married, 2 children:
Married, 3 children:
Married, 4 children:
0
Rhode Island Bronze: $231
Silver: $328
Gold: $339
Single:
Married:
Married, 1 child:
Married, 2 children:
Married, 3 children:
Married, 4 children:
0
South Carolina Bronze: $328
Silver: $469
Gold: $513
Single: $12,880
Married: $17,420
Married, 1 child: $21,960
Married, 2 children: $26,500
Married, 3 children: $31,040
Married, 4 children: $35,580
0
South Dakota Bronze: $454
Silver: $609
Gold: $652
Single: $12,880
Married: $17,240
Married, 1 child: $21,960
Married, 2 children: $26,500
Married, 3 children: $31,040
Married, 4 children: $35,580
0
Tennessee Bronze: $340
Silver: $454
Gold: $564
Single: $12,880
Married: $17,420
Married, 1 child: $21,960
Married, 2 children: $26,500
Married, 3 children: $31,040
Married, 4 children: $35,580
0
Texas Bronze: $301
Silver: $420
Gold: $429
Single: $12,880
Married: $17,420
Married, 1 child: $21,960
Married, 2 children: $2,6500
Married, 3 children: $31,040
Married, 4 children: $25,580
0
Utah Bronze: $285
Silver: $467
Gold: $483
Single: $17,774
Married: $24,039
Married, 1 child: $30,304
Married, 2 children: $36,570
Married, 3 children: $42,835
Married, 4 children: $41,900
0
Vermont Bronze: $491
Silver: $666
Gold: $674
Single:
Married:
Married, 1 child:
Married, 2 children:
Married, 3 children:
Married, 4 children:
0
Virginia Bronze: $358
Silver: $470
Gold: $464
Single: $17,774
Married: $24,039
Married, 1 child: $36.570
Married, 2 children: $42,835
Married, 3 children:$42,835
Married, 4 children:$49,100
0
Washington Bronze: $280
Silver: $380
Gold: $422
Single:
Married:
Married, 1 child:
Married, 2 children:
Married, 3 children:
Married, 4 children:
0
West Virginia Bronze: $596
Silver: $635
Gold: $825
Single: $17,774
Married: $24,039
Married, 1 child: $30,304
Married, 2 children: $36,570
Married, 3 children: $42,835
Married, 4 children: $49,100
0
Wisconsin Bronze: $338
Silver: $443
Gold: $480
Single: $12,880
Married: $17,420
Married, 1 child: $21,960
Married, 2 children: $26,500
Married, 3 children: $31,040
Married, 4 children: $35,580
0
Wyoming Bronze: $519
Silver: $785
Gold: $645
Single: $12,880
Married: $17,420
Married, 1 child: $21,960
Married, 2 children: $26,500
Married, 3 children: $31,040
Married, 4 children: $35,580
0

*Costs for most populated city

Are There More Options For Free Health Insurance?

Aside from affordable health insurance on the ACA marketplace and through Medicaid, you can save money on health insurance if you or a spouse has a job-based plan through an employer who shares the premium cost with you. If you’re a young adult, you can use your parents’ health insurance coverage until age 26, even if married or not living at home. And if you’re 65 or have a qualifying disability, you can get health care coverage through Medicare.

Before you discount whether you can find low-cost health insurance, Jones advises: “It costs nothing to verify where you stand. Know your options, and don’t be afraid to ask an insurance agent.”

Job-based health plan

Employers’ job-based health plans save you money on health insurance because the employer often shares the premium cost. Also, group plans tend to cost less. Some employers will pay up to 100% of the premium, and even if an employer splits the cost or pays much less, you still gain the benefit of lower-priced health insurance per month.

Suppose your job-based plan is considered affordable by the marketplace and meets minimum standards. In that case, you will not qualify for premium tax credits or other savings through the Marketplace if you opt for an ACA plan instead. Minimum coverage is if a plan pays at least 60% of the total cost of medical services for a standard population and includes physician and inpatient hospital services coverage. Job-based health plans are considered affordable if the cost is 9.83% or less of your household income.

Spouse’s health plan

If your spouse has a job-based plan through an employer, they can enroll you as a dependent, and you will get the same benefits. The marketplace also provides affordable health insurance for families, so your spouse can purchase a plan and add you as a dependent.

Parent’s health plan

If you’re younger than age 26, you can stay on a parent’s health insurance plan. Using a parent’s health plan is allowed even under these circumstances:

  • You’re married
  • You’re not living with your parents
  • You’re attending school
  • You have or adopt a child
  • You’re not financially dependent on your parents
  • You’re eligible to enroll in a job-based plan

If your parent buys health insurance through the marketplace, you can enroll on the initial application. Otherwise, your parent can add you during open enrollment. After you turn 26, you qualify for a Special Enrollment Period to purchase a marketplace plan.

Medicare

Not to be confused with Medicaid, Medicare is a government health care program for adults 65 and older or people with qualifying disabilities.

If you qualify for Original Medicare, you’re likely to get Part A (hospital coverage) for free and Part B (medical coverage) for a standard monthly premium of $148.50. Medicare Part D (prescription drug coverage) is usually around $30 to $35 per month. You can opt to replace Original Medicare with a Medicare Advantage Plan, which may have a $0 monthly premium.

If you have low income, you may qualify for both Medicare and Medicaid, which offers dual coverage. Generally, Medicare pays first, and Medicaid pays second.

Additional Resources

Sources