Yes. If your job doesn't offer health insurance, you can buy a plan through HealthCare.gov or your state's Marketplace, often with premium tax credits based on your income. Depending on your situation, you may also qualify for Medicaid, stay on a parent's plan until 26, join a spouse's plan, or use an employer reimbursement arrangement for individual coverage.
Lots of Americans work for employers that don’t offer health benefits. Small businesses, startups, restaurants, retail shops and gig platforms often skip them, and in many cases that’s perfectly legal. But it doesn’t leave you stuck.
You have more ways to get covered than you might think, and some of them can be surprisingly affordable. Here’s how to find the right one.
Can you get health insurance if your job doesn’t offer it?
Absolutely. Health insurance in the U.S. isn’t only available through employers. Since the Affordable Care Act, individuals can buy comprehensive coverage directly, and ACA-compliant plans can’t turn you down or charge you more because of a pre-existing condition.
First, a quick note on why your employer might not offer coverage. The federal employer mandate only applies to businesses with 50 or more full-time-equivalent employees, and only to full-time workers averaging 30 or more hours a week. Smaller businesses and part-time positions are generally exempt.
Option 1: The ACA Marketplace
For most people, the Marketplace is the best place to start. You can shop through HealthCare.gov, or through your state’s own exchange if your state runs one.
Why it’s worth checking
- Premium tax credits: depending on your household income and size, you may qualify for help that lowers your monthly premium.
- Cost-sharing reductions: if your income qualifies, Silver plans may come with lower deductibles and copays.
- Essential health benefits: plans cover services like preventive care, prescriptions, hospital stays, maternity care and mental health.
- An out-of-pocket maximum: a cap on what you pay for covered in-network care each year.
Subsidy rules and income limits have changed over the years, so use the official tools at HealthCare.gov or your state exchange to see current numbers for your household.
When you can enroll
Open Enrollment generally runs November 1 to January 15 in most states, though some state exchanges set different dates. Outside that window, you’ll usually need a qualifying life event, such as losing other coverage, moving, getting married or having a baby, which typically opens a 60-day Special Enrollment Period.
Option 2: Medicaid and CHIP
If your income is limited, you may qualify for Medicaid, which offers low- or no-cost coverage. Eligibility depends on your state, income and household. You can apply any time of year, not just during Open Enrollment. Children may qualify for the Children’s Health Insurance Program (CHIP) even if parents earn too much for Medicaid.
Option 3: A family member’s plan
- Parent’s plan: if you’re under 26, you can usually stay on a parent’s plan, even if you’re married, not living at home or financially independent.
- Spouse’s plan: if your spouse has employer coverage, you may be able to join during their open enrollment or after a qualifying event like marriage.
Compare costs. Adding a spouse to an employer plan isn’t always cheaper than a separate Marketplace plan.
Option 4: Employer reimbursement arrangements
Some employers that don’t offer a group plan offer an ICHRA (Individual Coverage Health Reimbursement Arrangement) or, for small employers, a QSEHRA. These reimburse you tax-free for individual health insurance you buy yourself. If your employer offers one, it can affect your Marketplace subsidy eligibility, so report it when you apply.
Option 5: Catastrophic plans
If you’re under 30, or qualify for a hardship or affordability exemption, a catastrophic plan offers low premiums and a very high deductible. It covers essential health benefits and some preventive care before the deductible, but premium tax credits can’t be used for it.
Options to approach with caution
Short-term health plans
Short-term plans may cost less, but they aren’t ACA-compliant. They can deny coverage or exclude pre-existing conditions, may leave out key benefits like maternity or mental health care, and have limits on how long you can keep them. Federal and state rules restrict their duration, and some states ban or heavily limit them.
Health care sharing ministries
These are faith-based groups where members share medical costs. They are not insurance, aren’t required to pay claims, and don’t have to follow ACA consumer protections.
Fixed indemnity and discount plans
These pay set amounts or offer discounts, but they don’t replace comprehensive coverage.
A real-world example
Say you’re a 34-year-old line cook in Texas working 38 hours a week at a family-owned restaurant with 15 employees. Your employer isn’t required to offer coverage and doesn’t. Your best move is to visit HealthCare.gov, enter your expected income and household size, and see what tax credits you qualify for. If your income is low enough, you may be able to find a plan with a very manageable premium. If you’re married and your spouse has job-based coverage, compare that option too. A free Marketplace navigator can walk you through the application and explain each plan’s network and drug coverage.
What about state mandates?
The federal penalty for going without health insurance has been $0 since 2019. But California, Massachusetts, New Jersey, Rhode Island and Washington D.C. have their own mandates with penalties. Vermont has a mandate without a penalty. If you live in one of those places, going uninsured could cost you at tax time.
Step-by-step: getting covered
- Estimate your household income for the coming year.
- Check whether you qualify for Medicaid or CHIP.
- Ask whether your employer offers an ICHRA or QSEHRA.
- See if a parent’s or spouse’s plan is an option.
- Compare Marketplace plans, looking at premiums, deductibles, networks and drug coverage.
- Enroll during Open Enrollment or within 60 days of a qualifying life event.
Bottom line
If your job doesn’t offer health insurance, you can still get solid coverage through the Marketplace, Medicaid, a family member’s plan or an employer reimbursement arrangement. Many people qualify for help with premiums. Rules vary by state and income, so check HealthCare.gov or your state exchange, and consider talking with a licensed agent or navigator for free, personalized help.
Frequently asked questions
Can I buy health insurance outside of Open Enrollment?
Only if you have a qualifying life event, such as losing coverage, moving, marrying or having a baby, which usually gives you 60 days to enroll. Medicaid and CHIP accept applications year-round.
Can I buy health insurance directly from an insurance company?
Yes, many insurers sell ACA-compliant plans directly, sometimes called off-exchange plans. However, premium tax credits are only available when you buy through HealthCare.gov or your state's Marketplace.
Is it illegal for my employer not to offer health insurance?
Usually not. Only employers with 50 or more full-time-equivalent employees face federal requirements, and only for full-time workers. Hawaii has its own broader employer requirement.
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This article is for general information only and is not insurance, legal, tax or medical advice. Rules, coverage and prices vary by state, plan and insurer. Check your policy documents and speak with a licensed agent, your HR department or HealthCare.gov before making decisions.
