In 2020, the average national cost for health insurance was $456 per month for an individual and $1,152 for a family, according to the ACA Index Report on Unsubsidized Consumers.
Thanks to the Affordable Care Act (also known as Obamacare), the uninsured rate among single mothers has fallen in recent years, though 13.4% of single mothers still had no health coverage. By comparison, only 6.7% of two-parent households were uninsured.
While many Americans receive health insurance benefits through an employer, those who don’t (or those who can’t afford their employer-sponsored plan), are at risk of not receiving the medical care they need or of paying astronomical medical bills out of pocket.
If your employer doesn’t offer affordable health insurance or you are currently job seeking, self employed, or unable to work, finding affordable health coverage for your family can be daunting.
We put together a list of health insurance options for single moms, with information about how to choose the plan that best suits your family’s needs:
- Government health insurance exchanges
- Medicaid
- CHIP
- Family health insurance plans
- Other ways of accessing health care without insurance
1. Healthcare.gov or state health insurance exchanges
If you cannot afford health insurance, go to Healthcare.gov, sometimes referred to as the health insurance “marketplace” or “exchange.” Your state may also have its own health insurance exchange.
Healthcare.gov was established as part of the Affordable Care Act, a federal statute enacted to provide health coverage to millions of uninsured Americans.
Louise Norris, a licensed broker and analyst for healthinsurance.org, an independent health insurance guide, says the health insurance exchange is the best place to start.
“Single parents who aren't eligible for employer-sponsored coverage will often find they and their kids are eligible for financial help with health coverage obtained through the exchange,” she says.
Depending on your income and family size, you may be eligible for subsidies, or premium tax credits, which will help cover the cost of your family’s health insurance. If you are eligible for insurance from your employer, you can still purchase a plan through the exchange, though you will likely not qualify for a subsidy.
To get started, head to Healthcare.gov and enter your zip code. This will bring up policies you are eligible for. If your state has its own exchange, you will be directed to your state’s website. Open enrollment begins on November 1 each year, and you must enroll by December 15 to get coverage for the following year. However, if you’ve experienced a major life event, you can qualify for a special enrollment period. These events include:
- losing your employer-sponsored health coverage
- getting married
- moving
- having a baby
- adopting a child
Depending on your situation, you may have 60 days before or 60 days after the event to enroll. To see if you’re eligible for a special enrollment period, you can complete a brief questionnaire on Healthcare.gov.
You can purchase a plan for your family through the website, or if you need assistance, you can use the Find Local Help tool to connect with someone in person who specializes in the healthcare exchange. You can also contact the marketplace call center at 1-800-318-2596. This number is available 24 hours a day, 7 days a week except on holidays. Finally, a mail-in application is available.
Who qualifies for the Affordable Care Act?
To be eligible to enroll in health coverage through the Affordable Care Act, you must live in the United States, be a U.S. citizen or national, and not be incarcerated.
Individuals who qualify for subsidies through the health insurance exchange must have a household income between 100% and 400% of the federal poverty line (FPL). The FPL is a measure of income issued every year by the Department of Health and Human Services.
As of 2022, the federal poverty level for a single person is $13,590. For each additional person in the household, the FPL increases by $4,720.
You can see if you are eligible for premium tax credits that would lower your insurance costs by answering a few questions about your income on Healthcare.gov.
2. Medicaid
Medicaid is a government program that provides free or low-cost health coverage for low-income adults, children, pregnant women, older adults, and people with disabilities. Centers for Medicare & Medicaid Services reports that 80 million Americans are covered by Medicaid.
Who is eligible for Medicaid?
Eligibility criteria for Medicaid varies state by state. Determining factors include household income, family size, age, and disability. You can take a quick screening on Healthcare.gov to see if you may qualify for Medicaid.
To qualify for full benefits, you must be a U.S. citizen, a U.S. national, or have satisfactory immigration status.
Under the ACA, many states expanded Medicaid coverage to cover all people with a household income below a certain threshold. In these states, you can qualify for Medicaid if your household income is below 138% of the federal poverty level.
However, 12 states have elected not to expand Medicaid coverage. These states are:
- Florida
- Georgia
- Kansas
- Mississippi
- North Carolina
- South Carolina
- Alabama
- Tennessee
- Texas
- South Dakota
- Wisconsin
- Wyoming
In these states, eligibility criteria for Medicaid is stricter with much lower income limits.
Individuals who don’t qualify for Medicaid based on income should still apply, especially those who are pregnant, have children, or have a disability, as you may be eligible for these reasons.
There is no open enrollment period for Medicaid, and you can apply at any time of year. You can apply through the health insurance marketplace or through your state Medicaid agency.
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What is the lowest income to qualify for Medicaid?
In states that have expanded Medicaid coverage, individuals qualify for Medicaid if their household income is below 138% of the federal poverty level.
For 2022, these are the federal poverty guidelines:
| Number of people in household | Qualifying income |
| 1 | $13,590 |
| 2 | $18,310 |
| 3 | $23,030 |
| 4 | $27,750 |
| 5 | $32,470 |
| 6 | $37,190 |
| 7 | $41,910 |
| 8 | $46,630 |
For households with more than eight people, add $4,720 for each additional person.
“Medicaid eligibility can be calculated based on monthly income, so if income temporarily drops to these levels, Medicaid can be available at that point even if the total annual income would be above those levels,” Norris says.
What does Medicaid cover?
Federal law requires states to provide certain mandatory benefits under Medicaid. These include:
- Inpatient and outpatient hospital services
- Doctor visits
- Laboratory and X-ray exams
- Home health services
It is up to the individual state to determine optional benefits, including prescription drugs, case management, physical therapy, and occupational therapy.
Is there Medicaid for single mothers?
Qualifications for Medicaid vary by state. Single mothers may qualify for Medicaid based on income and if they meet eligibility requirements set by their state.
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3. Children's Health Insurance Program (CHIP)
The Children’s Health Insurance Program, or CHIP, is another option for single moms to ensure health insurance for their children.
CHIP is a federal and state government program that provides healthcare for children of families who do not qualify for Medicaid but are unable to afford a private plan.
To qualify for CHIP, a child must be:
- Under 19 years old
- Uninsured and ineligible for Medicaid
- Not covered by a group plan or credible health insurance
- U.S. citizen or meet immigration requirements
- Resident of the state in which they apply
- Meet household income eligibility requirements, which vary by state. Some states offer CHIP for pregnant women and parents.
According to the Centers for Medicare & Medicaid Services, eligibility levels for CHIP range from 170% to 400% of the federal poverty line. To see if your children qualify for CHIP, visit the Medicaid & CHIP Eligibility Levels page.
Families and individuals can apply online through healthcare.gov’s health insurance marketplace or by calling 1-800-318-2596. Like Medicaid, there is no limited enrollment period, so you can sign up for CHIP at any time of the year.
In every state, it's common for kids to be eligible for Medicaid or CHIP, while the parent is eligible for a subsidized private plan instead, Norris notes.
“So an application submitted through the exchange may result in various family members having different coverage,” she says. “But it will ensure everyone has the financial assistance they're eligible to receive.”
What is included in CHIP?
Benefits under CHIP vary by state. However, all states provide essential health care services through CHIP, including:
- Routine check ups
- Doctor visits
- Immunizations
- Prescription medications
- Inpatient and outpatient hospital care
- Dental and vision services
- Laboratory and X-ray services
- Emergency services
You can check online to see what services your state covers through CHIP.
Is CHIP in every state?
Every state in the U.S. offers CHIP, though each has its own rules for who qualifies.
Which state has the best CHIP program?
According to Norris, New York's CHIP is the most generous, extending to 400% of the poverty level.
“For a household of two, that's $73,240 in annual income,” she says. “But several other states have CHIP income limits that extend to 300% of the poverty level or higher.”
4. Family health insurance
For young adults who are single parents, staying on their family’s health insurance plan can be a viable option to ensure their coverage.
Under the ACA, children can stay on their parent’s health insurance plan until the age of 26. This includes children who are married and have kids of their own.
However, keep in mind that the health insurance coverage does not extend to your children in most states (Pennsylvania, as an exception, covers a child for 31 days after birth on the mother’s plan).
If you decide to go this route and you are not already on your parents’ plan, you will need to be added during the open enrollment period. Your parents can check with their employer to see when this period is.
Can you stay on your parents’ health insurance plan?
As long as your parent’s health insurance plan covers dependents, you can usually join or remain on their plan until the age of 26. This is an option even if you are:
- Married
- Living separately from your parents
- Not financially dependent on your parents
- Attending school
- Eligible for health insurance through your employer
- Have a child (though your child will need separate health insurance)
Once you turn 26, this coverage will end. When that happens, you will qualify for a special enrollment period through the health exchange on healthcare.gov.
5. How to find access to health care when you don’t have health insurance
If you are uninsured and do not qualify for Medicaid or CHIP, you can find free or low-cost healthcare at community health centers.
These centers can be found in both urban and rural communities and provide general primary care, prenatal care, immunizations for babies, and referrals to specialized care. Typically, you will be charged for these services based on your income.
The HHS Health Resources Services Administration (HRSA) provides a directory of community health centers that operate on a sliding fee. You can receive care here even if you cannot pay.
Search “free walk-in clinics near me”
Another option is to simply search on Google. You can enter a search for “free walk-in clinics near me” or “community health clinic near me” to see where you can get free or low-cost health care in your area.
Go to an emergency room if there is a medical emergency
If you or your child is experiencing a medical emergency, go to your local emergency room. Federal law stipulates that anyone coming into an emergency department must be stabilized and treated, whether or not they have health insurance.
This means your family will be treated at the emergency room whether or not you can pay.
Health insurance FAQs
What health insurance terms should you know?
Premium – This is the amount you pay to have a health insurance plan. It is paid by the individual and/or employer monthly, quarterly, or yearly.
Copay – This is a fixed amount that you pay out of pocket for covered health care services. This amount can vary depending on the type of service and type of doctor you see.
Coinsurance – This is the amount of a covered health care service that you are responsible for paying after you’ve paid your deductible.
Deductible – This is the amount you owe for health care services covered by your plan before health insurance coverage begins. For example, if your deductible is $1,000, your health insurance coverage won’t kick in until you’ve paid $1,000 out of pocket for covered health services where the deductible applies. Note that certain services may not be subject to the deductible.
Out-of-pocket maximum – This is a set amount that will be the most you will pay during a policy period (typically a year) before your plan pays for 100% of services.
Prescription benefits – If your health plan has prescription benefits, this means you will get assistance in paying for prescription medications.
What is the free healthcare in the U.S. for low income?
Medicaid is a government program that provides free or low-cost health coverage for low-income adults, children, pregnant women, older adults, and people with disabilities.
CHIP is a federal and state government program that provides health care for families that do not qualify for Medicaid but are unable to afford a private plan.
What is the lowest income to qualify for Obamacare?
Obamacare is another word for the Affordable Care Act, so it includes private health insurance plans, which are often subsidized, as well as expanded Medicaid for low-income adults.
In most states (the 38 states where Medicaid has been expanded), adults are eligible for Medicaid with a household income of up to 138% of the poverty level. In 2022, that's $25,267 for a household of two, $31,781 for a household of three, and $38,295 for a household of four.
“If an exchange applicant is not eligible for Medicaid or CHIP, the eligibility determination system will then look to see whether they're eligible for premium tax credits to offset the cost of a private plan,” Norris explains.
How much is health insurance for a single mom?
The cost of health insurance for a single mom will depend entirely on how much her household income is, how large the household is, how old she is, and where she lives.
What is the best health insurance for single moms?
The best health insurance for a single mom will depend on her needs and budget. “The plan that works best for one mom won't be the best for another,” Norris says.
What is an alternative to buying traditional health insurance?
“An ACA-compliant major medical health plan is by far the best option for people who aren't eligible for Medicaid, Medicare, or CHIP,” Norris says. “And premium tax credits are only available for major medical plans purchased through the exchange.”
However, if a person missed open enrollment, doesn't qualify for a special enrollment period and needs health insurance temporarily until the end of the year, she recommends short-term health insurance if you do not have pre-existing conditions.
Some people benefit from health care sharing ministry plans, often combined with direct primary care or a fixed indemnity plan.
However, these options typically require you to pay full-price for medical care up-front, and file a lot of paperwork for reimbursement, neither of which are a fit for every family.
Here are some more resources for low-income families and individuals:
Medicaid is a government program that provides free or low-cost health coverage for low-income adults, children, pregnant women, older adults, and people with disabilities.
Obamacare is another word for the Affordable Care Act, so it includes private health insurance plans, which are often subsidized, as well as expanded Medicaid for low-income adults. In most states (the 38 states where Medicaid has been expanded), adults are eligible for Medicaid with a household income of up to 138% of the poverty level. In 2022, that's $25,267 for a household of two, $31,781 for a household of three, and $38,295 for a household of four.
“An ACA-compliant major medical health plan is by far the best option for people who aren't eligible for Medicaid, Medicare, or CHIP,” Louise Norris, a licensed broker and analyst, says.
