Health Insurance Options for Volunteers

Planning on volunteering? Although you’ll be contributing to society through your volunteer work, society isn’t always as generous in caring for its volunteers as it is in caring for its paid workforce. While more than 55% of Americans had employer-sponsored health insurance in 2019, don't count on your volunteer organization providing health insurance. Although some large, well-funded volunteer organizations do, many don’t.

Volunteers working outside together to erect a building
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If you’re going to volunteer, you not only need health insurance, you need a bit of savvy to navigate the complicated world of health insurance regulations. As of 2021, there is no longer a tax penalty for being without minimum essential coverage unless you're in California, DC, Massachusetts, New Jersey, or Rhode Island.

But being without health insurance is risky: You'd be on your own if and when you needed extensive medical care, and you might find that doctors and hospitals are unwilling to treat you if you don't have health coverage (federal law requires Medicare-participating hospitals to assess and stabilize anyone who arrives in their emergency rooms, regardless of ability to pay; care beyond stabilization does not have to be offered if the patient doesn't have the ability to pay for it).

Here are your options for health insurance coverage as a volunteer.

Volunteer for an Organization That Provides Health Insurance

Some large, well-known, well-funded volunteer organizations provide their full-time volunteers with health insurance. The Peace Corps, AmeriCorps, Lutheran Volunteer Corps, and organizations that are members of the Catholic Volunteer Network are among them.

Some of these organizations provide coverage that is not considered minimum essential coverage under the Affordable Care Act. This includes the Peace Corps short-term health plan that is offered to volunteers upon their return to the U.S. (the coverage that Peace Corps Volunteers have during their service is, however, considered minimum essential coverage), and the basic health coverage that AmeriCorps provides to volunteers at no cost.

Prior to 2019, volunteers utilizing coverage that wasn't minimum essential coverage would have to pay the individual mandate penalty unless they qualified for an exemption. That penalty no longer applies (with the exception of states that have established their own penalties) but it's still important for people to understand the ramifications of having a health plan that isn't considered minimum essential coverage. There's a reason for that distinction. In general, plans that aren't minimum essential coverage could have significant gaps in the coverage, potentially leaving enrollees on the hook for substantial out-of-pocket costs if and when they need extensive health care.

Volunteering abroad

Some countries allow those visiting under certain types of visas for long periods of time to buy into whatever the health insurance system of the country is. Whether this option would be available and what type of health insurance system is available will vary dramatically from country to country.

If you discover this is a viable option in the country where you'll be a long-term volunteer, investigate the coverage and the healthcare quality available in your host country carefully before committing.

Ask yourself if you'd be content getting care in your host country if you were to get seriously ill or severely injured. If you would want to come back home in that case, then you'll also need a plan to address how you'll pay for evacuation back home (see below for details about travel medical insurance) as well as how you'll pay for continued medical care back in the United States if your host country's health insurance system won't cover you when you return.


Medicaid is a government social welfare program that provides health insurance to some low-income U.S. residents. Since Medicaid is administered by the states, Medicaid eligibility differs from state to state. In most states, however, adults under the age of 65 will qualify for Medicaid with a household income of no more than 138% of federal poverty level. As of early 2021, this is true in 36 states and DC; two additional states—Missouri and Oklahoma—will expand their Medicaid eligibility as of mid-2021, covering adults with income up to 138% of the poverty level.

However, each state has its own Medicaid program, and coverage outside of the state is typically only provided in emergency situations. So Medicaid would be a good solution if your volunteer opportunity is in the same state where you have your Medicaid coverage. But if not, it may only work if you can come back to the state that provides your Medicaid coverage when you need health care.

Marketplace Health Insurance (Obamacare)

If you’re a citizen or legal resident of the United States, consider enrolling in an Obamacare plan sold through your state’s Affordable Care Act health insurance exchange/marketplace. All of these plans count as minimum essential coverage and provide comprehensive benefits without limits on how much they’ll pay for your health care.

Under the Affordable Care Act, each state has a health insurance marketplace. Most states use, but some states run their own marketplaces (if you go to, it will direct you to the right website if your state runs its own marketplace platform).

The marketplaces are designed for people who don't get coverage from an employer and need to purchase their own plan. But depending on your financial situation while volunteering, a plan purchased through the marketplace may or may not be financially realistic.

If you've got at least a modest source of taxable income in addition to your volunteer position, you may qualify for premium subsidies that would make the coverage quite affordable. But if you have no income during your time as a volunteer, and aren't in a state where Medicaid eligibility has been expanded under the Affordable Care Act, you might be in the coverage gap and unable to afford a private plan through the marketplace.

Assuming you do have enough income to be eligible for premium subsidies, the subsidies are available to people with incomes as high as 400% of the federal poverty level. There are even subsidies to help pay deductibles and copays for people with incomes below 250% of poverty level. (If you're not eligible for a premium subsidy, you may be able to afford a catastrophic plan, discussed in more detail below.)

Read each plan’s Summary of Benefits and Coverage carefully to make sure you’ll have coverage if you plan to travel out of the country, as many don’t offer coverage while traveling abroad. If the plan you’re considering is a managed care plan, look carefully at the provider network to make sure you’ll be able to find providers in the geographic area of your volunteer service. You may find that you still need to have travel insurance when you're outside of your plan's coverage area, but maintaining the ACA-compliant plan will ensure that you have coverage in place if you need to return home for medical treatment.

Obamacare Catastrophic Coverage

If you’re under 30 years old and a citizen or legal resident of the U.S., you’re eligible to buy a catastrophic health plan on your state’s Affordable Care Act health insurance exchange. Catastrophic plans may be cheaper than regular health plans but have very high deductibles (their out-of-pocket limit is the same as most bronze plans, however).

Because the deductible is so high, these plans best suit those not expecting to need to use their health insurance, or those with substantial savings that can afford to pay thousands of dollars out of pocket for health care before their health insurance kicks in.

Premium subsidies can't be used for catastrophic plans, so these plans are also generally only suitable for people who aren't eligible for premium subsidies.

If you’re 30 years old or over, you aren’t normally eligible to purchase a catastrophic plan. However, an exception to this rule allows those 30 and older to buy a catastrophic plan if they first get a hardship exemption from the ACA's individual mandate.jl

Short-Term Health Insurance

A short-term health plan can be purchased directly from a health insurance company or through a broker. Short-term health plans offer coverage for a specific time period. This can be up to 364 days in some states (with the option to renew the coverage for a total duration of up to three years), although other states limit them to as little as three months or prohibit them altogether.

Premiums tend to be lower for short-term policies than for major medical comprehensive coverage, but there are reasons these plans cost less than comprehensive coverage. Short-term plans don’t have to comply with all of the consumer protection mandates in the Affordable Care Act. This means short-term health insurance is still subject to underwriting: These plans generally do not cover pre-existing conditions, and can reject applications altogether based on medical history. They also place upper limits on how much they will pay in the event you’re sick or injured, and they do not have to cover all of the essential health benefits (most short-term plans do not cover mental health care, maternity coverage, or prescription drugs, for example).

Travel Insurance

If you have to travel a significant distance to reach your volunteer service site, consider travel insurance. Although travel insurance typically covers things like lost luggage and extra expenses incurred due to travel delays, there are travel insurance plans that are specifically designed to cover medical care outside the US.

As with short-term health insurance, the medical coverage portion of travel insurance isn’t subject to all of the Affordable Care Act’s rules. It may exclude pre-existing conditions, exclude coverage for certain types of medical problems, and limit its maximum payout. For example, it’s common for travel insurance to exclude coverage for injuries related to participation in extreme sports like bungee jumping and kiteboarding.

One big benefit of travel insurance: it may include evacuation coverage. This coverage would help pay for the costs associated with transporting you out of a remote area to a hospital capable of treating your illness or injury. Sometimes you can upgrade this benefit to provide coverage for transporting you not just to the nearest hospital capable of caring for you, but to the hospital of your choice. For example, if you’re volunteering in central Africa, this coverage could make the difference between being transported to a hospital in a major population center of your volunteer-site country, being transported to a hospital in a more developed nearby country such as South Africa, or being transported back to a hospital in your home country.

Coverage Under a Family Member’s Health Insurance

If you’re under age 26 and one of your parents lives in the United States and has comprehensive health insurance, you may be able to get health insurance coverage under his or her plan. This is true whether or not you live with your parents and even if you’re married. Once you turn 26, you’ll have to find other coverage, but you’ll have options.

If you’re married and your spouse has health insurance, look into getting coverage under his or her health plan. Some employers even help to offset the cost of the monthly premiums for their employees’ spouses.

With both of these options, if you’ll be traveling out of the country for your volunteer service, investigate how the insurer treats illness or injuries occurring abroad. Some cover emergencies only, some provide no coverage at all abroad, and some provide full coverage but only if you’ve been abroad for a limited period of time. So you may need to also purchase travel insurance to ensure that you're covered when you're outside the country.


If you currently have health insurance through your job, even after you quit your job you may be eligible to continue that coverage for up to 18 months by using COBRA continuation coverage. Under COBRA, you’ll pay the part of the premium that used to come out of each of your paychecks plus the part of the premium your employer used to pay. Additionally, you'll pay a 2% administrative fee.

COBRA is an expensive option, but if you can swing it financially, it will allow you to keep the same provider network and benefits structure that you had while you were working. 

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Article Sources
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  2. Internal Revenue Service. Individual Shared Responsibility Provision - Minimum Essential Coverage. Updated February 18, 2020.

  3. U.S. Peace Corps. RPCV Short-Term Health Insurance.

  4. Types of Health Insurance That Count as Coverage.

  5. A state-by-state guide to Medicaid expansion, eligibility, enrollment and benefits. Published January 14, 2020.

  6. Cost-sharing subsidies reduce out-of-pocket spending on Silver plans. Despite lack of federal funding, these benefits remain available to eligible enrollees. Published September 23, 2019.

  7. U.S. Centers for Medicare & Medicaid Services. Hardship exemptions, forms & how to apply.

  8. Norris, Louise. Short-Term Health Insurance by State. February 12, 2020.

  9. Planning a trip abroad? Or just to another state? Here's what you need to know about staying covered while you're trotting the globe. Published August 29, 2019.

  10. U.S. Department of Labor. FAQs on COBRA Continuation Health Coverage. Published November 2015.

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