What To Do If You Don’t Have Health Insurance?

Without health insurance, you are exposed to a lot of risks that can prove extremely costly. Read more to find out how you can minimize these risks.

In healthcare, it is certain that at some point, everybody will require medical attention. It might just be for the flu, but no one, no matter how healthy they are, is invulnerable to sickness. Even realizing this, there are still people without health insurance.

The reasons for not having health insurance vary. You could be a young, healthy adult who believes like you don’t need it. Or you might be experiencing tough times and just can’t pay for it. Whatever the reason may be, if you need healthcare and don’t have health insurance, it can be terrifying.

The article will answer your questions related to what can happen if you don’t have health insurance and how you can get health insurance?

What happens if I don’t have Health Insurance and get sick?

Getting extremely sick or hurt while uninsured is worrisome for millions of people. Going without health insurance coverage (even for a short period of time) exposes you to serious financial risk.

If you get sick or wounded and need medical assistance, receive therapist services, take prescription medication, or require emergency room (ER) services – an absence of health care insurance can wipe out your emergency fund or even bankrupt you.

Another genuine concern when having no health insurance is postponing treatment because of the apprehension of not being able to afford healthcare.

Without affordable preventive or typical routine care, illnesses can become severe and cost even more to treat.

Those without healthcare insurance may also go to the ER for illnesses and injuries which could have been treated elsewhere. They prefer to do this because billing usually happens after treatment.

This isn’t right for anyone because the patients can hardly ever afford the high-cost treatment they receive. And hospital staff devote time to patients who aren’t having medical emergencies.

What happens when you don’t have Health Insurance?

Many people with no health insurance are oblivious of the outcomes of not being insured. There are many different legal, financial, and health costs for those who do not have health insurance. Some of the most important consequences for not being insured are:

Tax Penalties

To incentivize more individuals to acquire health insurance, and thus eventually cause health insurance rates to drop, part of the Patient Protection and Affordable Care Act (ACA) was to introduce a tax penalty for those who are not insured. In 2015, if you remain uninsured for more than 3 months of the year, you will be obliged to pay the higher of two amounts: either (1) 2% of your yearly household income – over 10,000 – up to the national average premium cost of a bronze plan from the health insurance marketplace or (2) $325 per adult and $162.50 per child under 18 with a maximum amount of $975.

Limited Access to Necessary Health Care

In 2013, 30% of uninsured adults did not receive the medical care they wanted because of

the soaring costs associated with receiving treatment. Uninsured adults are also less expected than people with insurance to seek out preventative care and care for chronic diseases and other key health conditions.

Along with this propensity to not seek out care, being uninsured raises individuals’ risk of mortality. In other words, those with health insurance have a tendency to live longer and be healthier than those who are uninsured. One study indicates that the death rate of uninsured individuals is 25 percent higher than of those people who have health insurance. Extrapolating that percentage and applying it to the number of uninsured people in the United States, it’s possible that 18,000 deaths ensue each year due to people lacking insurance.

Significant Financial Burdens

Beyond being compelled to pay a tax penalty for not being insured, those who are uninsured also cope with more financial burdens than insured individuals. Rather unexpectedly, uninsured individuals are regularly billed for any and all care they receive and are charged more than those who are insured for that care. As a consequence of these billing practices, roughly 40% of uninsured adults have outstanding medical bills, and those who don’t have health insurance are more likely to delay getting health care because of the costs.

For these reasons and many more, it is crucial for those who do not currently have health insurance to get health insurance during open enrollment. During open enrollment, individuals who are uninsured can peruse through plans on the insurance marketplace and see if they meet the criteria for any financial assistance for purchasing health insurance. If you do purchase a plan, make it certain that it covers care from Meritage Medical Network.

Living without Health Insurance on Purpose

According to a recent report from the Kaiser Family Foundation (KFF), many people don’t have health insurance because of the sky-high costs of coverage. The KFF also reveals that “others do not have access to coverage through a job, and some people, especially poor adults in states that did not expand Medicaid, remain unqualified for financial aid for coverage.”

Some lose coverage when their job ends when they leave work for other reasons, or when they go through a life-changing event such as divorce. And if offered COBRA continuation coverage when a job ends, many cannot pay for the premiums.

Young people after a certain age become ineligible to be on their parent’s health insurance. Or they may emancipate at a younger age and face difficulties in finding affordable coverage.

People who are self-employed may also have a hard time paying health care premiums.

What happens if you don’t have Health Insurance and you go to the hospital?

If you find yourself in a hospital without health insurance during an urgent situation, medical professionals are mandated to provide you with necessary treatment under the Emergency Medical Treatment And Labor Act (EMTALA). This ensures that anyone with an emergency medical condition receives essential lifesaving services, regardless of their insurance coverage.

However, lacking health insurance means you’ll be responsible for covering all medical expenses incurred. These can include doctor fees, hospital and medical costs, as well as payments to specialists. Without the buffer of insurance, these bills can quickly accumulate to daunting amounts.

When you do have insurance, it typically covers a portion of your medical expenses, including doctor’s visits and prescription drugs. You’re then responsible for copayments, coinsurance, or deductibles, depending on your plan. Without insurance, you bear the full brunt of these costs.

Hospitals may offer discounts to uninsured individuals or allow flexible payment plans. Negotiated bills can often be paid in monthly installments, easing the financial burden. Seeking financial assistance programs, also known as “charity care,” can be beneficial. Non-profit hospitals are legally obligated to provide such assistance to low-income patients.

It’s advisable to negotiate bills before hospitalization, especially for elective procedures or childbirth. Contacting the hospital’s financial assistance department can help alleviate financial strain. Additionally, applying for assistance can halt bill collectors, as hospitals prefer working out payment plans directly with patients.

Individual doctors may also be willing to accommodate patients without the means to pay the full cost of care. Many physicians offer reduced fees or payment plans to alleviate financial stress on patients.

In summary, while lacking health insurance can result in substantial medical bills, exploring available assistance programs and negotiating with healthcare providers can help manage costs and ensure access to necessary care.

How do you get Health Insurance if you don’t have any?

The best decision if you’re uninsured is to find some kind of coverage. There are many alternatives available today, at various prices, through the Health Insurance Marketplace. Based on your income, you may be qualified for financial assistance to pay for insurance. The Marketplace will inform you if you meet the criteria for tax credits to help pay for your premium. You can find out if you will get aid with out-of-pocket costs as well. Applying through the Marketplace will also let you know if you are eligible for Medicaid.

Catastrophic Plans

Catastrophic plans and very high deductible plans are also offered. These plans will cover

you in case of a mishap or sickness. They have very low monthly premiums and offer a safety net if you need it. You can purchase these plans through the Marketplace, directly from an insurer, or through an agent or broker.

Community Healthcare

Still, almost half of people who are uninsured fall in a gap where the ACA and the Marketplace can’t support them. This comprises low-income adults in states that did not expand Medicaid, people whose income is too high to be eligible for federal assistance, and non-citizens. If you can’t pay for coverage or don’t meet the criteria for help, you can still get basic healthcare.

The ACA expanded funding for community health centers. These centers give healthcare on a

sliding scale that is dependent on your income. The amount you pay for care will be based on your income. You can find the following services at a community health center:

  • General primary care    
  • Prenatal care      
  • Referrals for specialized care, including mental health,
  • substance abuse, and HIV/AIDS      
  • Vaccinations

You can find these community health centers in both urban and rural areas.

Free and Low-cost Healthcare

There are also other sources from where you can buy free or low-cost healthcare including:

Direct primary care (DPC), which is a practice model some doctors are embracing. They charge a set monthly rate—usually under $100—that covers any office-based primary care you need. This typically contains lab services. DCP may be a reasonable option if you have constant primary care needs or a chronic medical condition.

Health fairs, which typically provide free or low-cost screenings, such as blood pressure and diabetes checks, and vaccinations, such as the flu shot. Some even provide services, such as mammograms, bone density testing, and smoking cessation. You can learn more about health fairs through hospitals, community pharmacies, your employer’s human resource department, and several other community or civic organizations.

Teaching hospitals and schools, which may provide free or low-cost services in order for their students to learn. A common example is dental schools offering free teeth cleanings and exams.

Urgent and Emergency Care

Addressing urgent or emergency medical needs is crucial for everyone’s well-being. Urgent care centers are ideal for managing non-emergency situations, like minor injuries or strep throat, offering affordable alternatives to emergency rooms (ERs). You can even negotiate cash discounts by liaising directly with their billing department.

In cases of genuine emergencies, swift action is paramount—head straight to the ER. Hospitals understand the financial strain emergencies can cause and often provide assistance in managing medical expenses. They may offer no-interest payment plans or even waive certain fees entirely.

Navigating the healthcare landscape can be daunting, especially without insurance. However, risking your health due to lack of coverage or facing overwhelming medical bills isn’t an option. Seeking out local social services agencies can provide invaluable assistance in finding healthcare options or securing insurance coverage.

Healthcare costs remain a concern for many, even with insurance. Yet, the consequences of untreated health conditions or the weight of medical debts far outweigh the expense of coverage. Prioritizing your health by obtaining insurance coverage is essential for peace of mind and financial security.

Sandra Johnson

Sandra Johnson

Sandra Johnson was a few years out of school and took a job as a life insurance agent in California, selling coverage door-to-door for Prudential. The experience taught her about the technical components of insurance and its benefits for individuals and society, as well as the misunderstandings people often have about insurance. She has over ten years’ experience in the insurance industry, having worked as both a Broker and Underwriter, assisting clients across a broad range of industries. At Insurance Noon, Sarah diligently gathers all the required information and curates up pieces to provide meaningful insurance solutions. Her personal value proposition is to demonstrate a genuine interest in always adding value for clients.Her determined approach to guiding clients has turned her into a platinum adviser to multiple insurers.

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