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?
Table of Contents
- 1 What happens if I don’t have Health Insurance and get sick?
- 2 What happens when you don’t have Health Insurance?
- 3 Living without Health Insurance on Purpose
- 4 What happens if you don’t have Health Insurance and you go to the hospital?
- 5 How do you get Health Insurance if you don’t have any?
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:
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 end up in the hospital in an urgent situation with no health insurance, doctors and medical professionals are obliged to treat you as a patient in need. This is because the Emergency Medical Treatment And Labor Act or EMTALA “[ensures] that any individual with an emergency medical condition, irrespective of the individual’s insurance coverage, is not refuted essential lifesaving services.”
However, if you do not have health insurance, you will be billed for all medical services, which may consist of doctor fees, hospital and medical costs, and specialists’ payments. Without an insurer to absorb some or even most of those costs, the bills can prove to be ridiculously expensive.
When you have insurance, based on your plan, your health insurance pays for at least a part
of your medical services, including doctor’s visits, prescription drugs, and emergency room trips. You’ll pay the remainder of the bills through a copayment, coinsurance, or a deductible, which is the amount you pay until insurance coverage begins. Without coverage, you’ll be liable for the entire bill, both from the hospital or a doctor who treats you as a patient. You can ask about the cost of treatment beforehand, outside of emergency situations, of course. Costs vary, often surprisingly, so it’s smart to call ahead or check a hospital’s website for details.
Hospitals may give uninsured individuals discounts or permit patients to pay negotiated amounts over time. For instance, negotiated bills are often divided into monthly amounts. It is
always best, when feasible, to negotiate bills before you are hospitalized, such as for elective surgery or to have a child.
You can also ask the hospital regulator or payment department about financial assistance programs, sometimes known as “charity care” that can adjust your bills to your capacity to pay. In fact, non-profit hospitals are obliged by law to provide assistance plans to low-income patients. Furthermore, sometimes applying for assistance can stop bill collectors. Hospitals would rather work out payments with patients for a variety of reasons, including that collectors usually keep 50% of whatever they get from patients.
It is recommended that If possible, you are usually in a good position negotiating with a regulator, who is there to settle patient issues, rather than the billing department that aims to collect revenue.
Moreover, many individual doctors frequently work with patients who don’t have the ability to pay the full cost of their care. Their policies differ but many physicians routinely split bills in half for the poor and even may cut down bills to as little as 10%.
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 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.
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
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
The aforementioned options can help cover your primary care needs, but what about urgent or emergency medical needs? Urgent care centers can manage non-emergency issues, such as minor injuries or strep throat. They will usually cost less than visiting an ER (emergency room) and may offer you a cash discount. Ask to work directly with their billing department to find out if this is an option.
In the case of a genuine emergency, seek care in an ER. Hospitals will usually work with you to help you pay your debts. This may involve a no-interest payment plan or they may cut or remove your bill altogether.
For assistance finding healthcare or insurance coverage, find a local social services agency.
Healthcare is pricey—even with insurance. Nevertheless, those who don’t have insurance coverage will be at a much greater risk. The failure to seek treatment for health conditions and the overwhelming burden of medical bills are two big reasons to get coverage.