Getting really sick or hurt while uninsured is a concern for millions of people. Going without health insurance coverage (even for a short period of time) puts you at serious financial risk.
Should you get sick or injured and need to see a doctor, receive therapist services, take prescription medication, or require emergency room (ER) services – a lack of health care insurance can erase your emergency fund or even bankrupt you.
Another real concern when having no health insurance is delaying treatment because of the fear of not being able to pay for care.
Without affordable preventive or typical routine care, illnesses can become serious and cost even more to treat.
Those lacking healthcare insurance may also go to the ER for illnesses and injuries which could have been treated elsewhere. They choose to do this because billing usually happens after treatment.
This isn’t good for anyone because the patients can rarely afford the high-cost treatment they receive. And hospital staff spend time with patients who aren’t having medical emergencies.
Why Are So Many People Uninsured?
According to a recent report from the Kaiser Family Foundation (KFF), many people remain without health insurance because of the high cost of coverage.
The KFF also shares that “others do not have access to coverage through a job, and some people, particularly poor adults in states that did not expand Medicaid, remain ineligible for financial assistance for coverage.”
Some lose coverage when their job ends, when they leave employment for other reasons, or when they go through a life event such as divorce. And if offered COBRA continuation coverage when a job ends, many cannot afford the premiums.
Young people reach an age where they become ineligible to be on their parent’s health insurance. Or they may emancipate at a younger age and struggle to find affordable coverage.
People who are self-employed may also have a difficult time paying health care premiums.
How Can the Uninsured Get Health Insurance?
If you lack healthcare coverage and are not eligible to get insurance through work or through a family member, you can visit HealthCare.gov to research options to purchase.
You can determine eligibility and if subsidies are available at your income level. You can find local help on the website too.
Seeking employment offering some level of employee health insurance is an important option too.
Just remember there will likely be a waiting period before coverage goes into effect or you may need to wait for open enrollment if you did not originally enroll for coverage.
If you're considered low-income or have a disability, be sure to check if you are eligible for government assistance programs such as Medicaid.
Some people are also using health care sharing ministries as a legal option for coverage.
If you're considering only purchasing a catastrophic health care plan because other plans cost too much, make sure you're meeting all of the guidelines explained at HealthCare.gov.
Children under the age of 18 may also qualify for a state CHIP or Children’s Health Insurance Plan if their family’s income exceeds Medicaid limits.
What Are My Other Options?
Many people think they lack health care options. But there are affordable or free options available to uninsured people in most communities.
If you're in between jobs, waiting for insurance to start, can’t afford insurance, or if you're making the choice to go uninsured, you may have low-cost options you haven’t considered.
And some don’t have income level qualifications preventing you from accessing services.
There are a variety of clinics available in most bigger communities. There are even traveling clinics stopping in rural towns and villages hoping to meet some of the health concerns of people living in those areas too.
- Community clinics usually provide basic primary care services and charge fees based on an income-based sliding scale. These are important health services supporting low-income people so they do not feel the need to access ER services to get health care. In many communities, you can call 2-1-1 to reach the United Way. They offer a free and confidential 24/7 service to help people locate the services they need.
- You can find Walk-in clinics in some grocery stores, pharmacies, or strip malls. The medical personnel who work in these clinics can provide basic services such as vaccines, physicals, health screenings, and treatment for minor illnesses or injuries, along with monitoring and managing ongoing health conditions. Many walk-in clinics supply a list of prices for each of their services so there are no surprises about the costs.
- “Good Samaritan” clinics in your area may receive funds from non-profits or religious groups. The services are usually offered free of charge to people without insurance. There may be long waits at these clinics, but it's worth it to many people who otherwise couldn’t afford high-cost dental treatments or vision exams.
- On-campus clinics are an excellent option for college students for basic primary care health service. Many college health care centers now offer extensive mental health services, in addition to monitoring medications and more serious health conditions of enrolled students.
Health Screening Events
You may find free or low-cost health screenings at medical facilities, clinics, fitness centers, or community organizations such as the YMCA.
Preventive screenings highlight a particular illness such as high cholesterol or diabetes, to address it and prevent further progress of the disease.
Paying Cash at Your Doctor’s Office
You might think you need to have insurance to see your primary care physician. Instead of assuming that's true, call and ask what the price of a visit is in cash.
The acceptance of cash is becoming more common in advance of treatment in many practices. You can even ask for a discount in writing before your appointment.
Pay a Flat Fee to a Direct Primary Care Provider
In some areas of the country, you can pay a physician a flat fee each month to join and receive unlimited primary and preventive health care services. Many prefer this because it is convenient and affordable.
Pairing these services with high deductible health plans (HDHP) to meet minimum coverage requirements by current law is possible. But it's also important to consult a tax advisor and HealthCare.gov to ensure you're meeting all requirements.
Urgent Care Centers
Seeking health care at an urgent care center may not save you money over visiting your primary care physician. But it's still an important option to consider for illnesses or injuries which are not serious or life-threatening.
Many centers have extensive equipment and labs and can treat a wide variety of patients.
Urgent care centers are usually open in the evenings and on weekends when your primary care doctor’s office isn't. Look online or call ahead to find out their hours and policy on making appointments.
Final Thoughts on Being Uninsured
One of the most important things you can do if you have no health insurance is to educate yourself on all of the low-cost or free options available to you.
Then if you get sick or injured, you won’t have to try to figure out what to do when you are not feeling well.
Always know where the closest clinic, urgent care center, and emergency room are located.
If you have a primary care physician, inquire about discounts for cash-paying customers, before you need an appointment.
Seek out direct primary care providers, review their costs and services, and see if they are accepting new patients.
If you're looking for a new job, consider health care and other benefits in addition to just looking at what your salary will be. Health insurance is an expensive benefit you need to include in making job decisions.
Even if you're very healthy and rarely need medical attention, take action and be prepared.
Don’t just hope you won’t need to see a doctor or visit the emergency room. And always remember to keep a focus on prevention and wellness to minimize health care costs now and in the future!
Additional Reading: What Should People Know if Something Bad Happens to Me?
Updated April 2020
Vicki and Amy are authors of Estate Planning 101 – a Crash Course in Planning for the Unexpected -coming soon from Adams Media.