Hypothyroidism Without Health Insurance

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Living without health insurance can be overwhelming, especially when managing a chronic condition like hypothyroidism, an autoimmune disease like Hashimoto’s, going through perimenopause or menopause, or considering focusing on weight gain with an approach like GLP-1 treatment. If you’re uninsured, you’re not alone. According to the U.S. Census Bureau, about 8% of Americans—nearly 27 million people—were without health insurance at some point in 2025. The numbers are even higher for women, young adults under 35, and households earning less than $48,000 annually.

Without insurance, many people delay doctor visits until their condition worsens, leading to expensive emergency room bills and financial strain. While the situation is challenging, there are options to consider to help you get the care you need.

The Affordable Care Act (ACA) is a federal health care law that regulates how individual health insurance is sold in the United States. It requires insurers to offer coverage to everyone regardless of pre-existing conditions, sets standards for what health plans must cover, and limits how premiums can be priced. The ACA created the Health Insurance Marketplace, where individuals and families can compare standardized plans, and established consumer protections to expand access to comprehensive health insurance outside employer-based coverage.

The end of ACA subsidies

Enhanced ACA premium subsidies, first expanded during the COVID-19 pandemic, expired at the end of 2025. These subsidies significantly lowered monthly insurance costs and broadened eligibility for financial assistance, including for middle-income households.

People who buy coverage through the ACA Marketplace have already seen sharp increases in their monthly premiums. According to the Kaiser Family Foundation (KFF), on average, ACA policy premiums are up around 26% nationally compared with 2025 prices before subsidies.

The effects are extending beyond premiums alone. As healthier individuals drop coverage due to rising costs, non-ACA private and employment-based policies will continue to raise base premiums to offset a sicker risk pool. Deductibles and out-of-pocket maximums are also increasing, further boosting the real cost of care even for those who remain insured. These pressures are affecting not only ACA plans but also the broader individual insurance market, particularly in states with fewer insurers or higher baseline premiums.

Perhaps the most significant impact is the increase in the number of uninsured Americans. Multiple nonpartisan analyses project that between 3 and 5 million people will lose health coverage in 2026 alone if the enhanced subsidies are not reinstated. Marketplace enrollment is already declining, and is expected to decrease substantially, with the most significant losses occurring among moderate-income adults who earn too much for Medicaid but cannot afford full-price private insurance. States that did not expand Medicaid are expected to see especially sharp increases in uninsured rates.

Your experience in 2026 — whether you are in an ACA plan, a non-ACA individual plan, or employer-sponsored health coverage — is one of higher costs across the board:

• ACA individual market: Sharply higher costs for many enrollees because of subsidy loss plus base premium increases.

• Non-ACA individual plans: Increased premiums due to insurer pricing strategies and market conditions.

• Employer-sponsored plans: Continued annual increases of 8 to 9%, reflecting broader healthcare cost trends.

Higher premiums, increased out-of-pocket costs, and millions of newly uninsured Americans will continue to strain households, healthcare providers, and state health systems—particularly for those of you managing chronic conditions who rely on consistent access to care.

ACA coverage in 2026

If you want to explore an ACA plan, you can preview plan options and pricing at HealthCare.gov. ACA plans are sold in standardized tiers — Bronze, Silver, Gold, and Platinum — which determine how costs are shared between you and the insurer. Premiums can vary only by age, location, family size, and tobacco use, not by medical history.

Open enrollment runs from November 1 to December 15 each year. If you missed open enrollment, you may still qualify if you’ve had a life event like:

• Getting married

• Having a baby

• Losing other health coverage

• Moving

As of 2026, the main difference between ACA health insurance and private insurance is that ACA Marketplace plans are required to offer coverage to anyone, regardless of health status, and prohibit denying coverage or charging more for pre-existing conditions. All ACA plans must cover essential health benefits, including doctor visits, hospitalization, prescription drugs, mental health care, and preventive services.

Until the expiration of subsidies, premiums were based on income, lowering premium costs.

Without subsidies, however, consumers must pay the full listed premium and all cost-sharing out of pocket. While coverage remains accessible, affordability becomes the major challenge — especially for people without employer-sponsored insurance, older adults, and those managing chronic health conditions.

Many professional organizations offer group health insurance plans for their members. Examples include:

• Freelancers unions: Provides access to plans in select states.

• Local Chamber of Commerce: Some chambers offer group health plans.

• Industry-specific associations: Check whether your field has a professional group that offers health benefits.

You can purchase private, individual health insurance plans directly from insurance companies, outside of employer coverage or government programs. These plans can be a good option if you are self-employed, between jobs, or not eligible for Medicaid. While some people buy plans through the ACA Marketplace, many others choose to purchase directly from insurers or independent websites.

Tips for choosing a plan

• Comparison shop: Don’t settle for the first plan you see. Use websites like eHealth, HealthSherpa, or insurers’ own sites to compare coverage options, premiums, and benefits. Look at multiple carriers to understand price differences and what each plan covers.

• Consider your needs: Think about how often you see doctors, whether you take prescription medications, and whether you have any chronic conditions. Plans with lower monthly premiums frequently have higher deductibles and out-of-pocket costs, while plans with higher premiums typically cover more of your care upfront.

• Check network coverage: Make sure your preferred doctors, specialists, and labs are in-network, and understand a plan’s prior authorization policies. Going out-of-network can dramatically increase costs.

• Understand cost-sharing: Look beyond premiums. Compare deductibles, copayments, coinsurance, and annual out-of-pocket maximums to understand your potential total costs.

• Look for plan features: Some plans offer additional benefits like telehealth visits, wellness programs, or discounts on prescriptions and lab tests. Decide which extras matter most to you.

• Watch for plan exclusions: While ACA-compliant plans cannot deny coverage for pre-existing conditions, non-ACA or short-term plans may not cover specific treatments such as GLP-1 medications for weight loss or may impose waiting periods.

By carefully evaluating your healthcare needs, costs, and network coverage, you can choose private individual insurance coverage that balances affordability with access to care.

If you’re in between jobs, waiting for ACA open enrollment, or about to get married, short-term insurance can provide temporary coverage. These plans are usually more affordable than comprehensive insurance and can help bridge the gap until you get long-term coverage.

To find a short-term plan, check directly with insurance providers or use sites like eHealthInsurance. Keep in mind that these plans typically cover only emergencies and basic medical services—they’re not a substitute for full health insurance, and they’re not likely to cover the treatment of hormonal conditions like hypothyroidism or menopause.

Medicaid is a government-funded healthcare program available to low-income people. The rules outlining who qualifies for coverage vary from state to state, but generally, people under the federal poverty line (and in some states, up to 120% of that) qualify.

You can apply by finding your state agency via Medicaid.gov and then applying on their site. If you aren’t sure whether or not you qualify, you can begin applying for ACA at HealthCare.gov, and it will notify you if you qualify for Medicaid instead.

If you’re waiting to activate ACA or other coverage, there are still some options for healthcare coverage. Search online for doctors, clinics, and urgent care facilities that accept uninsured patients. (Not all do.) You don’t want to be turned away from your nearby medical centers in the event that you need care, so it’s good to know in advance who will see the uninsured.

Clinics such as CVS Minute Clinic and local community clinics often accept patients without insurance. Search the database of local Community Health Centers to find one near you. Community Health Centers are government-funded, located in all 50 states, and “provide care regardless of your insurance status or ability to pay.”

Most urgent care facilities also accept patients without insurance, as do most emergency rooms. Urgent care visits are likely to be much less expensive than emergency room visits.

For specialized treatment of an underactive thyroid, Hashimoto’s, perimenopause, menopause, and GLP-1 weight loss therapy, Paloma Health offers an affordable option for personalized treatment via telehealth.

Most patients are unaware that many hospitals and medical centers offer discounts and debt forgiveness. Some facilities offer major discounts to patients willing to pay cash. Others offer discounted rates to uninsured patients and partial or even full debt forgiveness with proof of financial need.

Ideally, you’ll want to contact medical facilities and ask about available discounts in advance. If it’s too late and you’ve already received medical care, there’s nothing wrong with calling to talk to a facility’s financial services department and asking if you can receive some debt forgiveness. Even if they say no, they might be willing to negotiate with you for partial forgiveness or an extended payment plan to help keep what you owe from going to collections.

While asking friends, family, and the general public to help pay for your medical expenses isn’t ideal, it has become more popular in recent years. According to GoFundMe, they host over 250,000 medical fundraising campaigns per year, and some sources estimate that in 2024 alone, medical fundraisers on GoFundMe raised more than $1 billion.

GoFundMe even shares a medical crowdfunding guide online, offering tips on telling your health story and developing a social media strategy for sharing your page. One downside of using crowdfunding to help cover medical expenses is the loss of privacy that comes with it.

In the U.S., bloodwork and other lab tests are often marked up dramatically by doctors’ offices, hospitals, and insurers compared with the actual cost of performing the test, and the amount varies widely based on setting, billing practices, and whether you’re in-network.

Commercial insurance often pays 2 to 6 times more for the same blood test when performed through a doctor’s office or hospital outpatient department, and you can see bills – and copays -- that are higher than the underlying cost depending on how the test is billed.

Thyroid home test kits

For a complete thyroid panel, including thyroid stimulating hormone (TSH), free thyroxine (free T4), free triiodothyronine (free T3), and thyroid peroxidase antibodies (TPOAb), Paloma Health offers a very affordable and convenient home thyroid test kit. This kit lets you measure four key thyroid hormone levels and biomarkers with a simple, nearly painless finger-prick blood sample. Results are reviewed by health care professionals and delivered within days via a secure online portal. Paloma members get discounts on the test kit, making it even more economical. This user-friendly option lets you and your healthcare provider conveniently monitor your thyroid health from home.  

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Direct-to-consumer (DTC) online lab testing

Paloma also offers a direct-to-consumer (DTC) online lab testing service, JustLabs.  A DTC lab like JustLabs allows you to order blood tests online at a discounted rate without needing a doctor’s referral or insurance. The process is straightforward: you order your test online, visit a partner lab for the blood draw (usually without needing an appointment), and receive your results in several days via a secure online account. This method offers transparent pricing with no hidden fees, making it a convenient and discreet option.

A few popular DTC labs include

• JustLabs  - https://justlabs.health

• DirectLabs - https://directlabs.com

• HealthLabs - https://www.healthlabs.com

• Labcorp OnDemand - https://www.ondemand.labcorp.com

• Quest Direct - https://www.questhealth.com

Health centers and free clinics

Community health centers and free clinics are also valuable resources for low-cost or free blood tests. These centers often provide basic screenings such as cholesterol, glucose, and complete blood count (CBC) tests, tests for flu and COVID-19, and specialized tests like diabetes (A1C). In some cases, thyroid testing may be included, but it is likely to be the TSH test and not a complete thyroid panel.

Sliding fee scale clinics and centers

Some clinics operate on a sliding fee scale based on income, offering reduced rates for uninsured patients. Federally Qualified Health Centers (FQHCs) and local public health departments often provide these services. To access discounted services, you typically need to provide proof of income.

Urgent care centers

Urgent care centers are another option for quick, affordable blood testing without insurance. They offer tests like CBCs, metabolic panels, glucose checks, and more, with walk-in availability for convenience.

Free screening events

Occasionally, hospitals, nonprofits, or local governments host free health screening events that include basic blood tests. These events might offer screening for various health conditions, including diabetes risk assessments (A1C), cholesterol checks, or thyroid screening. (Again, most screening events test only for TSH levels.)  Checking local community boards or hospital websites can help you find these events.

Pro tip: compare costs

Finally, comparing costs across different labs is crucial. Blood test prices can vary widely depending on the facility and location.

By exploring these options, you can find affordable ways to access essential blood tests even without insurance. Always compare prices and check reviews to ensure quality service while saving money.

Prescription drug costs in the U.S. can be one of the most significant ongoing expenses for people managing chronic conditions like hypothyroidism or menopause symptoms, and especially for newer, brand-name medications such as GLP-1 agonists. There are multiple strategies and resources to lower what you pay — whether you’re uninsured, underinsured, or paying out of pocket:

Discount and coupon programs (free and easy)

GoodRx and SingleCare are two of the largest prescription price comparison and discount coupon services. Both are free to use and work even if you don’t have insurance:

• GoodRx lets you compare prices at thousands of pharmacies and get coupons for medications — including brand drugs like GLP-1s — often at significantly lower cash prices. Search for your drug at GoodRx.com and show the coupon at pickup.

• SingleCare also offers free coupons that can save up to ~80% off the retail cost for many generics and some brands. Coupons are accepted at major pharmacy chains nationwide (CVS, Walgreens, Walmart, Kroger, etc.).

• PharmaDiscounts.com is another free source for pharmacy discount cards and printable discount coupons.

Tip: Because discount prices can vary by pharmacy, always search both GoodRx and SingleCare (A list of similar tools is available at MoneyPantry) before you fill.

Manufacturer assistance and copay programs

For many brand-name medications — including some GLP-1s (e.g., Wegovy/Ozempic) — drug makers offer patient assistance or manufacturer savings programs:

• GoodRx’s database includes manufacturer copay cards and savings and assistance programs for hundreds of brand drugs, which can bring monthly costs down to very low levels or even $0 in some cases if you qualify.

• Searching directly on the manufacturer’s website (for example, Tirosint brand levothyroxine has a page with information on their savings programs) can show whether they currently offer a copay card or savings program. Many are free and easy to enroll in, even for people with high deductibles.

Important: Copay savings cards generally apply only if you have insurance (not Medicare/Medicaid), but some patient assistance programs also help uninsured people at income-based eligibility levels.

For more information, read “Saving Money on Your Thyroid Drugs with Copay Cards.”

Online pharmacies with lower cash prices

Online pharmacies can be a strong alternative to local brick-and-mortar pharmacy prices — especially for generics and maintenance meds:

• Mark Cuban Cost Plus Drugs sells generic medications with transparent pricing: manufacturer cost + a ~15% markup + small shipping/service fees. This often leads to much lower prices than typical retail pharmacy cash prices.

• Honeybee Health is another online pharmacy that offers medications at near-cost pricing with no insurance required, and can ship your prescriptions nationwide.

• Other reputable online options (like Amazon Pharmacy) may offer competitive pricing, especially if you compare cash prices across platforms.

How it works: Your doctor sends the prescription to the online pharmacy; you pay the cash price (which often beats retail), and the medication ships to your address. This is especially helpful if your plan doesn’t cover a drug well or if you are uninsured.

Smart shopping strategies

Here are additional practical ways to reduce costs week-to-week:

• Ask for generics or authorized generics — they are FDA-approved and usually significantly cheaper than brand names.)

• Check pharmacy price matching — sometimes a local pharmacy will match a lower competitor price.

• Fill 90-day supplies when possible — buying in bulk can lower the per-month cost for chronic meds.

• Use manufacturer patient-assistance programs — many offer $0 or deeply discounted meds based on income and residency. (Search via GoodRx or NeedyMeds for eligibility info.)
• Visit The Thyroid Medication Hub

Although it’s difficult living without health insurance, don’t despair. There can be affordable options that will allow you to obtain the hormonal healthcare you need to remain healthy.

Paloma Health provides affordable and comprehensive care for thyroid health, perimenopause, menopause, and weight management. Paloma’s services are designed to be accessible, offering telemedicine consultations with healthcare providers and at-home testing kits that eliminate the need for traditional clinic visits. Paloma membership is very affordable, ensuring cost-effective hormonal care even for those without insurance.

Paloma is committed to providing affordable, accessible thyroid and hormonal healthcare, and is your trusted resource for the treatment of hypothyroidism, Hashimoto’s, perimenopause, and menopause, and weight loss with the latest approaches, including GLP-1 drugs.

How many Americans are currently uninsured?

About 27 million Americans—roughly 8% of the population—were uninsured in 2025, with numbers expected to rise in 2026.

Why is the uninsured population expected to grow in 2026?

The expiration of enhanced ACA subsidies has significantly increased premiums, making coverage unaffordable for many households.

Can people with pre-existing conditions still get ACA coverage?

Yes. ACA Marketplace plans must accept applicants regardless of medical history and cannot charge higher premiums for pre-existing conditions.

When can I enroll in an ACA health plan?

Open enrollment runs from November 1 to December 15 each year, with special enrollment available after qualifying life events.

What alternatives exist if ACA coverage is too expensive?

Health system options include private individual plans, professional association plans, short-term insurance, Medicaid (if eligible), and low-cost care through clinics and telehealth providers.

Are short-term insurance plans a good option for chronic conditions?

Generally no. Short-term plans typically cover emergencies only and often exclude chronic or hormonal conditions.

Where can uninsured patients receive affordable medical care?

Community health centers, urgent care clinics, retail clinics, and telehealth services frequently accept uninsured patients at lower cost.

How can I get blood tests without insurance?

You can use direct-to-consumer lab services, at-home test kits, sliding-scale clinics, urgent care centers, or free screening events.

Will community clinics provide complete thyroid testing?

Often no. Many clinics offer only TSH testing, not a full thyroid panel including free T4, free T3, and antibodies.

What should I do if I can’t afford medical bills?

Ask about cash-pay discounts, hospital financial assistance or debt forgiveness programs, extended payment plans, or, as a last resort, medical crowdfunding.