It can be scary and frustrating to live without health insurance coverage, especially if you deal with a chronic condition. But, if you don’t have health insurance, you’re not alone. At the time of the last Census Bureau data collection in 2017, 8.8% of Americans did not have health insurance. That is 28.5 million people!
A late 2018 Gallup poll suggests that this number has risen to a high of 13.7% of adult Americans lacking health coverage. The percentage is even higher in women, young adults under 35, and households bringing in less than $48,000 per year.
People without health insurance can get stuck in a cycle of not seeking medical care because they aren’t insured, putting off doctors’ visits until their health problems become more severe, resulting in emergency room bills that add financial strain and make it all the more difficult to become insured.
ACA coverage pricing is calculated based on the state you live in and your yearly salary. Since the prices are based on income, they should be relatively affordable, like the name says. You can preview plans and their prices on HealthCare.gov.
Open enrollment is available through HealthCare.gov from November 1st to December 15th of every year. If you missed open enrollment, don’t worry. You can enroll at any time of year if you have recently experienced a qualifying life event. Such events include:
Under the ACA, it’s illegal not to have health insurance coverage as an American. At tax time, you will be charged a penalty if you weren’t insured the previous year, which is another reason to enroll in coverage as soon as possible.
Medicaid is the 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, 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 don’t have health insurance currently because you’re waiting for an upcoming event--a wedding, the school year, ACA open enrollment, or a new job start date--consider short term insurance to keep you covered in the meantime. Short term insurance is less expensive than comprehensive health insurance policies, so it is also a good option if you can’t currently afford what the ACA has to offer.
Short term insurance is a temporary health insurance option. Just like with ACA coverage, the choices available to you depend on what state you live in. You can contact insurance companies individually to find out what short term plans they offer, or you can use a site like eHealthInsurance to view multiple short term plans at once.
Note that short term insurance is not a substitute for a comprehensive plan. While it’s better than not being insured at all, it’s mostly for emergencies and very basic medical services.
Ideally, you will enroll in ACA coverage. If you can’t do so immediately, search online for doctors, clinics, and urgent care facilities that accept uninsured patients. Not all medical facilities accept uninsured patients. 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, however.
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 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 the facilities’ 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, helping patients raise over $650 million for medical care.
GoFundMe even shares a medical crowdfunding guide online, in which they give tips on telling your health story and developing a social media strategy for sharing your page. One downside of using crowdfunding to help with medical expenses is the required loss of privacy that comes along with it.
Although it’s difficult living without health insurance, don’t despair. There are options that will allow you to obtain the medical care you need to remain healthy.
Paloma offers at-home health tests that don’t require an office visit. Our tests are typically priced lower than out-of-pocket costs associated with such visits. For traditional tests, there are usually fees associated with an office visit (physician costs), as well as the lab.
Pricing is typically very complicated and not transparent for the consumer. The pricing will vary (sometimes dramatically) by laboratory, institution, test type, markers checked, your personal insurance coverage (or lack thereof), and more.
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