Whether you’ve just started exploring coverage options or you’ve been paying premiums and picking plans for years, figuring out how to afford health insurance is no walk in the park. If the stress of studying deductibles and coinsurance has you wondering if health insurance is even worth it, you’re not alone. The percentage of people ages 19 to 64 without insurance rose between 2016 and 2018 — from 12.7 percent to 15.5 percent. To put it in other terms, about 4 million people lost coverage.
Here’s a look at why people might give up insurance coverage and why they shouldn’t — and how to find coverage even if your budget is tight.
Why Americans Are Ditching Their Plans
If you ever run into a medical emergency, insurance can be the only thing between you and a mountain of bills. A recent survey found that more people are afraid of medical bills than of actually getting sick. So if insurance is so important, why aren’t Americans getting covered?
Medical bills may be frightening, but a health plan’s monthly premiums can cause financial stress, too. According to the same survey, a third of Americans have fallen into credit card debt to cover health care costs, and even more say paying for health care expenses has kept them from saving any money.
If your bank account is getting low and you have other expenses to take care of, health insurance doesn’t always seem like it should be your highest priority, especially if you’re pretty healthy and might not need all that much medical attention. Unfortunately, not having health insurance comes with serious risks.
Why Paying for Health Insurance Is Money Well Spent
When the Affordable Care Act (ACA) came on the scene, it introduced the individual mandate. This essentially means that anyone who doesn’t have health insurance that offers minimum essential coverage has to pay a penalty fee. (Wait — didn’t they repeal the individual mandate? The answer will depend on your state, so do some research before you make any health insurance decisions in 2019.)
Still, many people choose to take the penalty because it’s cheaper than a health plan. In most cases, the penalty is small enough that it won’t make or break a tight budget. People who skip getting health care coverage may not get into all that much financial trouble until they need medical help.
Among uninsured Americans, 20 percent of people say they’ve avoided getting care. The same is true of just 3 percent of privately insured Americans. Going without health insurance puts countless screenings, medications, treatments and tests out of reach. You might be able to power through a cold without needing to see a doctor, but what happens if you come down with pneumonia, break your leg or suffer something more serious? People who have been diagnosed with cancer are 60 percent more likely to die of the disease if they don’t have health insurance.
If you’ve been putting off getting covered because you’re concerned about how to afford health insurance, you might have more options than you think.
What to Do If Traditional Health Insurance Isn’t an Option
The ACA isn’t the only path to health insurance coverage. Depending on your specific situation, if a traditional plan is out of reach, the following alternatives may help you absorb an unexpected health cost.
- Health care sharing ministry. This actually isn’t insurance at all. This kind of faith-based cost-sharing plan, however, has a similar structure to traditional health plans. If you join this sort of plan, you’ll pay a monthly premium in return for coverage for specific medical needs. These plans generally offer limited coverage and don’t guarantee payment for claims, but members are exempt from the individual mandate penalty, if applicable.
- Primary care membership. Also known as direct primary care, this setup involves making a health care agreement directly with your doctor instead of a health insurance company. You’ll pay a monthly fee to see your doctor and receive other medical services. This arrangement really only exists for primary care, so if you need special services or have a chronic condition, you might need to pay your doctor separate fees or pair your membership with an insurance plan.
- Supplemental insurance. In some states, short-term insurance is now available for up to 364 days with two renewals, making it a viable option to maintain some coverage until your means or needs change. Meanwhile, supplemental policies like fixed indemnity or critical illness insurance tend to have lower monthly premiums than traditional health insurance plans. They pay out cash in fixed amounts to help cover medical costs. Joining this kind of plan won’t exempt you from the individual mandate penalty or cover every health care need, but they can be a good way to get help you handle the cost of a large medical bill.
Health insurance isn’t always the easiest thing to fit into your budget, but going without coverage and hoping for the best isn’t a very comfortable or safe way to live. Get covered, and save yourself from worrying about how you’ll manage your health care costs down the road.