Health insurance is a benefit that many Americans have come to expect from their employers. Unfortunately, this could become a thing of the past -- in 2009, "Forbes" magazine reported that nearly 20 percent of employers planned to eliminate health insurance benefits over the next three to five years. If you're one of the more than 50 million Americans without an employer-sponsored health insurance plan, you have options, although you'll have to pay out of pocket.
If you're a young, healthy person, it's tempting to go without insurance. Many Americans make this choice, but it's a financially risky decision. A simple trip to the emergency room can cost well over $1,000 without insurance, and if you encounter any serious health conditions, the cost can be crushing. In fact, CNN reports that in 2009 more than 60 percent of bankruptcies were a result of medical costs. At the least, you should find an insurance plan to cover large, unexpected costs.
If you're married or live in a state that offers domestic partner benefits, you might be able to sign on to your spouse's health insurance plan. Although you'll have to pay for this benefit, it's typically cheaper than other options while offering maximum coverage. Low-income workers may qualify for the state-funded Medicaid. Your local Medicaid office can help you determine whether you qualify. The large health insurance companies in your area -- BlueCross BlueShield and Kaiser, for examples -- should offer individual health insurance plans. Request a quote to see how much you'll have to pay and what that coverage includes. Discount medical plans are not health insurance plans but help you to minimize costs -- you pay a low monthly fee and then doctors in the network offer you a discount on their services.
Assessing Your Needs
The key to finding the right insurance plan is to accurately assess your probable health needs. You cannot predict everything that you might need insurance for, but you can make a few good guesses. For example, if you are a young person who doesn't regularly take medications, you could save money with an insurance plan that doesn't offer prescription coverage. If you're a woman in the childbearing years, you might decide to pay extra for maternity coverage, even if you don't plan on becoming pregnant soon. Make a list of the things that you'll need health insurance to cover and look for a plan that incorporates those needs.
Reducing the Cost
Purchasing individual health insurance is often expensive, which is why so many people go without. You can reduce your costs, however. Plans that have high deductibles typically have low monthly premiums and are a good option for people who are generally healthy. Your state might offer reduced-cost insurance plans for those whose income is too high to qualify for Medicaid, such as New York's "Healthy NY" plan. Group insurance plans are almost always less expensive than individual insurance plans -- sometimes, professional organizations offer group insurance to their members. This could be a way for you to reduce costs.
You face bigger challenges if you have preexisting conditions that you receive treatment for, such as diabetes and high blood pressure. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) offers some protection for this. If you had no lapse in insurance, your new insurance company must cover any preexisting conditions. However, you might pay more for your insurance because of your condition and you might have trouble finding an insurance company that will cover you. Most states offer a "high-risk pool" of insurance for people who have trouble getting insurance because of preexisting conditions.
- "Forbes"; What to Do If Your Job Doesn't Offer Health Insurance; Anna Vander Broek; July 22, 2009
- Kaiser Health News; Uninsured Rate Soars, 50+ Million Americans Without Coverage; Phil Galewitz and Andrew Villegas; September 16, 2010
- "The Washington Post"; Getting Coverage When Your Employer Doesn't Offer It; Albert B. Crenshaw; March 16, 2008
- U.S. Department of Labor. "Young Adults and the Affordable Care Act: Protecting Young Adults and Eliminating Burdens on Businesses and Families FAQs." Accessed Mar. 25, 2020.
- Healthcare.gov. "Health Coverage for Self-Employed." Accessed Mar. 25, 2020.
- U.S. Small Business Administration. "Plan to Offer Employee Benefits." Accessed Mar. 25, 2020.
- Healthcare.gov. "Small Business and the Affordable Care Act (ACA)." Accessed Mar. 25, 2020.
- Medicare.gov. "What's Medicare Supplement Insurance (Medigap)?" Accessed Mar. 25, 2020.
- HealthCare.gov. "No health insurance? See if you'll owe a fee."
- Kaiser Family Foundation. "2019 Employer Health Benefits Survey: Section 1: Cost of Health Insurance." Accessed Mar. 25, 2020.
- eHealth. "How Much Does Individual Health Insurance Cost?" Accessed Mar. 25, 2020.
- Healthcare.gov. "Enroll In or Change 2020 Plans — Only With a Special Enrollment Period." Accessed Mar. 25, 2020.
- U.S. Department of Health and Human Services. "Lifetime & Annual Limits." Accessed Mar. 25, 2020.
Maggie McCormick is a freelance writer. She lived in Japan for three years teaching preschool to young children and currently lives in Honolulu with her family. She received a B.A. in women's studies from Wellesley College.