The Disadvantages of Health Insurance

You might not think you’d find many disadvantages to having health insurance, other than the cost, but all plans aren’t the same. Based on coverage limitations of certain policies, you should review the alternatives to having health insurance to help you make your decisions regarding your financial and health plans throughout your life.

With the passage of the Affordable Care Act and subsequent changes to the ACA over the years, it’s a good idea to consider the advantages and disadvantages of health insurance for your personal situation.

​Read More:​ The Affordable Care Act: Facts & How It Affects Your Taxes

One of the biggest disadvantages to having health insurance is the cost of premiums, deductibles, co-pays, services, tests, medications and other items that aren’t covered in your premium.

To get a basic idea of what health care insurance might cost you under the ACA, visit HealthCare.gov, enter your information and see what plans and coverages you’re offered. Your income and the type of plan you choose will greatly affect your cost.

The gamble you pay not having health insurance is that you can face catastrophic financial or life-ending health consequences if you need emergency surgery or are diagnosed with a serious illness or disease and you have no insurance. If you or a family member you want to be covered has a pre-existing condition, your costs might soar, or you might even be turned down. As you age, your premiums can rise, as well.

Some health insurance policies limit who you can visit, in terms of health care providers. That could mean certain hospitals or clinics or even specific doctors. If you’ve had a family doctor for years, for example, you might not be able to see that doctor for a procedure and get it paid for by your insurer if that doctor isn’t part of their plan.

Few health insurance policies cover every type of medical need, and those that do are expensive. You will need to make sure that any policy you consider provides all of the coverage you want, including medicines, surgeries, treatments, checkups, tests, equipment (like a CPAP machine or wheelchair) and hospital stays.

​Read More:​ Are Medical Expenses Deductible? What You Need to Know

You won’t be able to sign up for every health care policy at any time during the year. For example, the ACA’s enrollment period is usually ​November 1 through January 15​.

If you miss this window or the window for insurance enrollment offered by your employer, you might still be able to qualify under an exception. If not, you’ll have to wait until next year for this program, get private health insurance or check to see if your state is part of the state health insurance exchange marketplace.

If you can’t afford your ideal private health insurance plan, you can supplement what you buy with a variety of other health care products. For example, you might be able to enroll in a tax-advantaged Health Reimbursement Arrangement, Flexible Spending Account or Health Savings Account.

You can purchase supplemental health insurance policies, such as cancer, dental, dental or disability income insurance plans. Depending on your income and age, you might qualify for Medicare and Medicaid.