Do I really need health insurance?
If you’ve never purchased a health plan on your own and don’t have many health problems, it may be tempting to skip health insurance to save money. But skipping coverage now may cost more later.
Getting a health plan when you can may help you save money and avoid medical debt. This includes millions of Americans who owe more than $10,000.1 In addition, about 1 in 5 Americans don't have emergency savings for a health crisis.2
There is a lot of health information online and on social media. It can be hard to know what is true or what is right for you. A health insurance plan can help protect you from unexpected medical costs. It can also connect you with trusted doctors who can help you make informed health decisions.
Why should I enroll in health insurance?
Health insurance can help protect you from high medical costs if you have a serious illness or injury. Without coverage, you may have to pay those costs yourself, which can lead to debt or even bankruptcy.
It may seem cheaper to wait to buy coverage until you need it. But if you don't have health insurance and need medical care, you may not be able to sign up right away. You may have to wait until open enrollment or a qualifying life event to sign up for health insurance. Some private plans are available year-round, but they may not cover pre-existing conditions or major medical needs.3
Learn more about the risks of not having health insurance.
Who is most at risk without health insurance?
People with chronic conditions who don’t have insurance are less likely than those with insurance to get care due to cost. For example, 42% of uninsured adults with diabetes delayed or skipped needed care because of cost.4
People without insurance are more likely to end up in the hospital for health problems that may have been avoided with preventive care. They may also have worse health outcomes. Without regular care, health conditions may go undiagnosed and get worse.4
What are the state penalties for not having health insurance?
The Affordable Care Act (ACA) once required most Americans to have health insurance or pay a federal tax penalty. This was called the individual mandate.5
That federal penalty no longer applies, but some states still require health coverage. If your state has a mandate, you may owe a penalty when you file your state taxes. States with individual mandates include:5
- California
- Washington, D.C.
- Massachusetts
- New Jersey
- Rhode Island
- Vermont (but there’s no financial penalty attached to the mandate)
Tax penalties vary but are often an amount based on your income or a flat rate per adult. On the other hand, some high-deductible health plans, which can be paired with a health savings account (HSA), offer tax benefits. An HSA may help lower the amount of federal taxes you owe. It can also help your money grow through interest or investments.
Are there any exemptions for state penalties?
Some states offer exemptions or hardship waivers if you cannot afford insurance or have another qualifying reason.
You may qualify for a hardship exemption if a financial challenge or other hardship kept you from getting coverage. These exemptions usually apply to the month before, during and after the hardship.6
Hardships may include:6
- Experiencing homelessness
- Eviction or foreclosure
- Getting a shut-off notice from a utility company
- Experiencing domestic violence
- Death of a family member
- Bankruptcy
- Medical expenses you couldn’t pay that resulted in substantial debt
Take the next step
If you’ve decided you will sign up for health coverage when it’s available, get ready by taking a few minutes to review these important tips for open enrollment.
The importance of a primary care provider
Once you have coverage, choosing a primary care provider can help you get the care and support you need.
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