What to do if You Absolutely Can’t Afford Health Insurance

Guest Post by Kevin Mercadante

Let’s get this point out of the way up front: everyone should have health insurance. We all know this without anyone emphasizing the point. But with job losses in recent years, companies canceling their coverage, and the cost of independent plans spiraling out of control, millions of people have been forced to drop coverage in favor of just surviving. Many just cannot afford health insurance any longer.

If you’re one of them, or think you might be in the near future, here are some suggestions that might help in the event that you absolutely can’t afford a traditional health insurance plan. One or a combination of several may at least partially offset the loss of the typical $1000-plus per month plans that cover all of the things we’re used to. 

AFLAC

This isn’t health insurance in any sense of the term, but AFLAC offers plans that will pay flat amounts for specified illnesses and injuries. Far less expensive than health care plans, you can buy a plan for well under $100 per month that will pay thousands of dollars at the time of a covered injury or illness.

Healthcare providers won’t accept it as health insurance, but the company pays direct to you so that you will have some opportunity to pay bills at your option after the fact.

Take care of yourself

We’re told relentlessly by healthcare providers to take better care of ourselves, but that advice becomes critical if you cannot afford health insurance. It goes beyond the standard eat-better-and-exercise-more advice. That’s important if you have no coverage, but perhaps even more so is avoiding dangerous behaviors.

Playing tackle football with your buddies on the weekend might help you blow off steam but it’s an accident waiting to happen. Alcohol consumption brings all kinds of potential for disaster, as does climbing a ladder to clean your gutters. And reckless driving is a complete no-go. Slow down and be more aware of what could go wrong, because now there’s no backup plan if it does.

Mini clinics

In the past few years, in-house mini clinics have opened at retail outlets by the thousands. If you cannot afford health insurance these are a definite option.

We had problems with a health plan conversion recently, during which time my wife had an ear infection. Since our insurance was invalid (though fully paid!) we opted to go to a clinic at Walgreens. They diagnosed the problem and prescribed three medications. Total cost: $49 for the visit, plus $63 for the prescriptions.

Now with a plan in place, we’d have paid $40 for the office visit and $20 each for the meds, or about $80. But for just $112, we took care of it at Walgreens. I’m not minimizing spending $112, but it’s quite a bit cheaper than $1000 per month for a plan, plus $80 for treatment co-pays.

Non-prescription substitutes for prescriptions

If you need a prescription and don’t have coverage, ask the pharmacist about a non-prescription alternative.

We’ve had two situations in the past couple of years where prescriptions were not covered under our plan for one reason or another. The alternative was for us to pay out of pocket. In both cases, the pharmacist recommended an over the counter alternative, and each time it did the job. Many over the counter meds were once prescription only.

We probably should be doing this all the time in an effort to keep healthcare costs down but it’s critical if you have no coverage.

Get your kids into a plan

If you cannot afford health insurance for your entire family, at least try to get your children covered. I can think of no more tragic situation than a parent facing a medical emergency for their child with severely constrained treatment options due to finances.

You can generally get a plan for a child in the low 100s per month, and well below with reduced coverage. Eliminate your cable TV, cut back to eating rice and beans every day, sell your second car, or do whatever you need to do to make room in your budget to get your kids into a plan.

Government programs

Check and see what coverages may be available through Medicaid or state agencies. The income qualifications are stiff, but again try to at least get coverage for your kids, and to see what other benefits might be available.

Buy the LEAST EXPENSIVE plan available

Finally, consider buying the cheapest health insurance possible, sometimes referred to as “catastrophic coverage”. This isn’t the kind of coverage that will pay for all of your healthcare needs, but it will cover the big ones where it matters most.

As an example, let’s assume a married couple, both 40, with two children, considering a plan under Assurant’s popular CoreMed Plan. (This is not an endorsement of Assurant, but their website is extremely user friendly!)

With a $1000 deductible, $35 office co-pay, 80% coinsurance (to $3500) and a $6 million lifetime maximum, the monthly premium is $1213. That’s the size of a typical house payment! And your out-of-pocket maximum could be as high as $4500 (deductible plus coinsurance) on any single event.

But by going with a $10,000 deductible, no office visit coverage, but zero coinsurance with a $6 million lifetime maximum, the monthly premium falls to $303, or about the size of a modest car payment. You wouldn’t have much coverage for routine care, but your out of pocket maximum would be limited to $10,000—true catastrophic coverage.

Many people view the quality of a health plan by the routine care it covers, such as doctor visits and tests, but that kind of coverage is where the expensive premiums are and if you’re reading this article you probably can’t swing that level of protection right now.

While it’s true that the cheaper plan would leave you paying for most (or even all) of your medical costs in most years—in addition to your monthly premiums—it will offer undeniable advantages:

  1. Just having an insurance ID card will make it far easier to be admitted to a hospital
  2. You will be part of a network that requires providers to discount their services. My son had surgery a few months back in which the providers discounted their fees by up to two-thirds; absent network coverage, we’d have been on the hook for 100%.
  3. Though you will pay for routine procedures, you WILL have coverage for the truly big ones—the kind that land people in bankruptcy court when they have no coverage
  4. In a truly serious medical situation—where costs exceed $10,000—you will have coverage available that will enable you to have access to what ever treatment options are available.

Get a part-job with health insurance

Many people are unaware that there are companies that offer health insurance to their part-time employees. I’ve compiled a list of prominent employers with health insurance for part-timers in the post, 20 Part-time Jobs With Health Insurance.

This is an excellent source to consider if you don’t have health insurance on your primary job, can’t qualify for private coverage due to pre-existing conditions, or you just cannot afford health insurance at the going rate.

There’s a saying in the health insurance business, ”any coverage is better than no coverage”, and that’s generally true. Better to have low premium/high out of pocket coverage than none at all. One serious medical emergency will have made it money well spent.

Kevin Mercadante runs the blog Out of Your Rut, which regularly features expense-reduction strategies and cost saving programs in health care as well as other areas. This post originally appeared on Out of Your Rut.

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One Response to What to do if You Absolutely Can’t Afford Health Insurance

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