Millions of people don't.
But how can you still pay for medical care if you don't have health insurance?
You might actually have more options than you think.
But it's super important to be aware of those options before the need for medical care happens.
And just as important, having a plan in advance – and preferably several plans – can give you options that you won't have if you're totally unprepared.
In this article, we’re providing five such plans, as well as three more that will help you to eventually get at least some form of ongoing coverage.
1. Take Care of Your Health
When it comes to health care, preventative medicine is the best kind. Any type of illness or injury you can avoid is an expense you won't have pay.
And while it's always important to take good care of your health, it's even more important if you don't have health insurance.
For example, if you smoke cigarettes or regularly consume alcohol, you might want to give those habits up while you have no coverage.
While cigarettes can lead the long-term health consequences, excess alcohol consumption can result in accidents and injuries.
Speaking of which, you should do all you can to avoid dangerous behaviors in general.
If you're in the habit of playing tackle football with the boys, or mountain climbing on weekends, you might want to give those up while you have no coverage.
In fact, any activities that have more than an average risk of injury should be avoided.
It should go without saying that you should eat a balanced diet, get regular exercise, and get plenty of sleep.
Not only will those practices help to maintain your health, but they can also help to avoid accidents and injuries due to fatigue.
2. Set up a Medical Emergency Fund
You obviously won't be able to save enough money to cover a major medical procedure.
But having just a few thousand dollars saved in an emergency fund can cover the majority of medical expenses.
For example, while it may not cover a surgical procedure, it should be sufficient to pay for routine trips to the doctor or even to an emergency clinic.
And if you do have to resort to any of the other options, having some money earmarked for medical costs can improve the outcome.
For example, if you plan to negotiate expenses, which we’ll cover in the next section, having a few thousand dollars available immediately can strengthen your bargaining position.
3. Negotiate Medical Costs in Advance
This obviously won't be possible in an emergency situation.
But if you have a procedure coming up, you may be able to negotiate the cost up front.
Just by letting a provider know that you don't have insurance coverage – but you do plan to pay bill – might enable you to get a significant reduction in the cost.
The willingness of providers to accept a negotiated price in advance will vary by the doctor or facility you're working with.
But since you'll have time in advance, you'll be able to shop among providers who may be willing to work a “cash pay” deal, and do so at the lowest possible cost.
4. Set up a Payment Plan with Your Provider(s)
If you don't have health insurance, it's important to understand you're far from the only one.
In fact, there were more than 27 million Americans without health insurance in 2018.
And apart from that population, millions of people pay thousands of dollars in out-of-pocket medical costs each year, due to rising deductibles and copayments.
For this reason, health care providers typically have provisions to set up payment plans.
Depending on the laws in your state, and the willingness of the provider, you may be able to spread the payments over anywhere from 12 to 36 months.
Under extreme circumstances, you might want to look into setting up a GoFundMe page.
They even have a dedicated page for medical fundraising.
If your story is compelling enough, and particularly if it involves providing medical care for your children, you may be able to raise thousands of dollars in contributions from people you don't even know.
That could cover at least a good portion of a major medical procedure.
5. Look into Local Government Healthcare Services
People are often unaware that certain medical services are available through local governments.
They may set up clinics or even hospitals that will take patients who have limited means to pay or even none at all.
Check out the Health Resources & Services Administration’s Health Center Program.
It’s an agency of the federal government that provides a list of primary and preventive care facilities throughout the country that provide care to millions of patients regardless of ability to pay.
Make Sure Your Time Without Health Insurance is Only Temporary
Going without health insurance is a stressful situation, particularly if you have a family.
For that reason, it should be as temporary as possible.
The obvious first best solution:
Get a job with health insurance coverage.
But failing that, here are some other options to try:
Join a Health Sharing Ministry
These aren't true health insurance plans, but they work in much the same way.
Participants pool their funds by making monthly contributions, similar to insurance premiums. The money is then available for any member who has a medical need.
Typically, the monthly contributions are only about half what you will pay for traditional health insurance.
Examples include Medi-Share and Liberty HealthShare.
But be aware that any health sharing ministry has qualification requirements, and not everyone will be accepted.
For example, you must be an actively participating Christian, living by Biblical principles, and also qualify based on your health condition.
Unfortunately, they may not accept people with pre-existing health conditions.
Find a Part-time Job with Health Insurance
There are a surprising number of employers offering part-time jobs with health insurance.
Starbucks is an often cited example, but there are many more.
Common employers offering coverage include local governments, colleges and universities, hospitals, banks and credit unions, airlines, and even many grocery chains.
Due to cost, and the potential for limited benefits, this option may be best suited for singles and couples.
But it may be a good option if you’re self-employed or you have a full-time job that doesn't provide coverage.
Health Insurance Exchanges
Some people hear the horror stories about huge premiums on policies offered through the health insurance exchanges.
Those stories are often true. It's not hard to find monthly premiums running over $1,000, $1,500, or even $2,000. This is especially true if you're over 50, or you have a family to cover.
But as the saying goes, never overlook the obvious.
Premiums are notoriously high.
But there might be light at the end of that tunnel.
The main reason most people don't have health insurance is because of a low income.
But one of the advantages of the health insurance exchanges is that you can get a generous tax subsidy if low income is the problem. The credit can be applied to your monthly premium, rather than taken as a tax refund at the end of the year.
As a result:
You may be able to get a plan with a net monthly premium of no more than a couple hundred dollars.
Check out Healthcare.gov’s health insurance estimator page.
The site can enable you to shop for plans and prices available in your area, without going through the exhaustive process of making a formal application.
In just a few minutes of your time, you can get a list of the plans that are available, with approximate premiums based on your income level. Check it out, and you may be pleasantly surprised.
The absolute worst option when it comes to health insurance is to do nothing at all.
While you may feel it's unnecessary to prepare for health care expenses when you're healthy, the situation can change rapidly after an accident or the onset of a sudden illness.
Having at least some preparation in place can give you options that wouldn't otherwise exist.
At a minimum, set up an emergency medical fund.
That would at least enable you to cover the basics, as well as to have money available to negotiate prices or a payment plan.
But you may also want to investigate government-provided health services in your area, as well as health care providers that will accept cash payments.
Just knowing this information in advance can help you to go to the right providers if a medical emergency occurs on short notice.