If you're struggling to make ends meet, you may be tempted to forgo health insurance. While it may not seem worthwhile to pay a monthly premium for a healthcare plan when you can't pay your bills, going without health insurance puts not only your health at risk, but your wallet too.
This is because medical emergencies can happen without warning, and at any age. When they do, they can be very costly if you have to foot the bill on your own. Without the help from insurance, you may end up owing a lot of money, which could lead to years of debt. For this reason, it's crucial to have a plan for paying medical costs that doesn't break the bank. It may mean paying in small amounts over time, to prevent a massive windfall later on.
These tips for paying for health care will challenge the notion that you can't afford health insurance, and adopt a plan that suits your budget.
In 2019, adults (not counting the elderly) who did not have a health plan were twice as likely to struggle paying medical bills when compared to adults who had health plans. This does not account for the three in ten who skipped healthcare due to cost.
High Deductible Health Plans (HDHPs)
If you are struggling to find health insurance with monthly premiums you can afford, you might want to look into getting a high deductible health plan (HDHP). An HDHP covers many of the same services as a standard plan, including costs for awful events that could otherwise bankrupt you, but it comes with a higher deductible. This means that in exchange for lower bills each month, you'll have to pay more out of pocket before the plan kicks in and pays for the rest. The IRS sets upper and lower limits for plans to be defined as HDHPs. In 2020 the deductible had to be at least $1,400 for a single person or $2,800 for a family. Also, any extra costs out of pocket (deductibles, copays, and coinsurance) for these plans could be no more than $6,900 for a single person and $13,800 for a family, per year.
Limits for costs out of pocket only apply to services within a plan's network. If you see a doctor or other care provider out of network, it will be on your own dime, and the payment won't count towards your deductible.
These figures may seem daunting, but it is a lot less daunting to pay $1,400 than it would be to pay for a $7,500 for a broken leg. If you have an extended hospital stay, costs can add up even faster; a three-day stay alone can set you back up to $30,000 or more. The perks should be clear: if you've paid your (low) monthly bill for an HDHP, once you meet the limit, the plan kicks in and covers a large portion of the costs still due, while you must only pay a small portion of coinsurance. Copays are not included in the limit, so those will be added to your bill as well, but they tend to be quite minor.
Often, the best and cheapest HDHP is the one offered through your workplace. But you may be able to find a cheaper option by looking through the health exchanges set up under the Affordable Care Act (ACA), or direct through insurance companies. Plans under the ACA may offer extra discounts based on your current financial status, though this varies by state and by plan.
Short-term plans provide coverage for as little as three months, and up to 364 days. Like HDHPs, short term plans also have lower monthly premiums than most standard plans. They're a good option for those who can't afford hefty health plans, or who may need to bridge gaps in health coverage, such as when taking a long trip, or starting a new job.
It's worth noting that you will get what you pay for with these plans. They offer fewer perks and they protect against less than most plans created under the ACA, which can make them risky. People who have known health concerns or need ongoing care should proceed with caution. Chances are you will be turned down if you have a pre-existing condition. Also, short term plans often impose limits on the number and dollar value of visits to care providers, and they fully exclude coverage for many common health needs, such as maternity care and certain chronic illnesses.
But if you are young, healthy, and simply looking for a cheap way to cover healthcare for a few months (and even then, just in case), short term plans may work for you.
Some states, such as Oregon and New York, banned short-term plans that don't cover pre-existing conditions, and many others are doing the same in years to come.
Reduce Costs for Doctor Visits
Even with a health plan, many people have a hard time paying for the extra out of pocket costs. For instance, if you need an MRI done, you may have to pay for your deductible and then the coinsurance costs, which means that the test could still run you hundreds of dollars or more.
Since many tests and procedures are used to help catch an illness before it becomes grave, opting out of the tests may be risky in the long run. It's much wiser to think of your health before it becomes a problem; by taking measures to stay healthy, and plan ahead, you may be able to reduce the amount you have to pay when you do receive health services.
Look Inside the Network
If you have a health plan, use the provider look-up tool on the website of your insurer to find local doctors and hospitals that are in the plan's network. Going "in network" will most often save you money because network providers contract with your insurer to charge lower rates.
Some types of plans, such as Health Maintenance Organization (HMO) plans, only cover services that you receive from providers in the network. With other plans, such as Preferred Provider Organization (PPO) plans, you will still pay less for services from providers within the network, but they allow you to seek care outside of the network for a fee.
Even within a network, the range in prices between health providers in your region can be huge. Take the time to call doctors, urgent care centers, and hospitals to hone in one the ones that offer services at prices you can afford.
You may also be able to find lower rates at hospitals and testing centers that are slightly farther from your home. Use websites like FairHealthConsumer.com to look up can compare the costs of common medical procedures so you won't be caught by surprise at the doctor's office.
Some teaching hospitals and centers that work with students have programs that offer discounts when you agree to partake as a model patient in their training programs. Though you may not want something major treated by a trainee, for many minor concerns or routine visits, it's a win-win.
Set Up a Payment Plan
Many hospitals and clinics are willing to set up a payment plan that will allow you to get tests and other procedures when you need them, and spread out the costs over time if you can't afford to pay for them all at once.
But be mindful with this approach, as debt can get tricky if kept too long. Also, if you end up needing to set up many payment plans with sources, costs can really add up. The better way would be to set up a DIY payment plan ahead of time. If you can afford to put some money away in savings each month, think about starting a small fund to match amount that you need to cover your deductible each year, and keep it safe in its own account, apart from the one you use for your other banking.
Get Routine Check-Ups
Routine health screenings will help you stay healthy and avoid common illnesses that can incur large medical bills in the future. There are many measures you can practice to take charge of your own health, such as exercise, proper diet, and not smoking.
You can also save on medical costs by promptly getting care for minor issues, before they become severe and end up needing more costly treatment. If you feel sick, take the time to get treated so that you do not end up hospitalized overnight or in surgery.
Look Into Clinics
If you can't afford health insurance, and you need medical care, look into local options. Many clinics forgo the standard model, and treat patients for many common concerns fairly cheaply. By staying out of the mainstream system, clinics are often able to charge much less than a hospital would charge for the same procedure.
Many cities have free or low-cost clinics that offer fees on a sliding scale based on your income, and health insurance may further reduce the amount you pay should you get the care.