Are You Legally Required to Have Health Insurance | eHealth

October 21, 2022

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Many people worry about a penalty for not having health insurance, which can be stressful. If you find yourself in this position, you may be wondering, “what if you don’t have health insurance?” If you don’t have health insurance, do you have to pay a fine? Although there is currently no federally assessed tax penalty for not having health insurance, there are risks associated with being uninsured.

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It’s best for most people to have insurance that can help cover health care costs, such as doctor visits, prescription drugs, and possible emergency room visits; however, it is not always accessible to everyone. There are many different reasons why people may go without health insurance for a period, from the cost of coverage to job changes.

Reading: How long can i go without health insurance 2020

It’s important to understand what you can expect if you don’t have health insurance, as well as your options for getting coverage no matter what your current situation is. Read on or use the links below to learn more.

why don’t people have insurance?

The number of people without insurance has risen steadily in recent years. According to a Kaiser Family Foundation (KFF) publication in November 2020, the number of uninsured older Americans increased for three years in a row, beginning in 2017. In 2019, there were 28.9 million uninsured for a variety of reasons.

The KFF report found that low-income families were the most likely to be uninsured, with more than 73% citing the high cost of insurance as the main reason for not having coverage. Other reasons people stated for not having health insurance included:

not eligible for coverage (25.3%)
does not need or want coverage (21.3%)
signing up was too difficult or confusing (18.4%)
can’t find a plan that meets your needs (18%)
lost his job (2.8%)

According to the report, adults were more likely than children to be uninsured, and people of color were at higher risk of being uninsured than non-Hispanic whites. More than 73% of uninsured families had at least one full-time worker in their family.

Despite this, the most recent data has shown a change in these trends. According to hhs.gov, as of early 2022, only 8% of the us. uu. residents are uninsured, an all-time low. In addition, 5.2 million people have obtained health coverage since 2020.

If you find yourself without coverage for any reason, ehealth can help. We offer a wide range of plans in each state to meet the needs and budget of each individual. our representatives are available online or by phone to answer your questions and help you find the right coverage for you and your family.

what if you need medical services but don’t have health insurance?

The Affordable Care Act made it easier for people to get health insurance, but many people still don’t have health insurance. in this case, you may have to pay for your health services out of pocket. If you go to a doctor for a routine physical exam and you don’t have health insurance, you will be asked to pay for the visit out of pocket.

As a result, you may not be able to pay the cost of care. Even if you are denied some medical services because you cannot pay, you can still access emergency room care. if you have a medical emergency, you can still go to the emergency room and not be turned away.

what if you don’t have health insurance? the risks

The risks of being uninsured are primarily related to cost. Some of the main risks you could face if you don’t have insurance include:

higher charges for the same services

Without health insurance, you may be charged much more for care that would otherwise be covered by your plan. This is because no one, usually the insurance company, will subsidize the cost of your care. As a result, you may have to pay higher charges for the same services. You’ll have to pay for everything out of pocket, and if you can’t pay the cost of care, the hospital or medical practice could take legal action against you.

medical debt

Because you may be charged full out-of-pocket for any health care you receive while uninsured, you may be drowning in medical bills fast. Medical debt can quickly become overwhelming for many people and take a toll on other aspects of their finances. Having extra debt could make it harder for you to apply for a student loan, mortgage, or car loan.

state tax penalties

While the individual mandate has been repealed and is no longer enforced as of 2019 at the federal level, there are states with their own health insurance penalties. If you don’t have health insurance, you could end up paying a penalty for not having health insurance. therefore, you should make an effort to find health insurance that works for your needs.

check to see if your state still has a statewide individual mandate that could affect you if you don’t have insurance.

postponing or neglecting medical care

Because you may not be able to afford medical care, you may end up putting off necessary medical visits. this could include visits to the dentist, ophthalmologist or regular doctor. According to the KFF report, three in 10 uninsured adults did not receive the health care they needed due to the high cost of health care without insurance. If you hesitate to put your health first, you risk making health problems worse over time.

inability to pay for medications

Due to rising prescription drug prices in the United States, many prescription drugs are incredibly expensive, especially without a health insurance plan to help them. As such, some people without health insurance forgo the medications they need to manage acute and chronic medical problems, often leading to worsening conditions and higher long-term medical costs.

according to the kff, uninsured adults were three times more likely to delay or not purchase needed medications due to cost.

can a hospital deny you care if you don’t have insurance?

A hospital may deny some forms of care, but not all. if you have a medical emergency, a hospital will still be required to treat you; however, if you want certain types of care that are not emergencies, the hospital may deny those treatment options. you may have fewer options when you go to the hospital because you don’t have health coverage.

can i get insurance after losing coverage through employer, family or medicaid?

If you lose coverage through a spouse or parent, or become ineligible for Medicaid, you can still get insurance coverage. these coverage losses are examples of qualifying life events that may give you eligibility in a special enrollment period. A special enrollment period allows you to enroll in major medical health insurance plans outside of the open enrollment period (which ran from November 1 to December 15, 2020 and will run from November 1 to December 15, 2020). January 2022 for 2022 coverage).

If you qualify for a special enrollment period, which typically lasts 60 days, you’ll need to show you experienced a qualifying life event to purchase a health insurance plan on the federal or state marketplace, or through a licensed broker.

if you lose coverage through an employer or a family member and think you may qualify for federal assistance, you can apply for medicaid and chip at any time of the year, two government programs that seek to provide free or affordable health insurance. low cost to low-income individuals and families.

Even if you think you won’t qualify for Medicaid or Chip based on income alone, it’s a good idea to apply anyway, especially if you have a disability, have children, or are pregnant.

Is it worth not having medical attention?

There are some situations where you may need to go without medical care for a short time, but preventive care is the best way to avoid more serious problems. If you go to the dentist, eye doctor, and doctor regularly as you should, you can prevent chronic medical conditions from developing. a medical professional can detect potentially serious health problems before they cause symptoms, helping you stay healthy. therefore, you should make sure you have access to the health services you need by having strong health insurance if possible.

Fortunately, there are cheaper plans available to you that can make health insurance more affordable.

how do i get affordable coverage?

If cost is keeping you from buying coverage, you’ll be glad to know there are Affordable Care Act subsidies you may qualify for.

qualification for subsidies is based on your annual income and how it compares to the federal poverty line (fpl). If you earn between 100% and 400% of the FPL, you may qualify for some help paying your monthly insurance premium.

You may still qualify for subsidies if you choose to shop through an online broker like eHealth, as long as you choose an ACA-compliant plan that includes the 10 essential benefits required by federal law. ehealth also lets you compare plans that aren’t on government exchanges, so you can find the best health insurance for your budget and needs.

At ehealth, we’re committed to making sure everyone gets the best health care coverage for their needs and budget. We have licensed brokers in every state, and once you enroll in a plan, we offer 24/7 support to help you manage and renew your plan as needed. Contact ehealth today to start comparing plans in your state.