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What Happens if I Don’t Have Health Insurance?

Health, Health Resources
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“I don’t have health insurance.” If you don’t have coverage, you might be worried about the future. What happens if you need medical care, and can you be penalized for being uninsured? We consider these points and more below. 

How Many Americans Don’t Have Health Insurance?

Worryingly, over 9% of Americans are uninsured, according to the latest data from the National Center for Health Statistics. This works out at just over 31 million people – a staggering number of individuals who don’t have enough insurance to cover their medical expenses. Other key findings include: 

  • 3.7 million of children under 5 are uninsured.
  • 31.2 million people under 65 don’t have health insurance. 
  • 27.5 million Americans aged between 18 and 64 aren’t insured.   

Are You Legally Required to Have Health Insurance?

No – there’s no legal requirement at the federal level to have health insurance. However, some individual states still require you to have health insurance. You must have coverage if you live in:

  • California
  • District of Columbia 
  • Massachusetts
  • New Jersey
  • Rhode Island 
  • Vermont

Are You Penalized if You Don’t Have Health Insurance?

There’s no tax penalty at the federal level. However, if you’re in a state where health insurance is mandated, then you could face tax penalties if you don’t have coverage. 

The penalties vary by state. In California, for example, you’ll pay:

  • At least $425 for each uninsured child under 18 
  • At least $850 for each uninsured adult in the household  

If you need an exemption, you might be able to claim one when you file your tax return, or follow your state’s specific guidelines.   

If You Don’t Have Health Insurance, What Happens?

If you don’t have health insurance, a few things can happen. 

  • If it’s a medical emergency, doctors must treat you. However, once you are stable, they don’t have to provide treatment unless you’re insured – or you can prove how you will cover the costs. 
  • You will be expected to cover the full costs of treatment including prescription medicines, medical devices, and related care. 
  • It will be your responsibility to pay for procedures you might need for your health and wellbeing. 

While health insurance may not pay for every fee, it certainly helps to cover the costs.  

Do I Need Health Insurance?

You need health insurance if it’s mandated in your state. Otherwise, it’s a personal choice, but here’s why it might be worth it. 

  • Without health insurance, you’re responsible for all of your own medical bills. This could make healthcare unaffordable for many people.  
  • You may find yourself in debt trying to cover the costs of medical care. This could have serious consequences for your financial health e.g. your credit score. 
  • Health insurance gives you peace of mind, knowing that your health needs are covered. You can focus on getting better rather than stressing over money. 

Need health insurance? Contact Healthedly. We can help you find, compare, and enroll in the best available individual and family health plans – reach out today.

January 10, 2023
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