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What to Do if You Can’t Afford Health Insurance

Despite the Affordable Care Act’s debut on January 1, 2014, 16 percent of Americans remain uninsured, according to a recent Gallup poll. That’s millions of people, many of whom are uninsured because they can’t afford health insurance.

Who is uninsured

One of the most common reasons Americans are not insured is the Medicaid gap, a big problem in today’s healthcare. The ACA required states to provide Medicaid coverage for adults aged 18 to 65 with incomes up to 133% of the federal poverty level, along with tax credits for people with incomes between 100 and 400 of the federal poverty level to buy private insurance plans in the Marketplace. But those with incomes below 100 percent of the federal poverty level fall through the cracks—their incomes are too high to get Medicaid but too low to qualify for help buying private insurance.

Another group of people who are commonly uninsured are undocumented immigrants, and the Affordable Care Act does little to change that. But while the healthcare options for undocumented immigrants are limited, there are a few solutions. Student health plans, private insurance companies and employer-based health insurance are some healthcare options that generally don’t question immigration status. Some state-funded healthcare programs, like Medi-Cal in California, grants some undocumented immigrants insurance. Check your state’s healthcare office to see if you qualify.

What to know about being uninsured

Twenty-six states expanded their Medicaid programs to fight the Medicaid gap, so if you live in one of these states and make up to 16,105 a year for 1 person (32,913 for a family of 4) you’ll probably qualify. Check Healthcare.gov to see if your state expanded Medicaid—if it has not, call your state Medicaid office to ask if you qualify. Many low-income Americans will still qualify for some kind of state health coverage.

Some other important facts to know:

  • If you don’t have income, and can’t afford health insurance, the federal government does not require you to get it, and won’t fine you if you don’t have it. The rule is if you don’t make enough money to file a federal tax return, you don’t need to pay for federal-mandated health insurance.
  • If the cheapest policy you can get costs more than 8 percent of your income, you don’t need to get health insurance. Keep an eye out when you file your taxes—you should get an exemption from the coverage requirement.
  • If you get a new job, that new income could require you to get health insurance. Check the requirements with every new job to make sure you don’t get fined for being uninsured.
  • If you are paying more than 9.5 percent of your income for an employer-based insurance plan, you should qualify for exchanges, or federally-subsidized coverage in the new insurance markets.

Problems and a few solutions

While all this information is important to know, there will always be some Americans who still can’t afford health insurance. Many of them will not be immune to illness and disease and will end up racking up thousands of dollars in debt from unexpected trips to the hospital and live-saving surgeries.

So if you’re faced with medical bills you can’t afford, what can you do?

Negotiate. Some hospitals will allow you to negotiate your bills, and can help you set up a payment plan that will make paying them easier. Don’t be shy to be honest with your doctor about what you can and can’t afford to pay.

Review all your bills for extra costs you shouldn’t pay. Often hospital bills have errors and overcharges, so as with any receipt, make sure you check to make sure you aren’t paying for any services you didn’t receive. Some common mistakes include charging patients a full day when they were discharged in the morning, charging patients for medications when they brought their own and charging patients for supplies like gowns, gloves and sheets (these should be included in the daily room charge already).

Take to the web. If you’ve exhausted all your options and still find yourself faced with mounting debt, you may want to try online crowdfunding websites to help with medical bills. Personalized fundraising pages allow friends and family from around the world to contribute and create a central location for love and support. Sites like GiveForward have already helped people raise millions of dollars to help pay off medical bills. Start a fundraiser today!

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