- While you can pay for medical expenses without health insurance, there are various factors you may want to consider.
- The ACA requires large employers (50 or more full-time employees) to provide health insurance to 95% of their workers or pay a fine.
- Young adults can consider many affordable health insurance options including Mira, catastrophic or Bronze tier health insurance plans, Medicaid, or their parent's or spouse's health insurance.
Do I need health insurance?
If you're a young adult, you may think since you are young and healthy, health insurance is not entirely necessary. Especially since if the high costs and stress to choose a plan.
While you can pay for medical expenses without health insurance, the following reasons may influence your decision when debating whether or not to get health insurance:
- Medical emergencies are expensive: While it may not seem like you'd encounter a medical emergency, all it takes is one brief moment (tripping while going up the stairs, breaking a bone, etc.) which can cost thousands of dollars in medical bills- even before accounting for surgeries and other treatment.
- Preventative care is more important than you think: Without insurance, you may be tempted to avoid preventative visits due to the cost. However, preventative doctor visits are actually very important and directly affect developing a more serious condition that would cost even more money to manage down the road.
- There are alternatives to health insurance: If you truly can't afford health insurance, you may want to consider Mira. Mira is a membership healthcare service for just $45/mo. It's ideal for people who don't have pre-existing conditions and need preventative urgent care visits. You also get affordable lab testing and prescription discounts.
Affordable Care Act (ACA) Tax Penalty- 2021
As of 2019, you no longer have to pay a penalty on your federal tax return if you're not insured, this fine was rescinded for the 2019 tax year. However, some states may still have mandates.
Even though there's no longer a penalty, you're protecting both your health and your financial status by taking out a health insurance policy.
My employer doesn't offer me health insurance, what should I do?
The ACA requires large employers (50 or more full-time employees) to provide health insurance to 95% of their workers or pay a fine.
The health insurance provided must meet certain affordability requirements and must cover a minimum set of essential services.
Whether individuals have to pay a penalty if they do not have health insurance depends on their state of residence and is in flux due to lawsuits challenging the ACA.
There are several options in terms of getting health insurance even if your employer does not provide coverage.
- If you live in the United States, you are eligible to sign up for a membership with Mira.
- If you are under the age of 26, you are permitted to stay on your parent's health insurance.
- You can buy an individual plan through a health insurance company. You can sign up for an individual plan during the open enrollment period, which typically runs from mid-November to early-December.
- If you are married and your partner's employer offers health insurance, you may be able to get coverage through his/her plan.
- You may be able to get group health insurance by joining a professional organization.
Can I deny the healthcare coverage my employer offers?
Yes, employees may decline the health insurance offered by employers.
This is called a waiver of coverage. If you waive coverage for yourself, you may not cover dependents under the employer's plan.
What are the best health insurance options for young adults?
The least expensive health insurance options tend to be Catastrophic or Bronze level plans.
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However, with these plans, you will likely have to pay the bulk of any medical expenses. However, most of them cover three primary care visits per year at no cost and certain free preventative services.
Here are some inexpensive health insurance options to consider if you're a young adult:
Catastrophic Health Insurance
- The premium amount you pay each month for health care is generally lower than for other Quality Health Plans, but the out-of-pocket costs for deductibles, copayments, and coinsurance are generally higher.
- To qualify for a Catastrophic plan, you must be under 30 years old or get a "hardship exemption" because the Marketplace determined that you’re unable to afford health coverage.
Bronze Health Insurance
- A great option for healthy people who don’t see the doctor often and only take generic prescriptions.
- Low premium, a high deductible.
- 60% of covered health costs paid by insurance, 40% paid by you.
- No premiums or deductibles. Membership-based healthcare service.
- $45/mo, low-copays and offers 80% off prescriptions and low-cost lab testing
- Clinics are located all over the United States
Student Health Insurance
- If your school offers a student health plan, it can be an easy and affordable way to get basic insurance coverage.
- If you're enrolled in a student health plan, in most cases it counts as qualifying health coverage.
- This means you're considered covered under the health care law and won't have to pay the penalty for not having insurance. Be sure to check with the plan to be sure.
- If your income is low or you have certain life situations, you could qualify for free or low-cost coverage through Medicaid.
- If your state has expanded Medicaid coverage, you can qualify based on your income alone — in many states that have expanded, that's about $17,608 or less for a single person, about $23,791 or less for a married couple with no children.
- In all states, you can qualify based on factors including income, some family situations like pregnancy and having young children, and disability.
Your parent's or spouse's insurance
- According to the ACA, individuals can stay on their parent's health insurance plan until they're 26.
- You have 30 days to get on your spouse’s employer-sponsored health insurance if you have recently lost your job and health insurance.
- If your spouse’s company allows it, you can get on your spouse’s insurance plan by asking your spouse to speak to their company’s human resources department for further details.
Do I need a health savings account (HSA)?
If you're generally healthy and want to save for future health care expenses, an HSA may be an attractive choice. Or if you're near retirement, an HSA may make sense because the money can be used to offset the costs of medical care after retirement.
On the other hand, if you think you might need expensive medical care in the next year and would find it hard to meet a high deductible, an HSA might not be your best option.
Pros of HSAs
- You can decide how much money to set aside for health care costs.
- You will control how your HSA money is spent. You are able to shop around for care based on quality and cost.
- Your employer may contribute to your HSA, but you own the account and the money is yours even if you change jobs.
- Any unused money at the end of the year rolls over (stays in your account) to the next year and is yours indefinitely.
- You won't have to pay taxes on money going into your HSA.
- Some HSAs pay interest on the unused money in your account or invest the money in mutual funds or other financial products. The earnings from an HSA are also tax-free.
Cons of HSAs
- Illness can be unpredictable, so it's difficult to accurately budget for health care expenses.
- Some people find it challenging to set aside money to put into their HSAs. People who are older and sicker may not be able to save as much as younger, healthier people.
- There's pressure to save the money in your HSA might lead you to not seek medical care when you need it.
- When you take the money out of your HSA for nonmedical expenses, you'll have to pay taxes on it.
Health Insurance Comparisons
Want to compare health insurance plans? Our team conducted comparison research on some of the most popular health insurance plans:
- Oscar Health Catastrophic Plan vs. Fidelis Care Catastrophic Plan
- Healthfirst Catastrophic Plan vs. Fidelis Care Catastrophic Plan
- Oscar Health Classic Bronze vs. Fidelis Care Bronze
- Healthfirst Bronze vs. MetroPlusHealth Bronze B-2
- Empire BlueCross BlueShield Bronze vs. UnitedHealthcare Bronze
- Oscar Health Simple Bronze vs. UnitedHealthcare Compass Bronze
- Empire BlueCross Silver Health Plan vs. Healthfirst Silver
- EmblemHealth Silver Bold vs. Oscar Health Saver Silver
- Oscar Health Classic Silver vs. UnitedHealthcare Compass Silver