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My name is Jacob, a husband to a wine-blogger wife, father to two bouncy-boy toddlers, and I'm the owner/author of My Personal Finance Journey. By day, I am a scientist working in bio-pharmaceutical development. Personal finance has been my hobby since 2007 when I started teaching myself through books (that finance B.S. degree didn't teach me much!). Learning how to save, adopt a frugal mindset, and invest my own money soundly has allowed me to have a savings rate > 50%, increase my net worth by > 20 times, grow my career, and always do what I love. Check out the About Me page to learn more!
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In most personal finance self-help books I’ve read, one of the first, most important, and fundamental assumptions made before proceeding to discuss the usual personal finance topics such as 401ks, IRA’s, emergency funds, etc is that a person should have health insurance to protect themselves in the event of a health emergency.ย
Indeed, even in the My Personal Finance Journey Account Hierarchy, securing adequate health insurance is listed as the highest and most basic priority for your funds as they come in. However, no detail is gone in to about how to secure this coverage.
Because of the very fact that health insurance is listed first in the pecking order, having health insurance is something that I think a lot of people take for granted in focusing their discussions about personal finance. This is either because they figure health insurance is provided as a health benefit at people’s work or they simply use the first funds they receive each month to pay the monthly premiums, and they have plenty of money left over to cover their other necessary expenses.
However, in today’s economy with many people out of work, facing tight budgets, or having to take ANY job that comes their way in the stale job market, I’ve begun to realize (after talking with several friends facing this problem) that many people are 1) left to obtain independent health insurance coverage, 2) unable to cover the cost of an independent health insurance plan because it is so expensive, and 3) earn income above the poverty level and as such, do not qualify for government health coverage.
Because of this realization, I thought it would be valuable to discuss today about the various options that exist (if any) for people that are having trouble affording this crucial life need.ย
But first, let’s take a step back and look at the health insurance landscape we are currently facing…
Yet another fascinating statistic to look at (also sourced from the same CNN article above) is the percentage of employers that offer health insurance to their full time employees. To my shock, only 55.3% of employees have health insurance through their employer – down from 65% in 2000.
I suppose this decrease in company health insurance coverage makes sense with the recession we have experienced and companies trying to cut costs. Looking at this statistic, it really makes you feel thankful if you are one of the ones that gets health insurance through your employer. Personally, I had no idea that this figure was this low.
It’s clear that the numbers shared above do not paint a very pretty picture – with approximately 50 million Americans without health insurance and only half of employers paying for health insurance plans.
Putting politics aside (please – this is not a politics blog), it leaves a person asking the following – “With the high price of health care, what are my options within my control if I simply cannot afford standard health insurance? I don’t want to get hurt and owe $80,000 for the surgery bill.”
Listed below are several things I could come up with after searching around and applying some interpretations of my own. I will approach this issue by taking the perspective of someone that is above the poverty level, earning $20,000-$30,000 per year. I’ll also assume you’re not yet old enough to qualify for senior citizen coverage through Medicare, are looking for a somewhat long term solution, and cannot afford COBRAย extensionย coverage through your old job.
I know. I know. This option won’t work for the many of you out there reading who are above 26 years of age. But, it’s worth mentioning since young adults age 19-25 represent one of the largest groups of un-insured in the nation. The CNN article above mentioned that some 70% of young adults in this age group are uninsured. This is simply amazing. Please, don’t think you are invincible. Talk to your parents to get on their health insurance plan if this is at all possible.
Conclusion for Option 1 – Great if you’re 26 or younger, but useless for everyone else.
Listed below are the eligibility requirements for Medicaid/Children’s Health Insurance Program:
The last option I found (and optimized slightly) when researching about this topic was a somewhat mixed approach. It was also one of my most favorite (along with getting on your parents plan if you’re under 26 and getting a part time job that has health insurance) because it is very concrete and doesn’t hinge on income level requirements, etc.
Essentially, this strategy is based on the purpose of insurance in general at it’s most bare-bones level being to protect you from financial disaster by not letting you go in to multiple ten’s of thousands of Dollars in debt (not to pay for routine visits to the doctor, etc). Using this underlying purpose in assuming that health insurance is A MUST, this strategy involves the following steps:
In putting this post together, I was thinking about any negative aspects to mention about free clinics – such as strict low income requirements or long wait times. Therefore, I reached out to my Mom, who worked in a free clinic several years ago for her experience. Her input is quoted below, in the true full sentence form that she always writes emails in no matter what the topic or brevity of the message (she reads this blog by email feed and will probably think it’s neat to be included here):
I last worked in a free community health clinic in 1994. We had good staffing and all people were seen during each clinic period in the evening. They had to wait several hours, some waiting for about 3 hours. All services were free, including some medications. People could show up at the clinic and be seen. There were not many restrictions on receiving this care.ย
Conclusion for Option 6 – While not perfect, using a high deductible health insurance plan coupled with community health care clinics can save you from bankruptcy by providing you with health coverage for expensive surgeries/injuries at a feasible cost.
To wrap up this post, today, we’ve explored 6 options for people that are having trouble affording health insurance. While none of them are as ideal as simply having a full time job that you commit yourself to (and then have weekends off) that provides low cost health insurance, they are worth exploring in order to obtain health care coverage. It is my belief that having health insurance is STILL the most important financial priority, so it really is essential to not take this lightly and obtain coverage. Thanks for reading!
How about you all? Do you have health insurance? If so, did you obtain the coverage from your employer or through an independent plan? What do you pay for health insurance premiums each month?
Have you ever tried any of the 6 options mentioned above or know anyone that has?
Share your experiences by commenting below!
***Photo courtesy ofย http://farm4.static.flickr.com/3110/2898187808_744e8b82a5.jpg
Hi folks! My name is Jacob. I am the owner and operator of My Personal Finance Journey. I started this blog in January of 2010 and have enjoyed the journey ever since. Since finishing up graduate school in Virginia in 2014, I have been working in biopharmaceutical development in Colorado. You can read more about me and this site hereโ. Please contact me if you have any questions!
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A friend of mine has insurance through his employer, a bank. His child has an illness but the bank will not cover. He has had to sell so much to get her cured. Thankfully she is well on the way. But even having insurance guarantees nothing. Her life would have been ruined if not for her father. Good ol bank of america
Sorry to hear about that Marcus! What reason did the bank give for not covering it?
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You are right. I lost my health insurance last year when budget cuts eliminated my job. I have COPD and hypertension and depression. I use six kinds of medications a month one of which cost $180.00 a pop. I am reluctant to change doctors because of this. I have steadily been accumulating debt. I cannot get state sponsored insurance because my income is to high on unemployment. I can't buy insurance because I don't have the money. I am fortunate that none of my doctor's are money grubbing and have continued to see me, but it is nerve racking to wonder where it will all end and if you can ever get out of debt. If I get a job, how long will it take to become solvent again?
I could have sworn I already commented on this post, maybe it didn't submit right. Anyways, I love all the options and it seems like you put a ton of work into this post. Fabulous!
-Jen
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Thanks so much for reading Jen!
My recent post Long Term Life Insurance
We had COBRA for 18 months at about $800 a month. Then we incorporated our business to be able to buy small group insurance, we have some pre existing conditions that would have been excluded under an individual plan. The problem is that to cover our family with 2 kids is over 150% of our mortgage costs.
I would not be without it.
I bet $800 per month was pretty tough Karen. Glad you all didn't have to do that for long!
My recent post Long Term Life Insurance
Thanks for this post. The best bet seems to be working part-time at a place that offers health insurance. When I quit my job, HR quoted me $2,800 a month for COBRA insurance for my family. As if that was any where close to what I could afford.
@Melissa – Geez! What a deal at $2,800 a month?! Personally, if I were the health insurance company, I don't think I would be able to give that quote while keeping a straight face. I mean seriously, how many ANYONE AFFORD that high of a price?!
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Right after I completed graduate school and was teaching part-time at a number of schools, I was only covered in case of an emergency. I hated the feeling of not being able to afford going to the doctor if I was sick, but not sick enough to be hospitalized. Now, with three kids, I would never have that type of insurance. If my husband didn't have insurance, one of us would work part-time at a place like Starbuck's or Trader Joe's just to get the insurance benefits.
Thanks for reading linsey! Looks like you did the best you could with your situation after graduate school. How much were the premiums on the emergency only coverage?
My recent post $141.20 Giveaway – Community and Charity 10% Monthly Blog Income Give Back # 5 – February 2012 Edition
Reading this makes me feel so fortunate to still be covered under my dad's health insurance plan and work for a company that offers insurance after his insurance on me runs out. I would live in constant fear if I had to survive without insurance. Last year I had an emergency appendectomy and later an emergency gallbladder removal I imagine that without insurance I'd be up over my head in medical bills.
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Thanks for reading Addie. It's good to hear you're keeping constant health coverage!
So you're using Option 1 – getting covered under your parents coverage until the age of 26? That's a nice option eh!?
My recent post What Do You Do If You Really Cannot Afford Regular Health Insurance?
I am so thankful to have health care coverage through my wife's job. Its great because I am more of the entrepreneur so if I stop working to pursue other things we all are still covered. People tell me so many horror stories about there insurance. Never knew about group insurance through organizations.
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We moved out of the country. Full coverage here in Thailand is about $3000 a year for our family. Even if we couldn't afford that my wife and daughter would be covered under the government sponsored health care here and would have to pay just $1 per procedure. It is almost sickening to think that even with my employer sponsored health care in the U.S. I paid more than I pay here for full coverage.
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Hi Jacob–Thanks for the mention and the link! Excellent post with information that needs to be discussed frequently (I'm overdue for another on my site!).
There's almost a matrix factor with health insurance coverage–what you do depends mostly on your specific circumstances. I think that for most middle-middle class people, and especially the self-employed, the best choices are either taking a part time job with health coverage, or going for a private plan with high deductibles (aka “catastrophic”).
Back in the good old days when soup-to-nuts coverage was widely available and relatively inexpensive, we got used to having everything from doctor visits to heart surgery covered at close to 100%. But the times have changed. We mostly need to get coverage for the medical disasters that can cost into six figures, and catastrophic accomplishes that.
Though it leaves us on the hook for a lot, we can cut down those costs by taking better care of ourselves. We've heard this from the medical community all our lives, but now it's more important than ever. Another
is to take advantage of the clinics at pharmacy chains and grocery stores that are all over now. You can be treated by a nurse practitioner for about $60 while going to the doctor for the same care can be $150-$200. They're excellent for routine care like colds, flu, ear infections and the like, especially when you have kids. You can also ask the pharmacist for non-prescription alternatives, which are MUCH cheaper.
It gets complicated, but if you can cut a $1000/mo premium in half it'll be worth the extra effort.
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Thanks for reading Kevin. I found your post very helpful in researching the options above. In fact, your post was the primary motivator for Option 6.
You make a good point about using clinics at pharmacy chains and grocery stores. I suppose that with that treatment option, the cost would be slightly higher than free community health clinics, but you might get care faster?
Not only faster care, but public health clinics might be means tested, so if you're over a certain income threshhold you may not qualify. You may even have to be on public assistance of some form as evidence of qualification. With the chain clinics, anyone can go, and they're all over the country too, so you never have to worry about the out-of-network issues.
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Good points Kevin – for the community health centers, I only read (here – http://findahealthcenter.hrsa.gov/Search_HCC.aspx… that you “pay what you can based on your income,” but was wondering in the back of my head if there were any income requirements. That's one of the reasons I reached out to my Mom. Based on her experience, she said there weren't a ton of requirements. However, that was 1994, so times have likely changed!
According to this link – http://www.vhcf.org/looking-for-help/, Virginia free clinics only accept people at less than or equal to 200% of the Federal Poverty Level, which, for a family of two, would be about a $30,000 cap. A good site for a listing of the Federal Poverty Limit and if you qualify for free clinics can be found here – http://www.coalitionclinics.org/fpl.html
My recent post What Do You Do If You Really Cannot Afford Regular Health Insurance?
This is a fantastic post. In Australia health insurance isn't a necessity like in the USA, but I would dearly love to live over there for a while. I think this article and the options you have outlined will help many people. Thank you for doing such great research into it all.
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I think so too Kylie. Thanks for reading. I tried my best to investigate options that would be feasible for the many people I've realized fall in to the health insurance coverage “gap” because they have too high income to be covered by government health insurance programs but not enough money to afford independent health insurance on their own.
My recent post What Do You Do If You Really Cannot Afford Regular Health Insurance?
I have health insurance now. It's 100% paid by my company. But I went through around 2-3 years without any insurance and it was truly terrifying.
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I bet that was very scary Michelle. Do you have children as well that were uncovered during that time?
I'm curious – did you ever look in to affordable health coverage options, or try any of the things listed above? I'm very interested to how this type of stuff would roll out in real life and not just on paper.
My recent post What Do You Do If You Really Cannot Afford Regular Health Insurance?