Staying Healthy When Your Job Doesn’t Provide Health Insurance | Part 2

glasses placed in front of eye exam sheet of paper making the letters clearer

Now that we’ve discussed some of your health coverage questions, let’s tackle dental and vision. These areas of coverage are usually included in health plans at a nominal fee for the insured.

Dental and vision care

Do you need to add this coverage to your plan? The answer depends on you as an individual. Dental and vision needs tend to be a little more predictable than other health care needs for adults, so you may be able to plan ahead .

If you wear glasses or contacts or if you see the eye doctor regularly, a separate vision coverage plan might be worth the cash. Otherwise you can skip the premiums and pay out of pocket for an annual eye exam.

Dental insurance, similarly, can be a good investment if you think you’ll see the dentist for more than a twice-a-year checkup. Without fillings or high-maintenance dental issues (and with brushing and flossing) you’ll save by paying out of pocket. Don’t skip the checkups, though—they can catch cavities and other problems early, saving you major repairs down the road.

When major health issues arise

Whether you deal with a chronic condition or simply run into the unanticipated, you might face a medical emergency. And as you may know, emergencies are where insurance really pays for itself. Out-of-pocket hospital bills can run into the thousands.

With or without insurance, it’s best to have a plan in case major health issues come up. Research doctors, clinics, and hospitals near you that offer low-cost services or charge patients on a sliding scale. Stash some money in a medical emergency fund if you’re able to do so.

Know the location of your nearest low-cost community health center or clinic (Idealist.org lists several community health centers across the country) and learn the details—for example, is it a walk-in clinic or do you need to make an appointment in advance? Then get treatment as soon as you think you need it. Waiting may seem like the more cost-effective thing to do without insurance, but it’s always preferable, not to mention cheaper, to catch a health issue before it gets worse.

You can apply for a free or low-cost prescription discount card if you take medication. While these cards offer steep discounts at pharmacies, be sure to read the fine print to make sure the medication you need is covered.

If you do get stuck with a huge hospital bill, you can negotiate a payment plan or apply for charity care. Many hospitals have options for uninsured and low-income patients.

Pro tip: If you don’t have Medicaid coverage when you’re treated for an emergency, you can apply for coverage afterward, so hold onto your medical bills. In most states Medicaid will cover bills dated as far back as three months before you sign up for insurance.

Can you go uninsured?

You can still get healthcare without insurance, though you’ll have fewer choices. Some providers won’t treat patients who don’t have coverage.

The Affordable Care Act does charge a tax penalty for going uninsured. If you’re uninsured for three full, consecutive months (every day in the month) you’ll get charged either a flat rate or a small percentage of your income, whichever is higher. You may save more money purchasing a plan!

But there are exceptions. You’re exempt from the penalty charge if your income is low enough that you don’t have to pay taxes, or if you’d be paying more than 8% of your income for coverage.

If you can afford Marketplace or private insurance, it’s a good idea to get coverage even if you’re healthy. The insurance marketplace relies on healthy people opting into coverage to keep costs reasonable for everyone. You benefit too, since you’re covered if the unexpected happens. It’s a win-win situation.

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How have you handled a lack of employer-provided health insurance? Do you have any tips to share?

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Amy Bergen is a writer based in Portland, Maine. She has experience in the social impact space in Baltimore, Maryland, the educational museum sphere in Columbus, Ohio, and the literary world of New York City.
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