How to Manage Without Health Insurance

Health insurance is one of the most crucial bills you might have—or not have. While your health is priceless, the reality is that many people in the U.S. can’t afford their high monthly insurance premiums.

The Affordable Care Act helps Americans supplement the cost of their insurance if they meet certain income requirements. However, if your income exceeds those requirements, you could be stuck with a high premium or deductible.

Previously, having health insurance was mandatory, but since 2019, there is no tax penalty for not having insurance, thanks to changes made during the Trump Administration.

If your employer doesn’t provide adequate coverage or if you’re a freelancer, you might be wondering if you can manage without health insurance. While I don’t recommend going without it, I did it, and there are alternative ways to receive healthcare without facing exorbitant bills.


When my husband had a 9-5 job, we used his employer’s health insurance, but it wasn’t great. We paid monthly premiums, contributed to an HSA (Health Savings Account), and still faced medical bills.

Once we both became self-employed, I started saving for medical bills separately. Instead of paying a high monthly premium, I set up automatic transfers to save money for doctor’s visits, dental care, etc., in advance.

We discovered we could still see our family doctor for $200 as self-pay patients. This might seem like a lot, but it was more manageable than an $800 monthly premium plus co-payments.


Paying for all your medical care out of pocket can be overwhelming. Health sharing ministries can be a helpful supplement. Christian health sharing ministries provide some coverage for larger medical expenses at a much lower cost.

Once you qualify to become a member, you pay a monthly fee similar to a premium, which goes toward another member’s medical expenses if you don’t have any. If you have a medical bill, you can submit it for sharing after paying your annual unshared amount (AUA), comparable to a deductible. Liberty Healthshare and Christian Healthcare Ministries are two popular options.

For instance, Liberty charges $249 per month for individuals under 30 and $479 per month for young families, with an annual unshared amount of $1,000. This is significantly better than the $12,000 deductible my family had under the Affordable Care Act.


In a medical emergency, consider visiting urgent care instead of the ER. An ER visit can result in some of the highest medical bills, whereas urgent care clinics often provide similar care at a fraction of the cost.

For example, the urgent care clinic in my area charges $150 for a basic visit and examination, much lower than the $1,000 you’d pay at the ER.


Once you receive care, prescription costs can add up. Sign up for free prescription discounts with companies like GoodRx to save on your medications if you don’t have health insurance.

GoodRx provides discounts on the spot through their app, making it easy and convenient to save on prescriptions.


Find a provider who is self-pay friendly. While many assume you have health insurance, some providers are willing to work with self-pay patients.

For example, our family doctor continued to see us as self-pay patients, and local clinics offered sliding-fee scales for appointments and check-ups.


Negotiate your medical bills to reduce the financial burden. Ask about payment plans or try to lower the bill altogether.

Some hospitals have programs to help patients cover a portion of their medical bills. For instance, I once settled a $1,000 hospital bill for around $700 because the provider wanted a quick payment. Be honest and ask; many providers are willing to work with you.


Managing without health insurance is a significant risk. Insurance exists for a reason. While high premiums might seem like a waste, insurance provides crucial coverage when you need extensive care.

Some of these alternatives might work for young and healthy individuals but may be temporary solutions. As you age, you’ll likely need more medical care. With open enrollment starting soon, I advise everyone to at least explore their options and see what’s available.

Going without health insurance should be a last resort, but options like self-pay and health share ministries can help you manage your health expenses.

Leave a Reply

Your email address will not be published.