Living in a World Without Company Sponsored Health Care

An employer-sponsored health care plan covers the majority of adults in the U.S. who work full time for a company. Getting health insurance through an employer remains the easiest way to get coverage for yourself and your family.

The problem is not everyone qualifies for employer-sponsored health insurance. If you’re self-employed, work part-time, or are employed by a small company, chances are you don’t have access to health insurance through work.

In that case, here’s a look at what you can do.

Skip health insurance (or put off getting it)

When you don’t have a quick way to sign up for health insurance, the default course of action is to do nothing. And that can work. You simply adopt the “pay as you go” method. Whenever you need to see a doctor, ask to pay the cash price. As long as you don’t get seriously hurt or sick, you’ll likely come out ahead.

If you’re worried about the tax penalties associated with not having adequate coverage, read this. Tax reform repealed the individual mandate.

That all said, you may regret choosing to go without insurance if something goes wrong with your health. Even young, healthy people can wind up with a serious problem. If that happens, it may be difficult to get the care you need from your preferred provider. And if you need services such as a life flight after an accident, that medical bill could wipe you out financially.

Purchase health insurance through the “Marketplace”

You can purchase subsidized health care coverage, also known as Obamacare, through a resource called the Health Insurance Marketplace. To qualify, your income must be within certain limits, and you can’t have access to affordable employer-sponsored insurance. In that sense, your health insurance is not “affordable” if:

• your employer doesn’t offer health insurance
• the plans available through your employer cover less than 60 percent of the benefits
• the premiums cost more than 9.5 percent of your annual household income

You can apply and purchase insurance coverage through the government website, HealthCare.gov. As you check out the options, make sure your income falls within the guidelines. It’s also important to note you can’t claim a tax credit if you qualify for government programs like Medicare and Medicaid or if your annual household income is above 100 percent and 400 percent of the federal poverty level, depending on your state.

If you’re considering purchasing insurance through the Marketplace, don’t delay! Open enrollment for 2019 plans started on Nov. 1, 2018 and ends on Dec. 15, 2018.  If you quit your job or have a child outside of the enrollment period, you can still apply for coverage through the Marketplace.

As a precautionary measure, beware of signing up for subsidized health insurance coverage if your income is undetermined for the year. For example, if you earn more income at the end of the year than you expected when you signed up, you may have to pay part or all the subsidy back when you file your tax return.

Purchase health insurance outside the marketplace

If you don’t qualify for a subsidy, there are other options available. You don’t have to use the Marketplace.

You can always purchase health insurance through an insurance broker, a professional organization, or directly from an insurance company. Those options can be more expensive, but they may be your best opportunity. That’s especially true if you want access to certain doctors, hospitals, or other care providers.

Join a health care sharing ministry

Health care sharing ministries are gaining popularity. They aren’t health insurance, however.

Instead, they are a group of individuals who pay each other’s medical bills through the sharing ministry. The funds typically cover major medical expenses only, and the group requires it’s members to uphold certain standards, such as no smoking or illegal drug use.