What Happens When You Can’t Afford Healthcare?

According to the CDC (Centers for Disease Control and Prevention), there were 28.2 million people under the age of sixty-five that were uninsured in 2016. For a lot of these people, the difficulty in maintaining health insurance due to premiums, causes cancellation in policies. For many others, the difficulty in obtaining health insurance causes them to go uninsured. If you are in uninsured, it helps to know what you can expect.

When you Stop Paying your Premium

If you are insured and stop making your monthly premium payments, you will of course, lose coverage. The timeframe in for when your health coverage stops depends on whether you are eligible for tax credits toward your premiums. If you qualify for those credits, you are given a 90-day grace period to catch up on your payments before your health insurance policy is cancelled and coverage is lost.

Possible Penalties

Then there are the ACA (Affordable Care Act) penalties. If you don’t have health insurance for 3-month period or more, you may have to pay penalties to the government called “individual shared responsibility payment”, which is the ACA penalty. You may qualify for an exemption. Keep in mind that inability to pay doesn’t automatically mean that you will avoid penalties.

What Can Be Done

There are assistance programs that you may qualify for if you’re unable to pay due to a drop in your income or a change in your family situation. You may qualify for Medicaid and your children may qualify for Children’s Health Insurance Program. Your local Medicaid office and the federal market place can help you determine if you’re eligible.


Try to prepare if you know that you will have to sacrifice your health insurance. Things happen and money gets tight. Health Insurance isn’t cheap. Try to prepare yourself for your cancelled policy and get in your planned medical services before you miss your premium.


Planning for open enrollment helps. This is the time that you can opt for a more affordable policy. You may consider going with a plan that has lower monthly premiums with higher out of pocket expenses. You will end up paying higher out of pocket expenses such as deductibles; however, your monthly premium will be much more manageable.

End Result

In the end, if you have coverage through your employer, the time to make your move is during the open enrollment period which only comes once a year. It is important to keep track of when this happens. That is where you can consider a different plan.

If you are paying for a private health insurance, knowing what you can expect will help you plan for going without coverage. If you lost coverage, state and federal assistance programs are out there. The last thing you want to consider is going without coverage. However, if there is simply no other choice and health insurance has to be dropped, prepare for the possibility of paying the “individual shared responsibility payment”.


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