That could literally be the $64,000 question!

Yes, selecting the right health insurance plan can require time and attention to evaluate the choices that are best for your individual situation. Even with employer-provided coverage, you will still likely need to make some decisions in terms of factors like available levels of coverage and voluntary options.

But throwing up your hands and giving up? Gambling on the odds of staying healthy or not getting injured? Neither of these are wise approaches.

What’s at stake can be important financial goals like saving for your kids’ college, preparing for retirement or even avoiding bankruptcy.

ER Visits

What happens if you get injured without insurance?

Let’s say you end up in the emergency room after being hurt in an accident. Most people don’t realize that, for patients unable to pay for care, the staff are required to provide only a medical screening exam and stabilizing treatment if warranted. You can’t be turned away, but “stabilization” is all that’s required of the hospital.

Based on a 1986 law, this policy applies to all hospitals that participate in Medicare, which virtually all do. And, ironically, they can still bill patients for services and try to collect.

Inability to collect for ER services also has an impact well beyond the individual directly involved. Those costs are typically passed on to paying customers and health insurance companies.

Moreover, any follow-up services like rehabilitation or treatment for chronic conditions would be done by providers outside the ER who are not required to accept patients who cannot pay for those services.

Beyond the ER

How about if you get sick without health insurance?

An ER visit for traumatic injury is just the most extreme example. Health insurance also helps cover other expenses such as doctor visits, therapeutic treatments, prescription medications and so forth. Personally footing the bill for those services can quickly rack up significant costs.

In addition, people without insurance often feel compelled to delay or forego care, whether it’s for a current condition or for preventive purposes. Of course, all that does is risk the chance of conditions becoming more severe or conditions arising that could have been avoided all together.

Financial Emergency

Of course, a severe injury or illness is bad enough. But an associated “trauma” can easily be a financial catastrophe from the expenses incurred for treatment. It’s been reported that a single major injury could soak up more than half of an individual’s annual income.

One study defined “catastrophic health spending” as out-of-pocket costs exceeding 40% of income after paying for food. Under that definition, some 71% of uninsured trauma patients 18 to 64 years of age are at risk annually.

These concerns are certainly unwelcome and damaging for those with adequate financial resources, but can be devastating for those of limited means.

Affordable Options

Are there options if someone, for whatever reason, simply cannot obtain coverage at some point in time? The answer is, yes.

Some community clinics provide services on a sliding scale based on income. Others are subsidized by non-profit or religious groups and may offer free services to people without insurance. College students can utilize the on-campus health center. Preventive screenings may be available at no charge as part of open events at clinics, fitness centers and community organizations.

Find the Right Solution

There are a number of situations in which an individual may lose their health insurance coverage including lack of access to Medicaid, loss of or between jobs, overall cost concerns, and aging out of parental coverage.

Keep in mind that, under the Affordable Care Act, pre-existing conditions are not considered for health insurance eligibility. So that should not stand in your way. Also, the 2020 open enrollment period for health insurance runs until December 15^th. If you are not currently insured, now is the time to find a plan with the right balance of services, deductibles and premiums.