If you don’t have medical insurance, you'll pay everything yourself if you get sick or injured. You might have to pay the full cost of treatment out of pocket from the nation's $4.9 trillion annual health care system, which averages $14,570 per person.
What Happens if You Don’t Have Health Insurance?
Updated: October 7, 2025
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Key Takeaways
Without insurance, you'll pay full hospital rates, creating medical debt that forces cuts to food, housing and essential spending.
Hospitals must treat emergencies, but can refuse non-emergency care. You'll need charity programs or payment plans to manage bills.
While there's currently no federal tax penalty for being uninsured, five states and the District of Columbia have their own mandates.
Health insurance provides financial protection, especially if you have a chronic illness or frequently require medical services.
What Happens if You Don't Have Health Insurance?
- 1Going to the Hospital Without Insurance
Hospital costs with no insurance can create a massive financial burden, as uninsured patients have to pay everything out of their own pockets. Although Federal law requires hospitals to provide emergency care regardless of your ability to pay, they aren't required to offer non-emergency services.
Some of the costs which you might pay:
- Minor treatment like stitches or basic X-rays: $150 to $700.
- Moderate issues like sprains or CT scans: $700 to $1,500.
- Critical conditions requiring surgery: Costs can reach tens of thousands of dollars or more.
The financial burden gets worse because uninsured patients receive bills at the hospital's complete "charge master" rates, which are much higher than what insurance companies negotiate for their members.
- 2Unaffordable Medication Costs
Rising prescription drug prices limit access to preventive drugs and medications for the uninsured, with prescription drug costs averaging around $1,050 per person, according to the National Health Expenditures Accounts (NHEA).
Lacking health insurance affects how you manage acute and chronic medical conditions. Without coverage, patients often skip essential medications for ongoing health issues, which worsens their condition and increases long-term medical costs.
- 3Medical Debt
Medical debt hits nearly one in 10 Americans, according to KFF and Peterson Center for Healthcare analysis. Six in 10 people with medical debt cut back on food and clothing, while adults with depression are three times more likely to carry medical debt.
This debt increases perceived stress and creates a destructive cycle: among adults with depression and medical debt, 36.9% delayed mental health care, and 38% skipped it entirely because costs prevent getting the treatment they need.
- 4Tax Penalties for Not Having Health Insurance
Congress eliminated the federal tax penalty in 2019, but several states maintain their own mandates with real penalties and require you to have health insurance.
These states calculate your fine using a flat dollar amount per person or a percentage of your household income above the tax filing threshold, whichever is higher. You'll owe money when filing state taxes if you're uninsured for over three months.
States With Tax Penalties
Five states, including Washington, D.C., require residents to have health insurance or pay penalties. A short coverage gap (less than three consecutive months) doesn't result in fines, but you must document this accurately on your state tax returns :
- California
- Massachusetts
- New Jersey
- Rhode Island
- District of Columbia
Vermont has an individual mandate but has yet to impose a tax penalty.
What Help Is Available if I Can’t Afford Health Insurance?
If you can’t afford insurance, several programs can help. These programs and options can help reduce your medical costs and provide access to care when needed most.
Community Health Centers
These provide primary care based on what you can afford to pay. HRSA (Health Resources and Services Administration) operates about 1,400 federally qualified health centers (community-based healthcare providers that receive federal funding to serve underserved areas) with over 16,200 service sites nationwide.
You can find a health center near you through HRSA's online locator tool. These centers offer medical, dental, mental health, and other services regardless of your ability to pay.
Prescription Assistance Programs
These programs can dramatically reduce medication costs. The Partnership for Prescription Assistance connects patients to more than 475 public and private programs, including about 200 programs offered by pharmaceutical companies. Many offer qualifying individuals free medications or significant discounts on brand-name drugs.
Hospital Charity Care Programs
Nonprofit hospitals are required by law to offer financial help. Hospitals set their own eligibility criteria, which vary widely. Among nonprofit hospitals offering free care, income limits range from 41% to 600% of the federal poverty level, with most hospitals requiring incomes at or below 200%.
You can check on the DollarFor website to see if you are eligible. You must apply directly to the hospital's financial assistance office, and they can't send debt collectors after you while they're reviewing your case.
Negotiate Your Bills
Negotiate your medical bills directly with providers. Most hospitals accept payment plans, and many reduce bills by 10% to 30% if you can pay a lump sum upfront. Don't ignore medical bills; contact the billing department immediately to discuss options before the debt goes to collections.
When It's Okay to Not Have Health Insurance
It is generally not recommended to go without medical insurance, as you are always at risk of facing sudden and severe health challenges. Buying a health coverage plan is a wise decision because of its many benefits.
If you're a young, healthy adult between jobs, you might be weighing the costs of COBRA or marketplace coverage against going temporarily uninsured. Some people in this situation choose to go without coverage if they have emergency savings and no chronic conditions, as they can weather a short coverage gap.
People qualifying for retroactive Medicaid coverage in expansion states may have protection during application processing. Medicaid can cover medical bills up to three months before your application date. This retroactive coverage only applies if you met eligibility requirements during those months.
Military veterans with VA benefits already have comprehensive coverage through the Veterans Health Administration, though coverage may be limited to VA facilities and approved providers. Access and cost-sharing can vary depending on a veteran's specific circumstances, such as their disability rating and income level.
MONEYGEEK EXPERT TIP
Affordable insurance plan options are available through employer-sponsored plans or subsidized plans on the Affordable Care Act (ACA) marketplace. Even if one doesn't qualify for subsidies, opting for a lower-cost plan, such as a Bronze plan on the marketplace or a high-deductible health plan from an employer, is prudent.
Not Having Health Insurance: Bottom Line
Without medical insurance, you have to face the hospital's full rates when you get sick or if the situation worsens, you might end up delaying rent payments. Community health centers and charity programs can help, but you're still one emergency away from serious financial trouble.
Health coverage protects you from these costs, and the Affordable Care Act covers many preventive services with no copay, providing valuable benefits for people who obtain health insurance.
Frequently Asked Questions (FAQs)
We've answered these frequently asked questions about what happens if you don't have health insurance:
Is it cheaper to go without health insurance?
Going without insurance might save you monthly premiums, but it's rarely cheaper overall. Without insurance, you'll pay full rates for everything. A three-day hospital stay can cost more than $30,000, and prescription medications average $1,050 per person yearly.
Can I go to the emergency room without insurance?
You can go to the emergency room since Federal law (EMTALA) requires hospitals to provide emergency treatment regardless of insurance status. However, you'll receive bills at full "charge master" rates, which are much higher than negotiated insurance prices.
How much do hospital visits cost with no insurance?
Hospitals can cost a lot. Emergency room visits average more than $750 for uninsured patients. Minor treatments like stitches or X-rays cost $150-$700. Moderate issues requiring CT scans or treating sprains run $700-$1,500. Critical conditions needing surgery can exceed tens of thousands.
Do I need health insurance if I'm young and healthy?
While young, healthy adults between jobs might temporarily forgo coverage with sufficient emergency savings, healthcare costs can be high. Even minor emergencies cost hundreds to thousands without insurance. Consider short-term coverage or marketplace plans rather than going completely uninsured.
Related Pages
About Mark Fitzpatrick
Mark Fitzpatrick, a Licensed Property and Casualty Insurance Producer, is MoneyGeek's resident Personal Finance Expert. With over five years of experience analyzing the insurance market, he conducts original research and creates tailored content for all types of buyers. His insights have been featured in publications like CNBC, NBC News and Mashable.
Fitzpatrick holds a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He's also a five-time Jeopardy champion!
He writes about economics and insurance, breaking down complex topics so people know what they're buying.
sources
- Kaiser Family Foundation. "Health Care Debt In The U.S.: The Broad Consequences Of Medical And Dental Bills." Accessed September 23, 2025.
- Kaiser Family Foundation and Peterson Centre for Healthcare. "Americans’ Challenges with Health Care Costs." Accessed September 23, 2025.
- Center for Medicare & Medicaid Services. "NHE Fact Sheet." Accessed September 23, 2025.
- Center for Medicare & Medicaid Services. "Emergency Medical Treatment & Labor Act (EMTALA)." Accessed September 23, 2025.
- The Pricer Org. "How Much Does an Emergency Room Visit Cost Without Insurance?." Accessed September 23, 2025.
- Kaiser Family Foundation and Peterson Centre for Healthcare. "What are the recent and forecasted trends in prescription drug spending?." Accessed September 23, 2025.
- PubMed Central. "The High Price of Debt: Household financial debt and its impact on mental and physical health." Accessed September 23, 2025.
- Health Affairs Org. "US Nonprofit Hospitals Have Widely Varying Criteria To Decide Who Qualifies For Free And Discounted Charity Care." Accessed September 23, 2025.
- Nova Region Org. "HIV Resources Project by Northern Virginia." Accessed September 23, 2025.
- Medicaid Official Site. "Eligibility Policy." Accessed September 23, 2025.