What Happens if You Don’t Have Health Insurance?

If you don't have health insurance, you pay full hospital rates, rely on charity programs and face financial risk for ongoing medical care.

Explore your health insurance options to avoid these costs below.

Written by Mark Fitzpatrick

Updated: December 4, 2025

Advertising & Editorial Disclosure

Key Takeaways

Without insurance, you'll pay full hospital rates, creating medical debt that forces many people to cut spending on food, housing and other essentials.

Hospitals must treat emergencies under federal law, but they can refuse non-emergency care. You'll need charity programs or payment plans to manage bills.

While there's no federal tax penalty for being uninsured, five states and Washington, D.C., have their own mandates with financial penalties.

Health insurance covers medical expenses, protecting your finances if you’ve a chronic condition or need frequent medical services.

What Happens if You Go Without Health Insurance?

If you don’t have health insurance, you pay the full cost of every medical bill when you get sick or hurt. Americans spend $14,570 per person on health care annually, according to the Centers for Medicare & Medicaid Services (CMS).

Hospitals must provide emergency treatment under federal law (EMTALA), but they can refuse non-emergency care to uninsured patients. This creates serious problems since 90% of health care costs come from chronic and mental health conditions. Delaying care makes these conditions more dangerous and expensive to treat.

1
Going to the Hospital Without Insurance
Hospital bills without insurance quickly drain savings. You'll pay the full cost yourself, and hospitals charge uninsured patients their full chargemaster rates which are much higher than the discounted prices insurance companies negotiate.

Some of the costs which you might actually have to 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
Most hospitals provide charity care programs and payment plans, but you'll need to ask about these options upfront.

The Affordable Care Act covers many preventive services with no copay when you have insurance, providing a valuable benefit for people who obtain health insurance.
2
Unaffordable Medication Costs
Without insurance, you pay full price for prescription drugs: $1,050 per person annually, according to the National Health Expenditures Accounts (NHEA). Insurance companies negotiate discounts that cut drug costs by half or more, but uninsured patients pay the full amount.

You'll face difficult financial choices about medications. Diabetes patients sometimes skip insulin refills to cover rent. High blood pressure patients may cut pills in half to stretch prescriptions longer. These decisions create medical emergencies that cost thousands more to treat.
3
Medical Debt
One in 10 U.S. adults carries medical debt, according to KFF and the Peterson Center for Healthcare analysis. The bills force impossible choices between medical care and basic needs.

Most people with medical debt cut spending on food and clothing to pay bills. Half drain their entire savings. Others max out credit cards or work second jobs, and some do both.

Depression and medical debt create a vicious cycle. People with depression carry medical debt three times more often than others. Cost concerns cause 37% to delay care and 38% to skip treatment entirely, worsening their condition and leading to more expensive care later.
4
Tax Penalties for Not Having Health Insurance
Congress eliminated the federal tax penalty in 2019, but six jurisdictions still fine you for going without coverage: California, Massachusetts, New Jersey, Rhode Island, Vermont and Washington, D.C. If you're uninsured for more than three months, you'll owe money when filing your state taxes.

The penalty hits your wallet in one of two ways. You'll pay either a flat fee per person or a percentage of your household income above the filing threshold; whichever costs more.

States That Require Health Insurance

Five states and D.C. maintain their own insurance requirements with real penalties. These states implemented individual mandates to stabilize their insurance markets and encourage residents to maintain coverage.

If you live in one of these mandated states without qualifying coverage for more than three months, you'll owe money when filing your state taxes. The penalty gets added to any taxes you owe or reduces your refund.

States use penalty revenue differently. California funds additional insurance subsidies, while New Jersey and Rhode Island help finance reinsurance programs that keep premiums lower. Let's walk through each state's penalty in detail below:

California: Staying uninsured costs at least $900 per adult and $450 per child under 18 annually. A family of four pays a minimum of $2,700 yearly. California charges either this flat amount or 2.5% of your gross income above filing thresholds, whichever hits your wallet harder.
Massachusetts: Your penalty equals half the cost of the cheapest ConnectorCare premium for your income bracket. Earn 150% of the Federal Poverty Level or less? You're off the hook. Higher earners pay based on what plans actually cost in their area.
New Jersey: You could pay anywhere from $695 as an individual to $19,800 for a family of five. Your household size and income determine where you fall in that range.
Rhode Island: Rhode Island runs three different calculations and charges you the lowest one. Options include monthly rates per uninsured person, 2.5% of your income after deductions or the bronze plan cost multiplied by months you went without coverage.
Washington, D.C.: The penalty mirrors the original ACA federal mandate, scaling with your income and household size.
Vermont: Vermont requires coverage but won't fine you for skipping it.

What Alternatives Are Available if You Don’t Have Health Insurance?

If you can't afford or don’t have health insurance, you have options beyond going without coverage. Federal and state programs cover millions of Americans who earn too little for marketplace plans. Community health centers provide care regardless of your ability to pay. Some hospitals offer charity care that wipes out bills entirely. These resources exist specifically for people in your situation, and knowing where to look can save you thousands in medical costs.

Community Health Centers

You'll pay what you can afford at community health centers. The Health Resources and Services Administration (HRSA) 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. Find a location near you through HRSA's online locator tool. Medical, dental, mental health and other services are available based on your income.

Prescription Assistance Programs

Your medications don't have to break your budget. The Partnership for Prescription Assistance connects you to more than 475 public and private programs, including about 200 run by pharmaceutical companies. Qualifying individuals get free medications or steep discounts on brand-name drugs through these programs.

Hospital Charity Care Programs

Nonprofit hospitals must offer financial help by law. Each hospital sets its own income limits, which range from 41% to 600% of the federal poverty level. Most hospitals require incomes at or below 200% to qualify. Check DollarFor to see if you're eligible for assistance. Apply directly to the hospital's financial assistance office. Hospitals can't send debt collectors while reviewing your application.

Negotiate Your Bills

Contact the billing department immediately to negotiate your medical bills. Most hospitals accept payment plans that spread costs over several months. Many hospitals cut bills by 10% to 30% if you can pay a lump sum upfront. Don't ignore medical bills as acting fast prevents debt from going to collections and protects your credit score.

How Can You Get Health Insurance?

You have several ways to get health insurance, even if you've lost your job or can't afford traditional plans. The Health Insurance Marketplace offers subsidized plans based on your income. Medicaid covers millions of low-income Americans at little to no cost. Employer-sponsored insurance remains the most common option if you're working. COBRA lets you keep your previous employer's plan temporarily, though you'll pay the full premium. Short-term plans fill gaps between coverage, and some organizations offer group rates to members.


Health Insurance Marketplace	Shop at HealthCare.gov during open enrollment (November 1 to January 15) or within 60 days of major life changes like losing coverage, getting married or moving. Premium tax credits can significantly lower your monthly costs if you earn up to 400% of the federal poverty level. Bronze plans save you money monthly but hit your wallet harder when you need care. Gold and Platinum plans cost more upfront but protect you better when medical bills arrive.
Medicaid	Medicaid covers you if you earn up to 138% of the federal poverty level in expansion states. Apply anytime at your state's Medicaid office or HealthCare.gov. Most people pay nothing.
Employer and Spouse Coverage	Full-time workers at companies with 50 or more employees typically get health insurance through their jobs. Joining your spouse's plan during their enrollment period is another option.
COBRA and Short-Term Options	COBRA keeps your old employer's plan for 18 months but costs a lot. Short-term plans run up to 12 months at half the price or less but exclude pre-existing conditions and may not cover prescriptions or mental health care.
Catastrophic Plans	Available under age 30, catastrophic plans offer low monthly costs with high deductibles around $9,450. Most care comes out of your pocket until you hit that amount.

When It's Okay to Not Have Health Insurance

Going without health insurance is a gamble with your finances. You'll pay full hospital rates, the same prices that make insurers negotiate discounts in the first place. Medical bills pile up fast. Suddenly you're choosing between filling a prescription and paying rent, or putting off that doctor's visit because you can't afford it right now. Delaying care turns a manageable condition into an emergency that costs far more to fix.

Some people weigh the risks and temporarily skip coverage, but they often don't realize how fast a broken bone or unexpected diagnosis can drain their savings.

If you're young, healthy and between jobs, skipping coverage for a few weeks might feel tempting. It's a calculated risk that works best when you've got emergency savings and no ongoing health issues. Can you handle a surprise $3,000 ER bill out of pocket? That's the question to answer honestly.

Medicaid in expansion states covers you retroactively for up to three months before you apply. Land in the hospital during your application process? Those bills could get covered, but only if you already qualified during that time. Apply immediately instead of waiting and hoping for retroactive help.

Veterans with VA benefits already have health care through the Veterans Health Administration. What you'll actually pay and where you can go depends on your disability rating, income and location. VA benefits typically work only at VA facilities and their approved providers, so check what's available near you before you need care.

MONEYGEEK EXPERT TIP

Affordable insurance plans are available through employer coverage or the Affordable Care Act (ACA) marketplace. Even if you don’t qualify for subsidies, you can still choose a lower-cost option, such as a Bronze marketplace plan or a high-deductible plan from your employer.

What Happens If I Have No Health Insurance: Bottom Line

Going without health insurance means paying full hospital rates that create medical debt, forcing you to cut spending on food and housing. While charity programs and community health centers provide help, you're always one diagnosis away from financial hardship. Getting coverage protects your finances and health, 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)

Here are some common questions people have about what happens if you don’t have health insurance and what you can do about it.

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 to $700. Moderate issues requiring CT scans or treating sprains run $700 to $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.

Can You Get Health Insurance at Any Time?

Marketplace health insurance has limited enrollment windows. Open enrollment runs November 1 to January 15 each year. Special Enrollment kicks in within 60 days of major life changes like job loss, marriage, childbirth or relocation. Medicaid and employer plans work differently. Medicaid accepts applications year-round while employers open enrollment once annually, usually in fall.

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.

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sources

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Kaiser Family Foundation and Peterson Centre for Healthcare. "What are the recent and forecasted trends in prescription drug spending?." Accessed November 24, 2025.
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