Healthcare costs in the U.S. have skyrocketed, making it a significant burden for many families and a hurdle for those wanting to leave traditional jobs for entrepreneurship or early retirement. But don’t worry, you’re not alone in this struggle, and there are solutions out there. Here are nine options to consider if you’re not getting health benefits from your employer, not old enough for Medicare, and don’t want to be without health insurance.
First, let’s talk about how to get health insurance without employer coverage. If you’re unemployed, self-employed, or your job doesn’t provide health coverage, or if you’re planning to retire before you’re eligible for Medicare, health insurance is probably a big concern for you. While it’s possible to get affordable medical care without health insurance, it’s risky to go without coverage.
So, what are your options if you don’t have an employer-sponsored plan? Health coverage can be complicated, so make sure to do your research before committing to a plan. Look out for deductible costs, prescription drug coverage, exclusions, copays, and maximum annual expenditures.
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Spouse’s Employer Plan: If you’re self-employed like me, you might be lucky enough to have a spouse with employer-sponsored health insurance that covers you. The stability and benefits of my wife’s job allow me to pursue higher-risk, higher-reward income and investments. Before quitting your job or switching to a single-income household, take a close look at your partner’s job and benefits. If they don’t currently have employer-sponsored health coverage for the whole family, consider exploring new jobs that offer it.
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Part-Time Job With Health Benefits: Not all part-time jobs exclude benefits. I know high-earning managers who work part-time jobs just to secure health insurance. Whether you plan to work full-time elsewhere, retire, or start your own business, a part-time job can provide health insurance and perhaps offer a fun, laid-back way to earn a little extra cash.
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ACA Exchanges: The Affordable Care Act (ACA, also known as Obamacare) created health insurance exchanges that offer another option for shopping and comparing health insurance plans. On your state’s ACA health insurance marketplace, you complete an application and then review the quotes available to you. One great feature of the exchanges is that health insurers cannot deny coverage based on preexisting conditions. Some Americans also qualify for subsidies based on their income.
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Private Insurance Marketplaces: All health insurance plans in the U.S. must comply with ACA requirements. But to be listed on the ACA health insurance exchanges, plans must meet a stricter set of requirements. Not all health plans in the U.S. meet these tighter requirements, so while they are legal, they’re not allowed to be sold on the ACA exchanges. This is where private health exchanges come in. On private health exchange marketplaces, you can search and view these non-certified plans not listed on the official ACA exchanges. You may just find lower-cost options to help save money on your health care costs.
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Association Health Plans: In October 2017, President Trump signed an executive order allowing private groups of individuals to negotiate with insurers for “association health plans” (AHPs). The idea is that trade associations and other groups can apply for coverage plans the way larger corporations do currently. While the future of AHPs remains uncertain, they could add another affordable option, particularly for self-employed people.
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Move Overseas: I interviewed a couple who retired early, sold their house, and bought a houseboat in Europe. They found a comprehensive health plan in Europe for $7,200 per year covering both of them. If you’re open to an expat adventure, check out these 10 countries where $2,000 per month buys the good life. And yes, that $2,000 includes health insurance.
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Health Savings Accounts (HSAs): For people with low health risks, health savings accounts (HSAs) can be an affordable and flexible option. You buy a low-cost, high-deductible insurance plan and open an HSA to build a cash cushion for health emergencies. When medical expenses come along, you pay for them with your HSA to cover the high deductible. Then, your insurance kicks in and covers the remaining costs.
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Retiree Health Coverage: Looking to retire early, but worried about the astronomical cost of health insurance without employer coverage? Some employers still offer post-retirement supplemental health coverage. If you’re thinking about early retirement, check with your employer to see if they offer it.
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COBRA Gap Coverage: The Consolidated Omnibus Budget Reconciliation Act (COBRA) requires insurers to allow ex-employees to remain on their current health care plan for up to 18 months after departing their jobs. It’s an option for gap insurance policy coverage, allowing some breathing room before you find permanent coverage.
With no end in sight for rising health care costs, working-age Americans without employer-sponsored health plans increasingly find themselves struggling to afford medical care. There’s no silver bullet for health insurance. Research as many options as you can and find the one that makes the most financial sense for you.
If your annual income qualifies, you can also secure family coverage through Medicaid. It provides state-sponsored health care help for low-income families across the U.S. Families who don’t qualify for Medicaid might still qualify for children’s coverage under the Children’s Health Insurance Program (CHIP).
As a final thought for the self-employed, keep in mind that you can deduct health insurance costs as a business expense. That lowers not only your taxable income but also your self-employment taxes.
And don’t write off moving abroad. My wife and I live overseas and enjoy affordable, high-quality health care with little stress and a $13.62 copay. I miss certain things from the U.S., but the tangled web of health insurance isn’t one of them.
