What to do if you can't afford health insurance

Check whether you qualify for help paying first

Before you give up on a plan, find out if the government will help pay for it. The help is called the premium tax credit. A premium is the monthly price of a plan, and the credit lowers that price. HealthCare.gov says you can take the credit in advance each month or claim it when you file your taxes.

For 2021 through 2025, Congress let people earning more than 400 percent of the poverty level get the credit. That change is over, and the IRS table for 2027 applies now. For 2027, people who qualify pay 2.15 to 10.22 percent of their income toward a set silver plan, called the benchmark plan. Our premium tax credit guide explains how the credit works, with examples.

Help stops for households above 400 percent of the federal poverty level, which is a yearly income line set by the government. By our math, that is $63,840 for one person in 2027, which is four times the 2026 level of $15,960.

You should still apply, even if you think you earn too much or too little. One application checks you for savings and for Medicaid. People and groups in the community offer free help with the application and with picking a plan, according to HealthCare.gov. The rules for some immigrants changed, and HealthCare.gov can tell you what applies to you.

Open enrollment on HealthCare.gov runs from November 1, 2026 to January 15, 2027. Our open enrollment guide lists each state's dates and deadlines.

Medicaid and CHIP are open to you any time of year

Medicaid and CHIP are government programs for people with low incomes, and CHIP stands for the Children's Health Insurance Program. These applications are accepted all year, according to HealthCare.gov, so you do not have to wait for open enrollment.

Apply even if you were turned down before. Your income and household may have changed since then, and so may the rules in your state. You can apply on HealthCare.gov or through your state Medicaid office.

Lower-cost plans and what you give up

If you do not qualify for enough help, you can still pick a plan with a lower premium, but it comes with a higher deductible. A deductible is the amount you pay yourself each year before the plan starts to share the cost of most care. A bronze plan usually has a high deductible, and the plan pays about 60 percent of covered costs, according to HealthCare.gov. These plans are sold on the Marketplace, which is HealthCare.gov or your state's own sign-up site.

Catastrophic plans are for people under 30 and for others with a hardship or affordability exemption, says HealthCare.gov. These plans have low premiums and very high deductibles. They mostly protect you from a huge bill after a serious illness or injury.

Every Marketplace plan has an out-of-pocket maximum, which is the most you pay in a year for covered care from doctors in the plan's network. For 2027, the limit is $12,000 for one person and $24,000 for a family, according to CMS. CMS is the federal agency that runs HealthCare.gov. Those are big numbers, so think about whether you could pay a bill that size.

Short-term health plans are not Marketplace plans, and they can turn you down or leave out care, so read the fine print.

Is it cheaper to go without insurance?

Month to month, you do save the premium. There is no federal tax penalty for having no insurance. A few states have their own rule, so check with your state tax agency.

The real risk is a large bill after a serious illness or accident. Federal law says emergency rooms must screen and stabilize anyone who comes in, with or without insurance, but the bill still arrives afterward. The IRS says nonprofit hospitals must have a written financial assistance policy. You can ask the billing office for a copy before you pay.

We do not tell anyone to go without a plan. We give you the facts so that you can decide for yourself.

If you think you are having an emergency, call 911 or go to the nearest emergency room.

How to get care if no plan fits your budget

Community health centers charge on a sliding scale based on your income. HRSA, the federal health resources agency, says they serve people regardless of ability to pay. Some other clinics also set fees by income, and some are free.

Direct primary care is another way to get regular visits. You pay a doctor a monthly membership, usually $50 to $200 a month, and in return you get regular visits. It is not insurance, and it does not pay for the hospital, the emergency room or surgery. Our plan cost comparison can help you compare a membership with other ways to pay.

For medicine, ask the pharmacist what the cash price is. It can be lower than you expect, and a cash price does not need a plan. Never stop or change a medicine unless your own doctor tells you to.

Our doctor directory lists about 20,000 doctors, so you can look for a cash-pay doctor near you. A cash-pay doctor does not bill insurance and tells you the price up front. This guide is general information and not medical advice.

If your income changes during the year

Be sure to tell the Marketplace when your income changes. When your income ends up higher than you guessed, you may have to pay back some of the credit you got early. Starting with tax years after 2025, the IRS says you must pay back all of the extra, with no cap.

A job loss, a move or another life change can open a special enrollment period. Our guide on missing open enrollment explains the rules and the time limits.