Is the cost of insurance worth it?
For many people, going uninsured is usually not worth the risk. While there is no federal or Michigan tax penalty for being without health insurance, you may have to pay the full cost of doctor visits, preventive care, emergency care and hospital stays on your own.
Health plans under the Affordable Care Act (ACA) can help make costs more predictable and may be more affordable than you expect, especially if you qualify for financial help. Read on to better understand the costs of going without coverage.
What care can cost without health insurance
Without health insurance, you may have to pay the full cost of care out of pocket. Actual costs can vary, but these examples show how quickly routine, preventive and emergency care can add up.
Cost for hospital services
- Ambulance ride: $500 – $1,200.1
- Emergency room visit: $1,150 – $2,0001, depending on the severity of the condition. If admitted, the cost can rise to $10,000 – $30,000.2
- Hospital stay (per day): $2,800 – $3,500 per inpatient day, not including procedures or specialist fees. A typical hospital stay is 4.5 days.3 The cost will vary based on the use of anesthesia, specialist consultations, medications, post-op care, imaging and diagnostics.
- Routine inpatient procedure: An appendectomy or gallbladder removal typically involves a 3 to 5-day hospital stay and can cost between $20,000 and $40,000 without insurance.2
Cost for office services
- An adult preventive care exam: $150 – $300. If bloodwork or immunizations are included, the total can increase to $400 – $600 or more.4
- A well-child exam for an 18-month old: $180 – $300. Adding recommended vaccines ($200 – $500) brings the total to $380 – $800.5
- A mammogram, or breast cancer screening: $255.4
- A colonoscopy, or colon cancer screening: $1,444.4
Hidden costs of being uninsured
The cost of going uninsured is not just about one medical bill. It can also affect how much you pay over time and how easy it is to get certain types of care.
- Paying the full billed amount for care, rather than lower rates that insurers often negotiate.
- Preventive care costs out of pocket, which can make it easier to put off checkups, screenings or vaccines.
- Higher costs for specialist or follow-up care.
- Some follow-ups or specialist care may feel harder to afford, especially if you are paying the full cost yourself.
- Unexpected bills may be harder to manage, especially after emergency care or a hospital stay.
- Medical debt that can affect your credit score and financial stability.
How ACA coverage can help
ACA coverage can do more than help pay for care when something goes wrong. It can also make healthcare costs more predictable, cover important preventive services and help protect you from large, unexpected bills. ACA plans offer:
- Financial help based on income, making coverage more accessible.
- Coverage that protects you from high medical bills, unlike health cost-sharing programs.
- Free preventive care, including exams, vaccines, screenings for breast, cervical and colon cancer and more.
- 10 Essential Health Benefits, including hospitalization, maternity and newborn care, prescription drug coverage, mental health care and more.
- Reduced out-of-pocket risk with limits on how much you pay out of pocket for covered care each year.
- Protection from surprise billing.
- Improved health outcomes with MyPriority® chronic condition management.
| With health insurance | Without health insurance | |
|---|---|---|
| Doctor visits | You may pay a copay or part of the cost | Full billed amount |
| Emergency care | Your plan helps cover the bill | Responsible for entire bill |
| Preventive care | Often covered at no added cost | Usually paid out of pocket |
| Financial risk | Costs are more predictable | Costs may be high and unexpected |
Michigan-specific resources
- Shop and enroll in a Michigan ACA plan through healthcare.gov or Priority Health. We'll check to see if you qualify for a subsidy.
- MIBridges – Apply for Michigan Medicaid, food assistance and other state assistance.
Bottom line
Going uninsured in Michigan may seem like a way to save money, but it can leave you paying the full cost of care on your own. ACA plans can help make costs more predictable and may be more affordable than you expect, especially if you qualify for financial help.