The Case for Skipping It (Stated Fairly)
Let's be honest about the argument: you're young, you're healthy, you haven't seen a doctor in two years, and there's no federal penalty for going uninsured. Every premium dollar feels like paying for something you won't use. That logic isn't crazy — insurance is, by design, a bet you hope to lose.
The problem isn't the logic; it's the numbers on the other side of the bet. A broken arm with surgery, an appendectomy, or one night in an ER can run into five figures. Young adults don't get billed less because they're usually healthy — they just get billed less often. And medical debt at 23 follows you into exactly the years you're trying to build credit, rent apartments, and start a career.
What Coverage Actually Costs at 23 in Utah
The sticker price isn't the real price for most 23-year-olds:
- Income under roughly 138% of the federal poverty level: Utah Medicaid — comprehensive coverage at little to no premium. For a low-income young adult, 'insurance is too expensive' usually isn't true; it's just unchecked.
- Modest income above that line: premium tax credits on a Marketplace plan, sliding-scale. Independent filers with part-time income often pay a small fraction of the sticker premium.
- Under 30 with no subsidy: a Catastrophic plan — the lowest-premium way to cap your worst case, with free preventive care and three primary-care visits included. See our [Catastrophic plan breakdown](/blog/catastrophic-health-plans-under-30).
- Under 26: a parent's plan may cost you nothing at all — the age-26 rule applies whether or not you live at home.
What You're Actually Buying
Even the cheapest compliant plan buys three things a healthy person uses: free preventive care (checkups, vaccines, screenings — no deductible), mental health coverage (one of the ten essential benefits, and the one young adults use most), and the out-of-pocket maximum — a legal ceiling on how bad a bad year can get. That ceiling is the entire product. You're not buying doctor visits; you're buying the guarantee that a ski accident is a bounded problem instead of a bankruptcy.
The one defensible skip: someone with genuinely no subsidy eligibility, significant savings that could absorb a five-figure bill, and a high risk tolerance. That describes very few 23-year-olds — and in Utah, where Medicaid expansion catches low incomes and credits catch modest ones, coverage is usually cheaper than the risk. Find your actual number in ten minutes: student health insurance hub.
Frequently Asked Questions
Is there any penalty for being uninsured?
There's no federal tax penalty, and Utah doesn't impose a state one. The cost of going uninsured is entirely in the risk: you pay full price for all care, and there's no ceiling on a catastrophic bill.
Can I just buy insurance if something bad happens?
No — that's exactly what enrollment windows prevent. Outside Open Enrollment (November 1 – January 15), you need a qualifying life event to enroll. A diagnosis or an accident is not a qualifying event; you'd carry those bills uninsured.
What about health sharing ministries or short-term plans?
Both cost less because they cover less: they can decline pre-existing conditions, cap payouts, and skip essential benefits — and sharing ministries aren't insurance at all, with no legal guarantee of payment. Compare a subsidized Marketplace plan first; for most young adults it's cheaper than people assume and vastly more reliable.
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