Going uninsured (self-insure): Cost and When It Beats Short-Term Insurance

A two-week gap with a $10,000 cushion is a defensible bet for a healthy adult. A two-year gap is not. The penalty is gone; the financial risk is not.

The comparison

Against short-term medical at $90-$250, going uninsured (self-insure) trades differently on every row — cost, guarantee of payment, and what happens on day one of a diagnosis.

When it beats short-term

Any prescription list, any pre-existing condition, any pregnancy, and any income that earns subsidies — each of these flips the comparison hard. Short-term wins the narrow case: healthy, short gap, cash cushion, and no subsidy eligibility.

• Run Healthcare.gov with real income numbers — the subsidy is bigger than most people guess.
• Check Medicaid in expansion states; eligibility surprise runs both directions.
• Treat health shares as budget tools, not insurance replacements.

When short-term still wins

A 45-day gap between jobs in a subsidy-ineligible household, with clean health history and a hospital-dodge temperament — that is the case short-term was built for, and at $100 a month it does the job honestly.

Going uninsured (self-insure) vs short-term medical: decide on prescriptions and health history, not on the premium line.