This means no doctor visits, eye exams, dental check-ups or annual women's tests.
It also means she's stressed.
"I just hope I don't get sick. I try to take care of myself, and if something does happen, I just take over-the-counter medicine," said Rafanan, 33, who said she earns "just enough to get by."
Rafanan last had insurance when she worked in California, but her job here doesn't offer insurance as a part of employee benefits. Although she's looked into individual and temporary health insurance plans, "they're just too expensive. I should be making more money than I do."
In October 2005, she visited the emergency room when she had a panic attack and paid chunks of the bill during the next two years.
"A couple of weeks ago I started getting high blood pressure because I was stressed out dealing with finances. It's been slower at work and harder to pay the bills," she said. "Not having insurance scares the crap out of me."
The Kaiser Family Foundation reports that about 30 percent of those who are uninsured are between 19 and 29. Many of these are recent college graduates who are unemployed or work at low wage jobs. Unlike other states that allow graduates to qualify for coverage under their parents' plans until 25 or 26, Georgia's young adults are only covered as full-time students.
"I was on my parents' but then didn't go directly to college after high school and was taken off," said Jessica Grubb, 20, who will attend Gainesville State College this fall. "I looked into my own plan, but it was too expensive, so I hope to get back on my parents' when I get back into school. For now, I'm super cautious when I'm driving. Anything could happen."
Several Gainesville area graduates have had their share of uncertain times while uninsured but have found ways to pull through. Josh Poole, 28, graduated from Gainesville State and went for three months without insurance in between jobs. He decided not to use the Consolidated Omnibus Budget Reconstruction Act (COBRA) temporary coverage designed for those between jobs, but needed a way to pay for monthly medications for asthma.
"I have a monthly need, so I pretty much had to bite the bullet," Poole said. He created a multimedia company and took his time to find individual health insurance.
"I think that's part of the evolution of our generation. We have to shop around," he said. "But I think I made the best choice. It's a middle of the road policy between quality and cost effectiveness, and I haven't had to use it much."
The majority of college students don't have to think about insurance options until after graduation. However, the University System of Georgia offers coverage for those who are international students, independent from their parents or have parents without health insurance. The company Pearce & Pearce serves the entire school system and offers insurance plans for $379 in the fall semester and $501 for the combined spring and summer semesters.
"Students can enroll at the beginning of each semester, and the spring fee covers them through July," which could help recent graduates, said Cori Loftis, a student affairs representative for the Board of Regents that implements the policy systemwide. "As long as you are full-time, you can enroll for it for any semester, and we can pro-rate it."
After graduation, staff on campus can help those who want to continue on the Pearce & Pearce plan.
"For graduates who want another individual plan, we can talk to them about researching it from an educational standpoint and give any contact's names if we have any," said Joanna Manzi, who handles students health insurance under the University of Georgia's Office of Human Resources.
However, no resources are specifically allotted in that office or the UGA Career Center for students who have general questions about health insurance after graduation. At the Gainesville State College Career Center, counselors can give general information, said Alicia Caudill, associate vice president for student affairs.
"There are some resources who provide insurance to alumni, but we don't have a formal relationship with them," she said. "But our counselors do talk about the importance of health care coverage and discuss insurance options and COBRA."
Students who are dropped from their parents' coverage may opt to go without insurance, but a few options - individual policies, short-term plans and catastrophic coverage - could be plausible choices.
Individual insurance policies are a popular option, but many companies can choose whom they insure and often refuse those with chronic conditions. These are also more expensive than short-term plans, which last up to six months and are a good way to fill in gaps between jobs. However, short-term policies are a temporary fix and carry a higher risk of companies dropping patients. For those who want to cover emergencies, catastrophic insurance is available but tends to have high deductibles and low premiums. This plan doesn't cover doctor visits or prescriptions.
For recent grads, short-term coverage is probably the best option, Loftis said.
"Short-term allows them to pay month-to-month, which can be beneficial while they're just searching for work," she said.
Many insurance companies also create plans for the target group right out of college. Most of these include emergency coverage, limit prescription benefits to generic drugs and cap total coverage.
Graduates like Rafanan may decide they can't afford any type of insurance and don't seek help at all, not even at local health departments or care clinics.
"We do see some young adults, but there's not a significant amount," said Cheryl Christian, executive director of Good News Clinics on Pine Street. "We've actually seen more volunteers at that age come in to volunteer while they're looking for jobs."
Karen Welchel, a recent graduate of Georgia Southern, is one of those new volunteers. She's completing an internship before entering graduate school.
"I had insurance under my parents while I was an undergrad and will be until I'm 25 as long as I'm a full-time student," she said. "But I do think about others my age. With the job market, they might not be finding anything that offers insurance."
That's what happened to Sara Hayes, who graduated several years ago from Brenau University. She worked several jobs before marrying her military husband and becoming a part of his insurance plan.
"There were about six months there, and it's scary. If something major happened to me, I don't know what I would have done financially. It would have followed me the rest of my life," she said. "I couldn't afford to pay $350 a month for emergency care insurance and a $4,000 deductible."
But there may be help for those who look.
"One thing that surprised me is with insurance I could get birth control for $9, but even without insurance I was able to get it for the same," she said. "That could be really important for some women."