Can’t Afford Health Insurance? Here’s What to Do

Editor’s note 10/17/11: When this article was originally published, it erroneously included the name CareSource rather than Care Resource. It has now been changed. CareSource is a different company and is no way affiliated with Care Resource.

Chuck, a good friend of mine, has now been without a “real” job for more than three years. He does odd jobs to stay alive, and because he’s skilled in both carpentry and mechanics, he gets by. But health insurance? Forget about it. So a few months back when got too sick to function, he utilized what he considered his only option: the emergency room.

Chuck’s not alone. According to the latest Census data, there are now 49.9 million Americans without health insurance. It’s a safe bet that many skip the doctor and use super-expensive emergency services. But if you’re one of the uninsured like Chuck, here’s something you need to know: You have other options. In fact, you can go to a doctor’s office and be treated just like everyone else. And when the bill comes, you’ll be asked to pay what you can afford – which includes zero if you’re earning zero.

Let’s take a closer look at options for those without insurance.

Federally qualified health centers

Care Resource, the health care center where I researched this story, is a Federally Qualified Health Center, one of hundreds nationwide. According to this page of the Health Resources and Services Administration’s website, here’s what they can do:

1. Checkups when you’re well
2. Treatment when you’re sick
3. Complete care when you’re pregnant
4. Immunizations and checkups for your children
5. Dental care and prescription drugs for your family
6. Mental health and substance abuse care if you need it

These places price their services based on your ability to pay. To find one near you, go to the HRSA search page and type in your address. And if you’re imagining these places look like some squalid clinic resembling the DMV, think again. While I obviously can’t speak for all, the one I went to for this story looked no better or worse than my doctor’s office. Remember, these aren’t government clinics: They’re private clinics that receive part of their funding from the government.

Medicaid

Another option for the low-income uninsured is Medicaid, state-run programs providing health coverage for families. As with Medicare, those who qualify receive all kinds of health services. While programs differ by state, most cover services ranging from eye doctor visits to hospice services.

To learn more about Medicaid, visit this page of the Department of Health and Human Services site. To find out if you qualify, you’ll want to visit your state’s Medicaid information site: Here’s a list of links (.pdf)

If you don’t qualify for Medicaid, your kids may still qualify for a state-run Children’s Health Insurance Program. In some states, this program is combined with Medicaid. The eligibility cutoff varies, but “children up to age 19 in families with incomes up to $45,000 per year (for a family of four) are likely to be eligible,” says the U.S. Department of Health and Human Services (HHS). To learn more about these programs, check out this page of insurekidsnow.gov.

Pre-existing conditions

You might also qualify for insurance through state-run high-risk insurance pools, designed for people who could normally afford insurance but have pre-existing conditions ranging from cancer to asthma that led to insurance denials.

That practice will be fully banned in 2014 because of the Affordable Care Act. Until then, HealthInsurance.org can tell you more about each state’s high-risk pool program. If you’ve looked at this option before, look again: HHS made it easier and cheaper to acquire coverage last July.

Affordable prescriptions

Those with low incomes can often get prescription drug assistance, including free drugs. There are dozens of private and public programs available: way too many to list here. But that’s OK, becasue we already listed a bunch of them in a prior story called Help Finding Discounted or Free Prescription Drugs. In addition, some states have discount programs.

Also keep in mind that some pharmacies and grocery stores, including Walmart, Kroger, Target, Publix, and others now offer some antibiotics and common medications free or at rates as low as $4 for a month’s supply. There’s a big list of others at this page of About.com.

Free help finding help

There are organizations charging little or nothing to help people find insurance and health care they can afford.

1. Patient Advocate Foundation is a national nonprofit that offers advice, case management assistance, a program that helps those who already have insurance and certain diseases get lower co-pays, and a database of financial resources sorted by state.

2. Healthcare.gov, originally designed to explain the changes made through the health care reform law enacted last year, is also a great resource for those seeking care. It offers an insurance plan finder, tools for comparing the quality of care across providers, advice on enrolling in free or low-cost programs, and plenty of other information.

3. The Access Project helps people enroll in many programs, find a doctor, or get cheaper care. They specialize in helping HIV and hepatitis patients, but offer many other resources for everyone.

Other solutions

1. Catastrophic coverage: If you find that typical insurance is too expensive, do what I did: Get a high-deductible policy. These policies are much less expensive because you pay the first $2,000 – $10,000 of expenses yourself – hence the name “catastrophic coverage.” While you’ll be out-of-pocket for things like doctor visits, at least if the worst happens, you’ll be able to avoid going bankrupt. Plus, just being associated with an insurance company will often result in significant discounts. To find a high-deductible policy, try our insurance search tool.

2. Part-time work: Benefits packages usually come only with full-time employment, but not always. A number of companies, including Starbucks and Lowe’s, offer insurance for part-time employees.

3. Non-insurance options: To see some ingenious ways some people have found to bypass the traditional health insurance system, check out Health Care Without Insurance – $50/Month? and Medi-Share: Health Care Without Insurance.