If you're newly uninsured because you've recently lost your job, you have some rights you might not be aware of. But if you simply cannot afford health insurance, here's what you should know:
Don't count on an emergency room. It's true that if you show up in an emergency room with a medical problem that requires urgent attention, such as a broken bone or bad cut, the hospital is legally required to stabilize you if it is one that accepts Medicare funds. But you will receive a bill afterward, possibly a very large one, and the hospital might be aggressive about trying to collect payment.
Investigate public programs. Eligibility for Medicaid and the Children's Health Insurance Program varies from state to state, so it pays to find out whether you or your children qualify. Healthcare.gov's plan finder can guide you to more information.
Go to a community health center. There are more than 8,000 across the country. They provide basic outpatient care—including, in some cases, dental and mental-health services—and they charge according to a person's ability to pay. Find the center nearest you.
Ask doctors to cut your bill. No one pays the sticker price for health care except, paradoxically, uninsured people who don't have the benefit of the big discounts that public and private insurers negotiate on behalf of their members. Many doctors will offer a similar discount to uninsured people paying bills, especially those paying at the time of treatment, but you have to ask.
Comparison shop for prescription drugs. You can easily end up paying more than you need to by, say, failing to compare prices at more than one pharmacy, or taking an expensive brand-name drug when a cheaper generic could work just as well. Our money-saving guides can help you evaluate the options.
Take advantage of health fairs. Many community groups periodically run health fairs that include free screenings for such conditions as hearing loss, high blood pressure, and high cholesterol. Some also offer free flu shots and vision screenings.
Look for disease-specific programs. There are dozens of them but you have to know where to look and, in many cases, follow some very specific rules. The federally funded Breast and Cervical Cancer Treatment Program, for example, will pick up the entire cost of treatment for low-income women. But to qualify in many states, your condition must have been diagnosed at one of the program's approved screening centers. If you received a diagnosis elsewhere, you're not eligible. Find the screening program nearest you. Needymeds.org, a website run by a nonprofit group, lists a number of financial-assistance programs for specific diseases in an easy-to-search format.
Apply for free or reduced-price hospital care. Many facilities have programs for people who are struggling financially. Community Catalyst, a consumer advocacy group in Boston, has an interactive map that can help you find relevant laws and policies in each state.
But it can be a challenge looking for charitable assistance and applying for it. The Affordable Care Act has several provisions designed to help uninsured or underinsured patients who can't afford hospital care. The law says that all nonprofit hospitals must develop a written policy on financial assistance, including information on who's eligible and how to apply, which they must make "widely available" to the public.
In addition, hospitals will no longer allowed be to charge uninsured patients the full list price for their care. And hospitals can no longer engage in aggressive bill-collecting tactics, like garnisheeing wages, putting liens on a home, or turning a debt over to an outside collection agency, without first making "reasonable efforts" to determine whether a person is eligible for financial assistance. But the government has yet to issue regulations or guidance on how the provisions are to be enforced, according to Jessica Curtis, director of the Hospital Accountability Project at Community Catalyst.
So for now it's up to you to aggressively pursue free or reduced-price care, Curtis says. Start with the hospital billing office, social worker, or patient representative. If you don't get satisfactory results the first time, keep trying. Curtis says hospital staff members might not know about the policy, even though they're supposed to.