Eligibility Guide To Government Benefits & Family Resources
Free Or Low-Cost Medical Assistance
Medical costs can be a crushing burden on American families. They arrive unexpectedly, and few of us are prepared for them. Many Americans work in the informal or freelance economies and don’t have employer-provided health insurance. Millions have no insurance at all, and many who are insured are opting for low-cost plans with deductibles as high as $5000. Many families just can’t cover that kind of expense, and medical costs have emerged as America’s leading cause of consumer bankruptcy. That prospect leads many people to avoid or postpone care that they need, a dangerous decision that can have a serious impact on long-term health. If you are facing medical expenses and don’t have the resources to pay for them, bankruptcy is not your only option. Low-cost care is available if you know where to look.
Most of us know that medical facilities cannot turn patients away because of an inability to pay. That’s not always the best solution because those services can leave bills that can take years to pay off and may do long term damage to your credit rating. If you are uninsured or underinsured, you are wise to seek out affordable providers before an emergency arises.
What to Look for
-Community Health Centers – Government funded clinics serve communities in both urban and rural areas. They are open to all community members regardless of whether they have private insurance, Medicaid or Medicare, are under-insured, or are uninsured. Most centers provide prenatal care, vaccinations, general primary care, referrals for specialized care, mental illness services, substance abuse support, HIV/AIDS testing and treatment, and many other services. You may have to pay for services, but the fees are usually substantially less than a hospital, urgent care, or private doctor’s office, and if you are in need, there will be systems to assure that you get affordable care.
-Sliding Scale Fee Facilities – A sliding scale facility offers variable pricing for services based on the patient’s ability to pay. These facilities consider the patient’s income and may inquire about your assets. Facilities operate on a predetermined equivalency. What you pay is based on your family income. You should be prepared to present evidence of your income and expenses.
-School Wellness Centers – Some larger schools, especially in urban areas, offer medical services for students. Services include treatment for sick students, lab work, routine check-ups, sports physicals, immunization, mental health care, and substance abuse support. Check at your teen’s school to see what, if any, services it provides.
-Free Clinics – Non-profit, non-government, privately owned and operated facilities may provide services only to persons with no insurance who do not qualify for Medicaid or Medicare. They may extend services to the underinsured who have only catastrophic care coverage with high deductibles. Services are available to undocumented aliens. Clinics offer basic services such as treatment for illness or injury, long-term chronic conditions, some lab work, some prescription drugs, women’s health, and possibly dental care. They may not be able to help with chronic pain because they often do not carry the license necessary to distribute narcotics.
-Non-Profit Organizations – The Susan G. Komen Organization is just one example of a nonprofit organization that funds community programs. Their local affiliate programs provide services such as free mammograms to uninsured women.
Where to Find Providers
Several databases are available to help you search for services in your area. Check the Links at the end of this article!
-Needymeds.org is a comprehensive database with information about low-cost facilities with sliding scale facilities. Their website lists facilities that provide some financial assistance. You will want to read carefully, not assuming that all facilities listed provide free services.
-The Health Resources and Services Administration, a project of the US Department of Health and Human Services, is the most current, complete source of information on community clinics.
-The Office of Disease Prevention and Health Promotion is another program of the US Department of Health and Human Services. This database has information beyond free and low-cost providers and expands to a wide range of providers including community clinics, hospice care, hospitals, dentists, and other providers.
-The National Association of Free and Charitable Clinics operates approximately 1200 Charitable Clinics nationwide targeting the “underserved.”
What About Insurance?
Free or low-cost insurance is available to families and individuals with limited income, both through government insurance programs and the Health Insurance Marketplaces established under the Affordable Care Act. Programs like Medicaid, Expanded Medicaid, and the Children’s Health Insurance Program (CHIP) provide insurance to families with severely constrained incomes. If your annual income falls below the line set by your state under either Medicaid, Expanded Medicaid, or CHIP you may apply for Medicaid. It is not necessary for you to enter the Marketplace and choose your coverage if you are eligible for Medicaid. Many of these plans are managed at the state level, and you will have to check the specific criteria in your state to see if you qualify.
Health Insurance Marketplaces offer cost assistance to qualified individuals and families with incomes too high to qualify for Medicaid. The Marketplace will automatically calculate your subsidy. 85% of the people enrolled in these exchanges are receiving some subsidy with an average amount of $291 a month. For most of us, that amount means something!
Why the Discussion?
When Congress passed the Affordable Care Act in 2010, many Americans anticipated a universal insurance provision giving all residents access to free care. The actual legislation fell well short of this goal: A 2012 report from the Congressional Budget Office predicts that there will still be 30 million uninsured non-elderly Americans in 2024.
For the uninsured or underinsured, the need to find low-cost medical assistance has never been greater. Knowing about the services in your area and making use of specific clinics and providers with manageable fees can save you hundreds of dollars in medical bills. You can use that money for many other important things, so it makes sense to keep track of free or low-cost care opportunities in your area! Don’t fall into the trap of postponing care or treatment because you’re worried about how to pay for it. Leaving that issue untreated might be setting yourself up for much worse problems and much higher costs in the future. Use the services that are available and deal with problems as soon as you can. Care doesn’t have to be expensive, and health is priceless!
Health Resources and Services Administration
Office of Disease Prevention and Health Promotion
The National Association of Free and Charitable Clinics