Tips and Tricks for Accessing Free and Low-Cost Healthcare

Key takeaways:

• Discuss your healthcare costs in advance and try to negotiate lower prices with hospitals and providers.
• Some healthcare providers — including free and charitable clinics as well as federally qualified health centers and safety-net hospitals — specifically serve those who are uninsured or underinsured.
• Enrolling in government health insurance programs, such as Medicare, Medicaid, and the Children’s Health Insurance Program, typically reduces out-of-pocket costs.

Having limited financial resources when you need medical care can raise concerns about your health and your budget. Still, there are options if you lack insurance or are underinsured. In addition to insurance coverage underwritten by the government, free and low-cost healthcare is available for adults, including seniors, and children.

How much do uninsured Americans pay for healthcare?

Uninsured people are charged more for their healthcare and typically pay more out of pocket. That’s because they don’t benefit from the reduced rates negotiated by private health insurance companies and public insurers such as Medicare and Medicaid. Additionally, most uninsured people do not receive discounted or free health services. Kaiser Family Foundation (KFF) found that in 2015, only 27% of uninsured adults reported receiving free or reduced-cost care.

Specifically, the research revealed that while people who lack insurance spend less on medical services than those with health insurance, the uninsured pay a far larger portion of medical costs out of pocket for the care they access. In 2014, those without insurance who used medical services paid $752 out of pocket, the KFF research found, compared to $658 for people with private health insurance coverage and $236 for those covered by public health insurance.

How can I get medical treatment without insurance?

Hospitals and clinics of all kinds will accept patients who do not have insurance. Some offer an uninsured patient discount or financial assistance programs.

Certain health centers were created to care for people who lack insurance and to work with them regarding payment. These providers include:

• Free and charitable clinics, which are specifically for “medically underserved” people, such as those without access to insurance. Typically, there is no charge for care, and, if there is a pharmacy, medications are provided at no cost. The National Association of Free & Charitable Clinics has more than 1,400 locations that can be searched by ZIP code or city and state with its Find A Clinic tool.
• Federally qualified health centers, known as FQHCs, are community health facilities funded by the federal government to provide medical care in underserved areas. Also known as community health centers, they charge patients based on ability to pay.
• Safety-net hospitals and clinics are comprehensive health centers that may be called county hospitals, public hospitals, or essential hospitals. They are designed to provide services to all people, including those who lack health insurance coverage. You can find a safety-net hospital on this state-by-state list or by searching online for a safety-net hospital, county hospital, public hospital, or essential hospital in your area.

How much does it cost to go to the ER without insurance?

An emergency room visit can set you back more than $1,000. According to the Agency for Healthcare Research and Quality, the average cost for an ER visit was $1,010 in 2018. The average national price has been north of $1,000 since 2015. If possible, [ask about prices upfront][14].

Why do the uninsured typically pay the highest prices?

As previously noted, people who are uninsured usually don’t have a financially responsible party advocating for a lower cost of services. According to KFF, people without insurance are sometimes asked to pay the full medical bill at the time of service. At that point, many negotiate a payment plan, pay with credit cards (often with high-interest rates), or are turned away. Among uninsured adults in 2015, 33% were asked to pay for the full cost of medical care before they could see a doctor, KFF reported.

Medicaid

One of the best ways for uninsured people to receive free and low-cost healthcare is to apply for government insurance programs such as Medicaid.

Medicaid covers more than 75 million people as of April 2021 and is the largest single source of health insurance in the U.S. The federal program is administered by states to provide health coverage to low-income children through the Children’s Health Insurance Program (known as CHIP), as well as to people who are pregnant, parents, seniors, and individuals with disabilities. Eligibility is determined by income and family size, among other factors. Emergency Medicaid is one of the only federal government health insurance programs available to undocumented immigrants.

Children’s Health Insurance Program (CHIP)

Comprehensive health insurance coverage is provided to about 10 million children in the U.S. through the Children’s Health Insurance Program, known as CHIP. Eligibility is targeted to low-income children and, in some states, low-income pregnant women.

Federally qualified health centers (FQHC)

Federally qualified health centers, or FQHCs, are community-based primary care providers funded by the federal government for underserved populations and areas. Also known as community health centers, they charge patients based on a sliding scale. According to the Health Resources & Services Administration, FQHCs serve 1 in 5 people who are uninsured. Use your ZIP code to locate an FQHC with the Find a Health Center search tool.

Safety-net hospitals and clinics

Safety-net hospitals and clinics are comprehensive health centers also known as county hospitals, public hospitals, or essential hospitals. They are designed to provide services to all people, including those who lack health insurance coverage, and provide billions of dollars in uncompensated care to the uninsured. Search this state-by-state list to find a safety-net hospital, county hospital, public hospital, or essential hospital in your area.

Rural health clinics

Rural health clinics were created to provide access to primary care and preventive services in rural areas for people covered by Medicare and Medicaid. There are more than 4,500 rural health clinics nationwide.

How can I get my medical bills forgiven?

Debt forgiveness, also known as debt cancellation, happens when a creditor stops pursuing collection. Forgiveness usually doesn’t affect your credit score, but if the forgiven debt is reported to the IRS, the amount could be taxed as income. Debt settlement — or paying less than what’s owed — can impact your credit score, and the unpaid portion may be reported as income for tax purposes.

The bottom line

Uninsured people can face a double whammy of medical expenses: higher prices charged for services and more due out of pocket. Accessing free and low-cost healthcare at a federally qualified health center or safety-net hospital can help you avoid both. To reduce costs, discuss charges upfront. Also, check your eligibility for government health insurance programs. If you qualify for Medicare, Medicaid or CHIP, you can greatly reduce out-of-pocket expenses. Remember to always check RxSaver for a prescription coupon before check out at the pharmacy.