Where Can You Go For Medical Care If You Don’t Have Insurance?
If you don’t have health insurance, you can still receive medical care from various clinics and emergency rooms where you can pay out of pocket or apply for financial assistance. Traditional health insurance isn’t the only way to get financial help for medical expenses; alternatives range from affordable government plans to Zoom clinics. There are ways to maintain your health without depleting your wallet.
Table of Contents
- Where Can You Go For Medical Care If You Don’t Have Insurance?
- The Challenges of Being Uninsured
- How Does Getting Medical Care Without Insurance Work?
- How Much Does Healthcare Cost for Uninsured Patients?
- Medical Care Options for Uninsured People
- Should You Get Medical Insurance?
- Beyond Traditional Health Insurance
- Navigating Financial Challenges Without Insurance
- The Importance of Preventive Care
- All in All
- Frequently Asked Questions
The Challenges of Being Uninsured
If you’re uninsured, you’re not alone. Around 1 in 10 Americans, or 30 million Americans, don’t have health insurance, primarily due to insurance’s high costs. The uninsured tend to be racial and ethnic minorities, people with less education, and people with lower incomes.
Government research indicates that people without health insurance coverage are at increased risk for serious health problems. Without a regular health care provider, the uninsured are likelier to skip routine health care that prevents serious problems. In addition, some states have health mandates that could lead to fees at tax time.
So even if you don’t have insurance, it’s important to get screenings or other interventions for diseases or conditions that become more expensive if untreated. You’ll also need medical care if you’ve been injured, are experiencing an emergency, or need medication.
How Does Getting Medical Care Without Insurance Work?
If you don’t have insurance, you still have access to care. Insured people pay a premium (monthly payment) to be enrolled in a plan, which helps reduce routine and emergency care costs. Plans compliant with the Affordable Care Act (ACA) provide a wide range of preventive care for free.
People without insurance should look for the term “self-payer” when reviewing pricing. But you may need to perform more research to accomplish your goals. You’re also unlikely to get free preventive care as with an ACA-compliant plan.
Rights for Uninsured Patients
Uninsured patients still have the same rights as insured patients.
- Emergency Care: The 1986 Emergency Medical Treatment & Labor Act (EMTALA) ensures emergency services regardless of ability to pay.
- Informed Consent: To gain your consent for any medical procedures or intervention, the doctor should explain the procedure’s nature, risks and benefits, and risks and benefits of alternatives.
- Privacy and Confidentiality: Care providers must protect your health-related information due to your rights under HIPAA.
- Access to Medical Records: HIPAA also gives you the right to access your medical records.
- No Surprise Bills: You can dispute charges if your final bill is more than $400 above the “good faith” care cost estimate provided before care.
- Complaint and Grievance Procedures: All states have methods for gathering complaints about care or provider behaviors if you feel you received inadequate or inappropriate care.
How Much Does Healthcare Cost for Uninsured Patients?
Insurance lowers the cost of treatment by both negotiating lower rates and sharing in paying for costs. Without insurance, you’ll pay the “self-pay” rate.
Here’s an idea of what some common treatments might cost:
Medical Service or Treatment
Average Cost Without Insurance
Primary care provider appointment in hospital outpatient facility
1-hour therapy session
Hospital stay per day, room only (no procedures)
Uncomplicated vaginal childbirth in a hospital
Chemotherapy session in a hospital
Hip replacement surgery
Coronary artery bypass surgery with one graft, plus anesthesia
Appendectomy for ruptured, infected appendix, with anesthesia in a hospital
Colonoscopy with anesthesia
Medical Care Options for Uninsured People
If you don’t have insurance but still hope to avoid the costs of serious illness — or are facing an emergency medical condition — here are several options.
Community Health Centers and Low-Cost Clinics
Community health centers offer millions of uninsured Americans primary care for free or on a sliding scale, including vaccinations for children and prenatal care. In some areas, you can also get help with oral health, pharmacy, mental health, and drug and alcohol treatment. If the center doesn’t coordinate services, providers can give referrals for specialized services. Find a health center near you to discover services available to you.
Retail clinics may be a stand-alone location or attached to a pharmacy. These walk-in clinics offer lower-cost same-day treatment for urgent illnesses and injuries. Primary care with preventive services may also be provided, which can include wellness exams, health screenings and lab tests, prescription refills and vaccinations. Some clinics are also expanding into specialty care, including dermatology, mental health, and women’s health. Clinics share pricing upfront, so you know how much you’ll pay out of pocket that day.
More states are expanding telehealth services, which allow you to use a secure video link to communicate with a clinician or physician. Some are associated with retail clinics or existing physician networks, while others are stand-alone services. These visits may be less expensive than many comparable, in-person services.
However, virtual care appointments don’t meet every need. For example, depending on your state or clinic, you may be unable to get a diagnosis for ADHD, confirm ear or skin infections, or get a sports physical done.
Urgent Care Centers
Urgent care centers may be attached to a hospital or health system but offer services at lower costs and shorter wait times than a hospital emergency room. These centers can be more equipped to deal with serious injuries, such as an X-ray machine to screen for broken bones. Unlike an emergency room, urgent care centers aren’t open 24 hours. They’re also unsuitable for primary or preventive care like the above options.
Hospital Emergency Room
An emergency room provides 24-hour care and focus on life-saving measures. Even if you’re uninsured, a hospital emergency room cannot turn you away if you’re experiencing an emergency, defined as any incident that is:
- Severe or life-threatening
- Seriously impairing bodily functions or organs
- When childbirth is imminent
However, you may not be seen if your condition isn’t an emergency, and you still must pay the (often very expensive) bill that results from hospital emergency room care.
Should You Get Medical Insurance?
Medical insurance can be expensive and difficult to understand — but insurance helps prevent debt by reducing unexpected, emergency, budget-breaking medical costs. Insurance benefits can also slow or stop the development of chronic diseases and related expenses. You can find discounted or low-premium insurance through the ACA Health Marketplace, or you may also be able to get insurance through your employer.
Finding a Policy in the Future
- Assess Your Healthcare Needs: Consider your situation, including any pre-existing conditions, family history of disease or health conditions, and plans such as pregnancy or children.
- Compare Healthcare Plans: Often, it’s easy to compare plans based on premiums alone. But also review the network available to you, any coverages, out-of-pocket costs, and exclusions to coverage.
- Explore Government Programs: Federal and state programs offer Medicaid for lower-income adults, Medicare for those 65 and older, and CHIP for children. Check eligibility requirements to access these free to lower-cost plans.
- Apply: Apply for insurance through your employer or the ACA Health Insurance Marketplace during the open enrollment period or a Special Enrollment Period.
- Review Plan: When you get the plan documents, carefully review the plan’s fine details to ensure your care is covered as expected. You may need to follow special procedures to choose a primary care provider, get a referral to an in-network specialist, or file a claim.
- Pay Premium: Your first premium payment activates the insurance plan, and you’ll receive an insurance card in the mail. However, make sure your plan coverage is active before visiting the doctor.
Beyond Traditional Health Insurance
There are a few alternatives to traditional health insurance — some more legitimate and valuable than others. Here’s what to watch out for and how to qualify for alternatives to insurance.
Medicaid and CHIP
Medicaid provides low-cost or free health insurance for lower-income adults, while the Children’s Health Insurance Program (CHIP) offers children free and reduced routine and emergency care. The states administer these programs, so income and qualification requirements depend on which state you live in.
In general, you’ll qualify based on your income, family size, and situation. For example, if you’re pregnant or have certain disabilities, you’re more likely to qualify. The best way to see if you qualify is to apply through the ACA Health Insurance Marketplace. If you (or family members) qualify, the site sends information to your state agency, which helps you enroll.
Short-Term Health Insurance Plans
Depending on your state, short-term plans are intended to offer affordable coverage if you’re between plans or job-based insurance. Coverage may last just a few months or renew for more than a year, depending on your state, and typically come with high deductibles.
However, short-term health insurance plans don’t provide ACA-compliant plan protections or benefits. An ACA-compliant affordable alternative for those who qualify is a catastrophic health plan, which you can purchase through the ACA Marketplace.
Discount Medical Cards
Discount medical cards may be marketed as insurance, but they are not. Instead, these cards give buyers access to a discount honored by participating doctors. However, not all providers accept the cards, and you may find it challenging to use the discount cards.
The U.S. Federal Trade Commission (FTC) warns that while some discount medical plans offer real discounts, others are scams. Discount prescription cards are widespread and may be available from your state, city, or private provider for no fee.
Healthcare Sharing Ministries
Healthcare-sharing ministries are primarily Christian nonprofit organizations where participants “share” healthcare costs. These ministries are not a form of insurance. The plan may not cover preexisting conditions, preventive care, or guarantee expense reimbursement — even in an emergency. Ministries can offer lower-than-average pricing for participation, but many state attorneys general have issued alerts regarding deceptive marketing.
Navigating Financial Challenges Without Insurance
Even if you’ve successfully found healthcare, you’ll still need to pay the bill at some point. Coming up with the money to pay down medical debt can be nerve-wracking.
- Financial Assistance Programs: Hospitals, states, and nonprofits offer “charity care” programs to help uninsured patients pay medical bills. To apply, follow the Consumer Financial Protection Bureau’s advice, or ask the billing department how to apply for charity care.
- Medical Bill Negotiation: Ensure your bill’s charges and services are accurate. Then, try to negotiate directly with the billing department and propose a realistic payment plan. You can also suggest an amount that would settle the entire debt, but the provider doesn’t have to agree to your plan. Try to take this step before the bill goes to collections.
- Payment Plans and Medical Credit Cards: If you negotiate a payment plan, you’ll send monthly payments to the care provider. If you agree to a lump-sum amount, you can take out a personal loan to pay off the bill or use a credit card. Certain cards, such as Care Credit, are intended specifically for medical/dental use.
- Medical Fundraising: Online tools such as GoFundMe, PlumFund, or CoFundHealth can help crowdfund medical bills. However, you won’t necessarily raise enough money to pay the bills, and each platform deducts a percentage of funds raised.
The Importance of Preventive Care
Even if you don’t have insurance or a primary care physician, you can still reduce your risks of expensive conditions such as cancer, stroke, diabetes, high blood pressure, and other problems. A medical provider’s preventive care includes annual physical and dental checkups, screenings based on your family history and individual needs, and keeping vaccinations current.
You can also make choices in your daily life that reduce your risks. For example, healthy eating reduces a wide variety of disease risks. Choose nutritious, fresh vegetables and fruits, whole grains, and low-fat meats and dairy products.
Moderate to vigorous exercise reduces the chance of broken bones and disease and improves brain health. Getting enough sleep for your age can reduce your chances of depression, diabetes, and obesity.
Resources for Uninsured People
Uninsured people can access free or low-cost preventive care, such as regular screenings, through several sources:
- Public Health Departments: Many health departments offer public health clinics that include maternity support services, family planning, vaccinations, infectious disease screening, and supplemental food programs, among others.
- Nonprofit Organizations: At community nonprofit organizations, uninsured patients may find multilingual medical, dental, health, and mental health services, 24-hour nurse lines, and education programs focused on nutrition, health, and fitness.
- Health Fairs: These events combine family-oriented fun (games, music) with health and wellness education and free services, including screenings, vaccinations, exams, and dental services for uninsured people.
- Prescription Assistance Programs: States may offer prescription drug assistance for those who qualify due to age (65 or older) or income level.
All in All
Health insurance provides essential benefits alongside preventive care that boosts your health. Insurance reduces overall medical costs and the risk of getting stuck with unexpected medical bills after an emergency. However, insurance can also be costly. Investigate low-cost, discounted, or government insurance options, including catastrophic plans that still offer free preventive care.
Research affordable care available to uninsured patients in your community. Look into costs for everyday, urgent, and emergency situations. This might be knowing which urgent care charges the least to look at a sore throat or where you can find the most-affordable flu shot. Having some affordable options in your back pocket can make life easier when the situation arises.
With planning and research, you can create a workable, short-term plan until you can find a health plan extending essential coverage, peace of mind, and a monthly premium that fits your budget.