House Call Doctor rounds up the current resources that may be available to people without health insurance.
After the U.S. Supreme Court upheld the Affordability Care Act, I was reminded of my experiences working in the public health system, taking care of many patients without health insurance. Along with losing their jobs, their homes, and their life as they knew it, many people also lost their health insurance. It was a sad experience to witness the grief that so many endured after the economy took a plunge. Very sick people were all of a sudden left without health care and I was seeing patient after patient in great emotional and physical distress. Here are some examples of my encounters:
A patient with a breast mass so large and so suspicious for cancer that you couldn’t miss it sitting across the room
A young 20-something with new-onset seizures whose family watched him recurrently fall to the floor and seize before they allowed themselves to call 911
A well-educated couple living in their car after losing their jobs and unable to afford their medication
A hardworking, eager male with a brain aneurysm operated on less than one year ago, without follow-up since, urging me to release him to go back to work because of his increasing financial debt
Reminiscing of these difficult times reminded me of how many people out there still could use some guidance in regards to accessing health care. So I’ve compiled a list of 14 resources that can potentially help some people who have had to do without health insurance.
See also: Legal Lad’s Take on Obamacare
1. Low-Cost Clinics: Depending on your county of residence, it may either have a public clinic health system or a community clinic system in place. Find out which one, then do an internet search to find the nearest low-cost clinic. Co-payments are typically based on an income sliding scale. You will likely be asked to provide proof of income and proof that you live in that particular county as well.
2. Medicaid: This is an American state-run program with strict income requirements. Rules and eligibility may vary from state-to-state. In the state of California for example, it’s currently geared towards those with children younger than age 18, pregnant women, and people with disabilities. Depending on your income, it may be extended to certain adults with children, as well. Check out their website for more info: www.cms.gov/home/medicaid.asp.
3. Medicare: This is a program for people aged 65 and above who have worked and contributed towards Medicare in their lifetime. Patients with certain disabilities and people on dialysis are also eligible. Part A is for inpatient hospital coverage and Part B is for outpatient/clinic services. It’s important to remember that Medicare doesn’t cover everything. There may be a monthly premium and deductible. Please refer to the Medicare website for more info and an online application: www.medicare.gov/default.aspx.
4. Emergency Medicaid: This program covers only potentially “life-threatening” conditions. Some examples may include catastrophic motor vehicle accidents, acute strokes, and seizures. Chronic or non-emergency issues, such as most fractures or lacerations are not typically covered. Immigration status is not a factor in determining eligibility. Please refer to the Medicaid website listed above.
5. Disability: This is a program for the disabled, such as some people with autism, mental delay, or paraplegia. The Social Security office typically has a list of physicians with whom they contract and who will meet and examine you for eligibility determination. You can find more info at: www.ssa.gov>.
6. Prenatal Care: Whether you are a legal or illegal resident of the United States, you are covered by Medicaid for your prenatal services once you become pregnant and are living in the United States. Please refer to the Medicaid website above.
7. County-Run Health Programs: Some counties may institute a program, but not a comprehensive insurance plan, for those without health insurance and in need of urgent health coverage and an inability to afford this care. Contact your local county hospital to inquire about an existing program in your area.
8. Breast and Cervical Cancer Detection Programs: Uninsured, low-income women may be eligible for free or low-cost breast cancer screenings and pap smears through a program sponsored by the Center for Disease Control (CDC) for women living in all 50 states. To find your local program, go to the CDC website: www.cdc.gov/cancer/nbccedp. For those living in the State of California, this program is paid for by federal grant and state tobacco revenue, and is called the “Cancer Detection Program: Every Woman Counts” (CDP) through the California Department of Public Health, and may be found at: www.cdph.ca.gov/programs/cancerdetection/pages/cancerdetectionprogramseverywomancounts.aspx
9. Contraception and Family Planning Services: Title X Family Planning Program is the only federally funded program designed to provide access to contraception and family planning services, such as pap smears, STD testing and treatment, pregnancy testing, and breast examinations and mammograms. Services are free or low-cost for those without insurance coverage. To learn more about this program, go to: www.hhs.gov/opa/familyplanning/index.html. To find your local clinic providing these services, go to: www.opaclearinghouse.or/db_search.asp.
10. Women, Infant, Children (WIC) Program: This is a federal program that provides grant funding to states for nutrition and food for kids less than or equal to age 5 and pregnant women with low incomes. Eligibility is regardless of immigration status. You can learn more at: www.fns.usda.gov/wic/default.htm.
11. Optometry Services: For those without health insurance, or for those with Medicaid (which no longer covers adult dental or optometry services), I often refer to the local Costco, Walmart, or Target optometry departments for an exam which costs about $50 currently. Also, glasses tend to be more affordable at these locations.
12. Medications: Walmart and Target pharmacies have a nice long list of medications for around $4 a month, or $9 for a 3 month supply. Many well-prescribed medications are on this list, including those for diabetes, hypertension, hyperlipidemia, thyroid disease, and much more. The cost for these medications is often even less than most insurance co-pays. For more info, please refer to their corresponding store websites.
For those living in the state of California, here are two other programs you may want to learn more about:
13. California Children’s Services (CCS): A state program that covers children up to age less than or equal to 21 meeting income criteria and in need of coverage for a specific disease or health problem. Other states besides California have similar programs for children. However, coverage is typically for only one diagnosis and must be on their “approval list,” such as Cystic Fibrosis, Hemophilia, Cerebral Palsy, etc. It covers all visits and treatments for the specified diagnosis only. Refer to their website for more information: http://www.dhcs.ca.gov/services/ccs/Pages/default.aspx
14. California Healthy Families Program: Covers only children who do not qualify for Medicaid services. There may be a small monthly premium. Similar programs exist in other states.
Despite all of these resources, many patients still are left without coverage – particularly the working class, unfortunately. Have you ever been without insurance? If so, what is your personal experience? Share it with us on the House Call Doctor’s Facebook and Twitter pages!
Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.