5 Places to Check out Medical Care for the Uninsured

By Tisha Tolar on 27 April 2009 (Updated 22 February 2010) 13 comments



With job loss on the rise and many people who can not afford medical insurance on their own, yet don't qualify for state or federal assistance, there are many who will skip medical treatment to save money. Your health is certainly not something you can take likely.

Here are 5 places you can check out when you need medical help but don't have the insurance to cover it:

Your Family Doctor

Many individuals do not realize it but you can still see your family physician without insurance and be able to afford it. It may take some gumption but approach your doctor about a reduction in rates for services because you are willing to pay cash. Many doctors are happy to work with you because they will likely get more money and get it in a faster time period than when having to deal with insurance or Medicare.

Health Care Centers

These are not the “free clinics” you might have in your community but there are health care centers regulated and sponsored by the federal government. These centers provide primary, preventative and dental services to people of all ages, based on a sliding payment scale. This means you pay for services based on how much income you make. Check out findahealthcenter.hrsa.gov to find a center in your area.

Planned Parenthood

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or services may be even lower than normal, but you will typically you'll be charged what you can afford, based on your income. Women can receive family planning services, plus other treatment and testing for STD's, pap tests, breast exams, and birth control for little or no cost. Be sure to call first to discuss your finances if you do not have insurance. You'll be able to get a ball park figure for how much it will cost prior to going to your appointment. ** UPDATE: An astute reader pointed out that PP is not only for women and men are welcome to be sure their reproductive and overall health is on track.**

Convenience Clinics

These are the walk-in health centers located in major retail shopping chains such as pharmacies and Walmart. Typically, these clinics are staffed by RN practitioners and physician's assistants who can treat and prescribe medications for general colds, flu, and infections. They can also help treat and do preventative check-ups for conditions such as diabetes and high blood pressure. The costs will vary from clinic to clinic and depends on your illness or treatment plan. Some places will offer “a la carte” services and some will charge a “flat-rate fee” for services rendered.

Free Screenings

Many community groups, civic organizations, and local hospitals will offer regular free clinics for specific screenings of disease such as cancer, diabetes, heart problems, high blood pressure, and other conditions. Check in your local news paper or group newsletter to see what is coming up in you area and take advantage of the free (or at least discounted) health services. Early detection of many diseases can certainly save your life.

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Guest's picture
Maria

You may not have intended it, but your wording made it sound as though Planned parenthood is only for women. Guys are welcome too! Beyond making sure our reproductive parts are working well, many PP clinics offer flu shots and other health services we don't normally associate with procreation. Spread the word!

Guest's picture
Trix

A very helpful post for me as I'm one of the well-educated working uninsured (which sucks, yo). However, that first link- ahealthcenter.hrsa.gov - doesn't go anywhere, so not quite so helpful actually. Correct link, please?

Guest's picture
Trix

I found the correct link of the health centers. Looks like you left out the "find". -- http://findahealthcenter.hrsa.gov/

Guest's picture

Great post.

This is very timely for many people. I would add if you know you will be laid off or fear it-- get all your medical and dental visits in while you still have coverage.

Tisha Tolar's picture

I appreciate your correcting my link - the result of posting late at night when my eyes can't focus!  Big help for catching the bad link. Sorry about that!! Correcting now!!

Guest's picture
Katie

As mentioned in a previous Wise Bread article, Walgreens in house clinics are offering some services free for recently unemployed and their families.

Guest's picture
Guest

FYI: Most people who don't have insurance or money for doctors do not even have a "family" doctor (and one assumes you mean a GP?).

Getting a referral from a friend to a physician may get them a name and a visit, but it's still the exception for physician to negotiate down their fees--cash or not. If you're lucky, they will treat you and let you pay as you go. Or give you an extended payment plan.

In many places, many physicians are already NOT taking any kind of insurance (government or private)--and require cash or credit card payment at the time of visit. These folks tend to have more reasonable fees (but not always), but again you need to pay up front.

You need to bring up the money issue with a physician because he has to understand that you may not be able to afford followup visits, tests or meds he would routinely order. My sister in law is going thru this now in Florida.

Her doctor has driven her to tears in his office by ignoring her and writing up tons of tests and meds --plus dragging out office visits instead of consolidating---and making it seem as if my sister in law is NOT choosing to get treatment--like she has the money but can't spend it. Hardly the case.

If you want to negotiate, you need to talk to the office or practice manager. The doctors themselves rarely get involved in this (maybe in a very small community). Being calm, polite and honest about your situation can help. Don't panic, don't pressure, don't beg and do not demand. The payment issue affects treatment options and timing, so it is part of the whole medical service.

I once had to have emergency surgery. I met the doctor who would ultimately perform it less than 24 hours before I ended up having surgery. As I waited in his office afterwards (his nurse had to get me into a hospital), I explained the situation to the office manager (no insurance, would have to pay myself, self-employed). She told me what she thought the hospital bills might be (Huge and out of her hands. The cost of my two-day stay for minor surgery? I could have stayed at a five-star spa for maybe a month!)

Then she told me the doctor's fee. It wasn't cheap, but it was reasonable, especially in comparison to the other costs involved.

I'm fairly certain that the surgeon's fees, which included weekly visits for four months and twice a week visits for two post surgery, were greatly reduced as they were only slightly more than the anesthesiologists (for 15 minutes work!).

It never hurts to ask. And it never hurts to reiterate: How can we combine visits, tests? How can we schedule treatments to be sure it's the most cost effective.

As a last resort, you can ask for any other local resources or physicians who might help.

As for the store clinics you mention, their quality varies greatly and they really are only good for small, not serious stuff. They're not going to be the folks who really check you out and can identify serious concerns you may not even be aware of.

It's a sad thing in our country today where people cannot afford either preventative care or even emergency care.

The system is set up to charge more to those who can least afford it. (And for those folks who pay insurance and are so annoyed because they feel they are "subsidizing" the healthcare of others? Wake up. That's not the case. You should be more upset in the inequality of what people are charged for the same level of care in the same facility based on WHO their insurer is or whether they have them. There are plenty of people without insurance who are in debt, have been forced to sell their homes, etc. to pay bills for services that are billed to them many times over what YOU pay. THEY are often subsidizing YOUR healthcare!)

Julie Rains's picture

I go to a family doctor also known as a family physician. I have a high deductible plan, meaning that I pay for nearly everything (though I do receive plan-negotiated discounts). I am often annoyed at the lack of understanding of some, not all, practices in regard to treatment costs and practices. My family practice is hospital/corporate owned and I doubt they'd consider a price break for upfront cash (though I would love for healthcare organizations to learn more about cash flow); however, I haven't tried (I figure it's just as easy to wait the several months it takes to process invoices and then pay) -- but privately run practices (there are just a few of these in my area) may be more likely to take cash upfront as they do understand cash flow principles.

Speaking of places to get inexpensive healthcare, I was just talking to a FNP (Family Nurse Practitioner) who volunteers at a faith-based clinic that provides discounted services to the working uninsured.

Guest's picture

Hello everyone,

I posted this same basic comment, on the "great deals" forum, but I think it's definitely worth posting here as well...

If you've had good experiences with discount plans (like I have), you may want to look at this website I found called, http://www.helpfulbenefits.com. It contains three different "benefit packages" and one if them is a Health Benefits package. It basically combines 5 different health benefit plans for about $17/month...which included my entire family. The plan contains discounts with prescriptions, vision care (through Coast-to-Coast), dental care (through Aetna Dental Access), chiropractic care, and some program called Teladoc (which you can call and talk live to a doctor - no charge).

The website also has benefit packages for other "non-health related" things like LifeLock and Legal Care Direct. All the packages seem to be around $15/month, and they include your immediate family. Anyway, great experiences all the way around, and great bang for your buck.

-Jeremy

Guest's picture
Guest

Thank you so very much for stating the blatently obvious!

Guest's picture

Here are a few simple thoughts to help with negotiations. Almost every customer in a medical office has a contract based on Medicare reimbursement rates negotiated by their insurance company before they are seen. If Medicare pays $100 for a particular item, then commercial insurance at 130% of Medicare would pay $130. Medicaid would pay 70-80% of Medicare or $70-80 for this item. Uninsured patients pay a fee unrelated to Medicare referred to as charges. This could be $250 if the practice decided to charge this much. Obviously, uninsured patients that don't negotiate ahead of time pay very high rates for their care, because they just pay charges.
I would recommend that you ask if you could pay Medicare or a percentage above Medicare rates taken from their most recent payment by Medicare. Ask if they would be willing to take 130% of Medicare if you pay when you leave the office. State your case clearly, I will pay in cash when leaving. I am not asking for charity care. You receive the same amount of money that insurance will pay in 45-90 days. As a patient I will pay in full. I will not ask for your money back like the insurance sometimes does and I will be very grateful for the help. I am a better customer than a patient with commercial insurance.

Mark Clapp, MD
Samaritan Diagnostics
sdsaves.com

Guest's picture

Here are a few simple thoughts to help with negotiations. Almost every customer in a medical office has a contract based on Medicare reimbursement rates negotiated by their insurance company before they are seen. If Medicare pays $100 for a particular item, then commercial insurance at 130% of Medicare would pay $130. Medicaid would pay 70-80% of Medicare or $70-80 for this item. Uninsured patients pay a fee unrelated to Medicare referred to as charges. This could be $250 if the practice decided to charge this much. Obviously, uninsured patients that don't negotiate ahead of time pay very high rates for their care, because they just pay charges.
I would recommend that you ask if you could pay Medicare or a percentage above Medicare rates taken from their most recent payment by Medicare. Ask if they would be willing to take 130% of Medicare if you pay when you leave the office. State your case clearly, I will pay in cash when leaving. I am not asking for charity care. You receive the same amount of money that insurance will pay in 45-90 days. As a patient I will pay in full. I will not ask for your money back like the insurance sometimes does and I will be very grateful for the help. I am a better customer than a patient with commercial insurance.

Mark Clapp, MD
Samaritan Diagnostics
sdsaves.com

Guest's picture
Guest

where does one go when a medical condition prevents you from work...no insurance, needing surgery, no money no help, no hope!!
all MD s require some money, hospitals and emeergency rooms want to know how you will pay before they will see you, too young for medicare, takes two years to be declared disabled --all this in the fine state of texas.