How do I get health insurance when I can't afford it?

You can get free or low-cost health coverage by applying through the Health Insurance Marketplace or your state's Medicaid program.

💡 Government Programs & Subsidies

• Medi-Cal (California Medicaid): Provides free or low-cost coverage if your household income is low. You can apply at any time of the year.
• Marketplace Subsidies: Visit HealthCare.gov or California's state exchange, Covered California, to see if you qualify for tax credits that lower or eliminate monthly premiums based on your household size and income.
• Open Enrollment: Standard enrollment runs from November 1 through January 15, but qualifying life events (like losing a job or moving) allow you to enroll anytime via a Special Enrollment Period.

🏥 Free and Low-Cost Care Options

• Federally Qualified Health Centers (FQHCs): Community-based clinics that offer primary medical and dental care on a sliding-fee scale based on what you can pay. You can find local options using the HRSA Health Center Finder.
• County Programs: Los Angeles County residents can access low-cost services through county safety-net facilities and programs like My Health LA regardless of immigration status or ability to pay.
• Dial 211: Call 211 or visit 211 LA to connect with local community health resources and financial aid programs in your specific neighborhood.

People who cannot afford health insurance often delay necessary medical care, accumulate severe medical debt, or face worse health outcomes, and thousands face preventable death each year.

Impact of Being Uninsured

• Delayed Care: Uninsured adults are twice as likely to delay or skip seeing a doctor or filling prescriptions due to cost.
• Medical Debt: Going without coverage frequently leads to massive out-of-pocket bills—such as tens of thousands of dollars for a hospital stay—resulting in collections, credit damage, or bankruptcy.
• Worse Health Outcomes: Lack of routine management for chronic conditions like diabetes or high blood pressure leads to severe emergencies and a higher mortality rate.

Emergency Protections and Alternatives

• Emergency Rooms: By federal law, emergency rooms must stabilize patients during a life-threatening crisis regardless of their ability to pay, though the hospital will still bill you for the cost.
• Free or Low-Cost Clinics: Uninsured individuals can often receive care on a sliding scale at Federally Qualified Health Centers or local safety-net hospitals.
• Financial Assistance: Nonprofit hospitals are required by federal law to offer charity care or financial assistance policies to low-income patients who cannot pay their bills.

If you cannot afford your health insurance payments, you can explore government programs, update your income details, or switch to a lower-cost plan.

Explore Government Assistance Programs

• Check for Medicaid or CHIP: Visit HealthCare.gov to see if your lowered income qualifies you or your children for state Medicaid or the Children's Health Insurance Program, which offer free or very low-cost coverage.
• Update Your Marketplace Income: If you get insurance through the Affordable Care Act Marketplace, report any drop in income immediately. A lower reported income can increase your federal premium tax credits and lower your monthly cost.
• Look into Medicare Extra Help: If you have Medicare, check if you qualify for the Part D Low-Income Subsidy (Extra Help) or Medicare Savings Programs to reduce prescription and premium costs.

Adjust Your Coverage

• Switch to a Bronze or Catastrophic Plan: Move to a lower-tier plan with lower monthly premiums during an open enrollment or qualifying life event window. Keep in mind these plans have higher deductibles and out-of-pocket costs when you receive care.
• Check for Hardship Exemptions: If the lowest-cost plan available costs more than a specific percentage of your household income, apply for an affordability or hardship exemption through HealthCare.gov to unlock access to catastrophic coverage.

Use Alternative Community Care

• Visit Community Health Centers: Use federally qualified health centers or free and charitable clinics for low-cost or sliding-scale primary medical care.
• Ask for Hospital Charity Care: Contact local hospital financial counselors to apply for non-profit financial assistance or indigent charity care programs.

You can get free or low-cost medical care without money or insurance by visiting a local Community Health Center.

Where to Go for Care

• Community Health Centers / FQHCs: Federally Qualified Health Centers use a sliding fee scale based on your income. They provide primary care, dental care, and mental health services. You can locate one near you using the HRSA Health Center Locator.
• Free and Charitable Clinics: Local volunteer-run facilities offer free medical, dental, or pharmacy services to uninsured people. Find a nearby site using the National Association of Free & Charitable Clinics tool.
• Public and County Health Departments: Local health departments offer free or low-cost immunizations, STI testing, and reproductive health services.
• Hospital Emergency Rooms: By law, emergency rooms must treat life-threatening conditions or severe injuries regardless of your ability to pay or insurance status. However, ER visits are very expensive and should be saved for true emergencies.
• Public Hospital Charity Care: Many public and non-profit hospitals offer charity care programs that completely forgive or reduce medical bills for low-income patients. Ask the hospital billing office about their financial assistance policy.

Many people afford health insurance through employer-sponsored plans, government programs like Medicaid, or income-based subsidies on the Affordable Care Act (ACA) marketplace, though rising costs leave many struggling.

People use several key approaches and programs to manage and afford coverage:

Government and Marketplace Programs

• ACA Marketplace Subsidies: Many enrollees lower their monthly payments using income-based tax credits, though expiration of enhanced federal credits has increased premiums for many. You can check your options on HealthCare.gov.
• Medicaid and CHIP: Low-income adults and children qualify for free or low-cost coverage through state-administered Medicaid programs.
• Employer-Sponsored Plans: Most working Americans rely on company-provided plans where employers pay a large portion of the monthly premium, though family coverage and deductibles can still be costly.
• Medicare: Adults aged 65 and older access coverage through Medicare, with low-income beneficiaries utilizing "Extra Help" for prescription drug costs.

Coping Strategies and Financial Assistance

• High-Deductible Health Plans (HDHPs): Consumers choose plans with lower monthly premiums paired with high deductibles, often using Health Savings Accounts (HSAs) to save pre-tax money for medical bills.
• Hospital Charity Care: Uninsured or underinsured individuals apply for sliding-scale fees or financial assistance directly through local hospital financial aid programs.
• Cutting Essentials: Many households report reducing spending on other basic necessities, such as food and utilities, to pay for rising health insurance premiums and medications.