Jeffrey Wade
In 2021, 8.3% of Americans, or roughly 27.2 million people, had no health insurance. This means that many people are faced with unaffordable medical bills and debt. However, being uninsured does not mean that there are no avenues to get health coverage. Hospitals that accept federal money must provide a certain amount of free or reduced-fee care. Doctors, clinics, and hospitals may offer reduced fees to people who do not have insurance, and generic medication is usually less expensive than branded medication. Additionally, some states provide charity care, or medical care that is free or has reduced rates. To find out about the Medicaid program in your state, you can call the Centers for Medicare and Medicaid Services (CMS) at 1-877-267-2323 or visit www.medicaid.gov.
| Characteristics | Values |
|---|---|
| Options for those without insurance | Doctors, clinics, and hospitals may offer reduced fees to people who do not have insurance. This is more likely to happen if the person discloses this information before their appointment. |
| Hospitals that accept federal money must provide a certain amount of free or reduced-fee care. | |
| Community health centers can provide basic medical care, such as vaccinations. | |
| Medicaid provides free or affordable medical care in Georgia, Texas, and other states. | |
| Medicare is a federal insurance program available to those younger than 65 years with a disability and have received Social Security Disability Insurance (SSDI) for at least 24 months. | |
| Charity care, medical care that is free or has reduced rates. | |
| Generic medication is usually less expensive than branded medication. | |
| Hospitals and other healthcare centers may offer affordable payment plans to people facing large medical bills. |
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What You'll Learn
Check eligibility for government-sponsored insurance
To check eligibility for government-sponsored insurance, you must first determine your immigration status. Official websites ending in .
As of 2023, undocumented immigrants are generally not eligible for federally funded coverage, including Medicaid, the Children's Health Insurance Program (CHIP), Medicare, or Affordable Care Act (ACA) Marketplace coverage. However, there are some exceptions and alternative options to consider.
Firstly, Emergency Medicaid may cover the costs of emergency care for immigrants who meet all other eligibility criteria except for their immigration status. Secondly, as of April 2025, 14 states plus Washington D.C. provide comprehensive state-funded coverage to children regardless of their immigration status. Therefore, checking state-specific programs is crucial.
Additionally, lawfully present immigrants may be eligible for Marketplace coverage and can qualify for premium tax credits and other savings on Marketplace plans. To determine eligibility, factors such as income, state residency, and immigration status are considered. For example, "qualified non-citizens," including some Lawful Permanent Residents, may be eligible for coverage through Medicaid and CHIP if they meet state income and residency rules. However, there may be a waiting period for some qualified non-citizens before they can receive benefits.
It is important to note that eligibility rules and restrictions can vary by state and change over time due to court orders and other factors. Therefore, it is essential to refer to official government websites and consult specific state guidelines to determine your eligibility for government-sponsored insurance accurately.
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Explore free or reduced-cost services
If you are undocumented, you may only be able to access federal benefits that are deemed necessary to protect life or guarantee safety in dire situations. This includes emergency Medicaid, access to treatment in hospital emergency rooms, and access to healthcare and nutrition programs under the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). To be eligible for these emergency services, undocumented immigrants need to meet all of Medicaid's other non-financial and financial eligibility requirements.
The Emergency Medical Treatment and Labor Act (EMTALA) ensures that all patients, regardless of citizenship or immigration status, have access to emergency medical treatment. Under EMTALA, Medicare-participating hospitals cannot turn away individuals who need life-saving care. Undocumented immigrants' use of EMTALA-related services is often covered via emergency Medicaid.
In some states, undocumented immigrants can access free or reduced-cost services at community health centers. These centers can provide basic medical care, such as vaccinations.
Additionally, doctors, clinics, and hospitals may offer reduced fees to people without insurance. This is more likely to happen if the patient discloses this information before their appointment. Fees vary by location, so it is a good idea to contact local hospitals and healthcare centers in advance to ask about their average fees for an appointment. This can also help locate clinics that offer free or sliding-scale services.
Generic medication is usually less expensive than branded medication and has the same active ingredients, risks, and benefits. Hospitals and other healthcare centers may also offer affordable payment plans to people facing large medical bills.
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Contact hospitals for free or reduced-fee care
If you require medical care and do not have insurance, doctors, clinics, and hospitals may offer reduced fees for those who are uninsured. This is more likely to happen if you disclose your lack of insurance before your appointment. Fees vary by location, so it is a good idea to contact local hospitals and healthcare centers to ask about their average fees for an appointment. This can also be a good way to locate clinics that offer free or sliding-scale services.
For example, Wisconsin Community Health Centers serve patients regardless of their insurance status and offer a sliding fee scale for people without insurance. The cost is based on income. Similarly, some states provide "charity care," or medical care that is free or has reduced rates. Additionally, Medicaid provides free or affordable medical care in certain states, including Georgia and Texas. To find out if you are eligible for Medicaid, you can check the program's website. Many states have expanded their Medicaid programs to cover all people below certain income levels.
If you are in need of mental health support, some community mental health centers offer free or low-cost counseling services. These centers often provide a range of services, including individual and group therapy, crisis intervention, and medication management. To find a community mental health center near you, you can search online or contact your local health department.
It is important to note that while these options can provide access to medical care without insurance, the availability and specifics of these programs may vary depending on your location. It is always a good idea to contact the hospitals and healthcare centers directly to understand their specific policies and offerings.
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Compare coverage options and costs
Comparing coverage options and costs is an important step in getting medical insurance. Undocumented immigrants face significant challenges in accessing health insurance due to their limited access to private and federally funded coverage options. They are not eligible for federally funded programs such as Medicaid, the Children's Health Insurance Program (CHIP), Medicare, or Affordable Care Act (ACA) Marketplace coverage. This leaves them with a restricted range of private coverage options and state- or locally-funded programs.
Private coverage options outside the ACA Marketplace are available for undocumented immigrants, but affordability is a significant concern due to limited incomes and the absence of subsidies. Some undocumented immigrants may obtain coverage through their employer or as a dependent of an employee. Student health programs can also provide coverage for this group. Additionally, six states (California, Illinois, Massachusetts, New York, Oregon, and Washington) and Washington, D.C., offer state-funded coverage to income-eligible children, regardless of immigration status. California has expanded its program to include young adults through its Medicaid program, funded solely by the state.
State-funded programs, such as Washington's 1332 waiver program and Oregon's Healthier Oregon, provide alternatives for undocumented immigrants to access health coverage. These programs allow eligible individuals to enroll in the same health plans as household members with regular marketplace coverage. Oregon's program ensures that all enrollees can choose from a range of managed care plans, regardless of their immigration status.
Community health centers and charity or community clinics can be good options for those without insurance. They often provide basic medical care, such as vaccinations, and may offer services at reduced rates or for free. Additionally, doctors, clinics, and hospitals may offer reduced fees for uninsured patients, especially if they disclose their uninsured status before the appointment. Fees can vary by location, so it is advisable to contact local healthcare providers in advance to understand their pricing and payment plans.
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Apply for Medicaid, Medicare, or Social Security
If you are a non-citizen, you can still get many benefits and services without a Social Security number. You do not need a Social Security number to obtain private health insurance. However, if you are applying for government benefits or services, you may need to apply for a Social Security number. To do this, you will need to present current original documents or copies certified by the issuing agency. These documents can include an I-94 Arrival/Departure Record with an unexpired foreign passport or an I-766 Employment Authorization Document (EAD, work permit) from DHS.
If you are 65 or older, you can enroll online in Medicare Parts A and B, or Part A only. If you are under 65, you may still be eligible for Medicare if you have permanent kidney failure or receive Disability benefits. You can apply for Medicare by calling 800-772-1213 and telling the representative that you want to apply. If you are deaf or hard of hearing, you can call TTY +1 800-325-0778.
You can apply for Medicaid at any time of the year. You can apply online, in person, or over the phone. To apply, you will need to contact your local Department of Social Services (DSS). You can find your local DSS by searching in the directory or calling the Medicaid Contact Center. You can also schedule an in-person or phone interview. If you need an interpreter, language services are available at DSS offices.
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Frequently asked questions
The best place to start is the Marketplace in your state. The Marketplace site will ask you basic questions about your income, family size, and where you live, and will provide an overview of the insurance options (both private and public) for which you qualify.
The Marketplace is a new way to find quality health coverage. It can help if you don’t have coverage or if you have it but want to look at other options.
Medicaid is a state-based assistance program serving low-income people under the age of 65. Patients usually pay no part of the costs for covered medical expenses, although a small co-payment may be required. Each state sets its own guidelines regarding eligibility and services.
Medicare is a federal insurance program available to those under 65 with a disability and who have received Social Security Disability Insurance (SSDI) for at least 24 months. Medicare enrollees pay part of the costs through deductibles for hospital and other costs. Small monthly premiums are required for non-hospital coverage.
Doctors, clinics, and hospitals may offer reduced fees to people who do not have insurance. This is more likely to happen if the person discloses this information before their appointment. Hospitals that accept federal money must provide a certain amount of free or reduced-fee care.
