Start here: which guide fits your situation?
Pick the line that sounds most like you. Each opens a full step-by-step guide.
I have no health insuranceHow to apply for Medicaid and find out if you qualifyCheck Medicaid first - any time of year.I earn too much for MedicaidHow to get affordable health insurance on the ACA MarketplaceMarketplace plans with tax credits.I missed open enrolmentMissed open enrolment? How to get health insurance with a Special Enrollment PeriodLife events that let you enrol now.My children need coverageHow to get free or low-cost health insurance for your kids (CHIP)CHIP and Medicaid for kids.I am pregnantPregnant without insurance? How to get Medicaid for pregnancyHigher limits, care from day one.I need a doctor now with no insuranceLow-cost doctor visits without insurance: community health centresSliding-fee care for everyone.I have a hospital bill I cannot payCan't pay a hospital bill? How to get it reduced or forgivenCharity care and bill reduction.I am on Medicare and costs are too highMedicare Savings Programs: how to get help paying Medicare premiumsHelp with premiums and drugs.
Step-by-step guides in this topic
Each guide answers one specific question in depth.
How to apply for Medicaid and find out if you qualifyApply for Medicaid through your state Medicaid agency or HealthCare.gov, which forwards eligible applications to your state. Eligibility depends…Read the guide →How to get free or low-cost health insurance for your kids (CHIP)CHIP, the Children's Health Insurance Program, provides low-cost health coverage for children up to age 19 in families that earn too much for…Read the guide →How to get affordable health insurance on the ACA MarketplaceBuy coverage on HealthCare.gov or your state's own marketplace during open enrolment each autumn, or within 60 days of a qualifying life event…Read the guide →Missed open enrolment? How to get health insurance with a Special Enrollment PeriodA Special Enrollment Period (SEP) lets you enrol in a Marketplace plan outside open enrolment, usually within 60 days of a qualifying life event:…Read the guide →Medicare Savings Programs: how to get help paying Medicare premiumsMedicare Savings Programs (MSPs) are run by state Medicaid agencies and help people on Medicare pay costs. The Qualified Medicare Beneficiary…Read the guide →Extra Help: how to lower your Medicare prescription drug costsExtra Help, also called the Part D Low-Income Subsidy, pays most or all of your Medicare drug plan premium and deductible and lowers copays for…Read the guide →Low-cost doctor visits without insurance: community health centresCommunity health centres, also called federally qualified health centres (FQHCs), provide primary care, and often dental, behavioural health and…Read the guide →Can't pay a hospital bill? How to get it reduced or forgivenTo reduce a hospital bill, ask the hospital's billing office for its financial assistance (charity care) application and apply - nonprofit…Read the guide →Can't afford your medication? Free and low-cost prescription helpTo lower prescription costs, ask your doctor about generics or cheaper alternatives; check whether the manufacturer runs a patient assistance…Read the guide →Where to get free or low-cost dental careFor low-cost dental care, try a community health centre with a dental clinic (sliding fees by income), a dental school clinic (reduced prices,…Read the guide →Free and low-cost mental health care and therapyIf you are in crisis, call or text 988 for the Suicide & Crisis Lifeline, free and available 24/7. For ongoing low-cost care, contact your…Read the guide →Lost your Medicaid? What to do next to get covered againIf your Medicaid ended, read the termination notice to see why. If it was for missing paperwork, contact your state Medicaid agency right away -…Read the guide →Pregnant without insurance? How to get Medicaid for pregnancyApply for pregnancy Medicaid through your state Medicaid agency or HealthCare.gov as soon as you know you are pregnant - there is no enrolment…Read the guide →How to get free or low-cost eye exams and glassesFor free or low-cost vision care, check Medicaid and CHIP (children's vision exams and glasses are covered; adult coverage varies by state); ask…Read the guide →
Programmes we point you to
Every one of these is free to apply for, and you apply directly. We are not affiliated with any of them and earn nothing from them.
Medicaid
What it isFree or very low-cost health coverage, run by each state.
Who it is forDepends heavily on your state - some cover most low-income adults, others cover far fewer. Children, pregnant people and those with disabilities qualify more widely everywhere.
How to applyThrough your state Medicaid agency, or by applying on the Marketplace, which forwards you automatically.
CHIP - coverage for children
What it isLow-cost coverage for children in families that earn too much for Medicaid.
Who it is forChildren, and in some states pregnant people. The income limits are considerably higher than most people expect.
How to applySame application as Medicaid - you are considered for both.
ACA Marketplace
What it isPrivate plans with income-based subsidies that often bring the monthly cost down sharply.
Who it is forAnyone without affordable coverage through work. Open enrolment runs each winter, with special periods after life changes.
How to applyAt HealthCare.gov or your state's own marketplace. Free local help is available in person.
Medicare Savings Programs and Extra Help
What it isProgrammes that pay Medicare premiums and cut prescription costs for people on a limited income.
Who it is forMedicare beneficiaries under the income and asset limits. Many who qualify never apply.
How to applyThrough your state Medicaid office, or Social Security for Extra Help. Free counselling is available from your state SHIP.
Community health centres
What it isClinics that charge on a sliding scale based on income, including dental and mental health in many locations.
Who it is forAnyone, insured or not. They cannot turn you away over inability to pay.
How to applyFind a centre near you and ask for the sliding fee schedule when you book.
Hospital financial assistance
What it isNonprofit hospitals are required by law to have a written financial assistance policy, which can reduce or clear a bill entirely.
Who it is forPatients under the hospital's income threshold - frequently well above the poverty line.
How to applyAsk the hospital's billing department for the financial assistance or charity care application, in writing.
What to have ready
- Photo ID and Social Security numbers for everyone applying
- Proof of income for the household - recent pay stubs or last year's tax return
- Immigration documents, if applicable
- Details of any coverage offered through a job
- For a hospital bill: the itemised bill, not the summary statement
Missing something on this list is rarely a reason not to start. Most offices will open a case and let you bring the rest afterwards — but the application date is what counts, so start now.
What people miss
The parts that are true, rarely explained, and change the outcome.
Nonprofit hospitals must have a charity care policy
It is a condition of their tax exemption. Many never mention it while a bill is in collections. Ask for the financial assistance application by name, and ask for it in writing.
Losing Medicaid opens a Marketplace window
Being dropped from Medicaid triggers a Special Enrolment Period, so you are not locked out until winter. The window is time-limited, so act when the letter arrives.
A health centre will see you without insurance
Community health centres charge on a sliding scale and cannot refuse you for inability to pay. For many people this is faster than resolving coverage first.
Always ask for the itemised bill
Hospital summary statements hide the detail. Itemised bills routinely contain charges for things that did not happen, and errors are easier to dispute than debts.
Extra Help is badly under-claimed
Hundreds of thousands of Medicare beneficiaries qualify for help with drug costs and never apply, usually because nobody told them it exists.
Coverage, care and bills are three different problems
Getting insured (Medicaid, CHIP, Marketplace), getting care while uninsured (community health centres), and dealing with bills you already have (hospital financial assistance) each have their own route. Work on all three at once rather than waiting for coverage before seeking care.
Common questions
I earn too much for Medicaid but cannot afford a plan. What now?
Check the Marketplace with your actual expected income - subsidies reach further up the income scale than most people assume. Check CHIP for any children separately; its limits are higher. And a community health centre will see you on a sliding scale meanwhile.
Can I get help with a bill from last year?
Often yes. Many hospital financial assistance policies apply retroactively, including to bills already sent to collections. Ask the hospital directly rather than the collection agency.
I missed open enrolment.
A life change - losing coverage, moving, having a baby, getting married, losing Medicaid - opens a Special Enrolment Period. Medicaid and CHIP have no enrolment season at all; you can apply any day of the year.
How do I get health insurance if I cannot afford it?
Apply through HealthCare.gov or your state Medicaid agency. The application checks you for Medicaid, CHIP and Marketplace subsidies at once. Many people qualify for free or very low-cost coverage, and Marketplace tax credits often cut premiums sharply.
Where can I see a doctor without insurance?
A community health centre, which charges on a sliding scale based on income and cannot turn you away for inability to pay. Find one at findahealthcenter.hrsa.gov or call 1-877-464-4772.
Can I get Medicaid any time of year?
Yes. Medicaid and CHIP have no enrolment period. Marketplace plans require open enrolment or a qualifying life event such as losing coverage, moving, marriage or a birth.
How can I lower my prescription costs?
Ask about generics, use a community health centre pharmacy, check manufacturer patient assistance programmes, and if you are on Medicare, apply for Extra Help through Social Security.
What should I do about a big hospital bill?
Ask the hospital for its financial assistance application and an itemised bill before paying. Nonprofit hospitals must offer financial assistance, which often reaches well above the poverty line, and many bills contain errors.
Is there help paying Medicare premiums?
Yes. Medicare Savings Programs, run by state Medicaid agencies, pay Part B premiums and, for the lowest incomes, deductibles and copays. Getting one also automatically enrols you in Extra Help for drugs.
Where can I get free or low-cost mental health care?
Community mental health centres, community health centres with counsellors, Medicaid, university training clinics, sliding-scale therapists and Employee Assistance Programs. In crisis, call or text 988.
Can my children get health insurance if I cannot?
Very often. Children qualify for Medicaid or CHIP at much higher family incomes than adults, so always apply for your children even if you do not qualify yourself.
What if I lost my Medicaid?
Read the notice. If it ended for paperwork, contact your state within the reconsideration period to be reinstated. If you no longer qualify, you have 60 days to enrol in a Marketplace plan.
Is there free dental or eye care?
Children's dental and vision care is covered by Medicaid and CHIP. Adults can use community health centre dental clinics, dental schools, free dental events and charity eyeglass programmes.
Related topics
Programme rules, income limits and deadlines change every year and differ
by state and county. We have deliberately left exact figures off this page so
it cannot go stale — follow the official links above for current numbers,
or call us and we will talk it through.