Essential health care resources to know about if you’re broke

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Since even a minor illness could wipe out your emergency fund, it’s essential to have some kind of health insurance. Depending on your income, you might not have to pay for it if you buy through the health care marketplace.

That doesn’t mean your troubles are over. In some cases (including my own) “affordable” insurance amounts basically to catastrophic coverage. That’s because our deductibles are so high that we’re wary about seeking medical care.

Some people have no coverage at all. Either they don’t believe in the Affordable Care Act, or they (mistakenly) believe they’re so healthy they don’t need insurance.

The following health care workarounds will help folks with high deductibles, and also those who (for whatever reason) don’t have insurance.

Read more: Your prescription history isn’t really private

Care on a sliding scale

Nationwide, more than 8,500 federally qualified health centers provide prenatal care, sick visits, annual checkups and ongoing care for babies and children. Some of these places also offer oral health, substance abuse, mental health and vision treatment.

State public health clinics provide varying degrees of basic care. Depending on where you live, you can receive ongoing exams, immunizations (including flu shots), family planning/pregnancy testing, well-child exams, mental health services and testing for sexually transmitted diseases.

The National Association of Free & Charitable Clinics offers links to more than 1,200 free and low-cost healthcare providers around the country. You might find one in your area.

Finally, dial 2-1-1 (a nationwide clearinghouse for social services) and ask about care options in your area. For example, the North Helpline agency in Seattle hosts two clinics per week, one of them free to the uninsured and the other operating on a sliding-scale basis. Maybe something like that exists in your area, too, but you won’t know unless you ask.

Need a hospital?

Read your insurance policy to learn which hospital(s) the provider prefers. If you’ve just been hit by a truck, the paramedics will want to take you to the closest emergency room – and you should let them! But if you slip on an icy sidewalk or take a spill during a bike ride, you have the luxury of choice.


However, you may not need to head for the ER. Say you twist an ankle during a softball game or develop a fever and cough on a Saturday afternoon. Such issues could likely be handled by an urgent care clinic, which are staffed with doctors and/or nurse practitioners.

These “doc in the box” centers cost less and you’ll probably get treated faster there than you would at a busy ER. You might not even be charged for the visit if they want to refer you elsewhere. Find out which urgent care facilities are on your insurance provider’s preferred list.

Women’s health issues

Medicare, Medicaid and most insurance programs cover the cost of mammograms and Pap smears in full. Here are some options for the un- or underinsured:

American Breast Cancer Foundation – Grants are available to pay for diagnostic treatment. Learn more at 844-219-2223 (toll-free).

The National Mammography ProgramFree mammograms and other services, plus continued treatment after abnormal test results or cancer diagnosis.

NBCCED – The National Breast and Cervical Cancer Early Detection Program provides free or low-cost screening to eligible women, plus services such as HPV tests, pelvic exams and further testing/referrals.

Susan G. Komen FoundationCheck the organization’s website or call 877-465-6636 (toll-free) to find low-cost mammography options in your region.

The YWCAFree cervical cancer screenings and mammograms are available in some parts of the United States.

Planned ParenthoodWomen’s health exams, including but not limited to birth control, cervical cancer screenings, plus pelvic and breast exams, all on a sliding-scale basis.

Local sources. Try doing a search for “free mammograms/Pap smears + [your city].” You might discover options that don’t show up anywhere else.


Cheaper (or free!) medications

Some meds – including but not limited to antibiotics, generic Lipitor, prenatal and children’s vitamins and the diabetes drug Metformin – are available for free at certain supermarket chains. Among them: Amigos United, Giant Eagle, Meijer, Price Chopper, Publix, Reasor’s, Schnucks, ShopRite and Wegman’s.

Those on extremely limited incomes may get free or deeply discounted meds. Apply for assistance through groups like NeedyMeds, MyGoodDays and the Partnership for Prescription Assistance.

Or go generic, i.e., $4 per month deals at Wal-Mart and other discount stores and pharmacies. Use a site called to find generic equivalents of the drugs you need.

No generic available? Sites like and let you find the cheapest prescriptions in your area.

Finally, ask your doctor if you can split pills – for example, buying 20-mg tablets and halving them for your 10-mg dose. Not all drugs can be safely divided, however. So you must ask first!

About online pharmacies

You can buy online even if no mail-order pharmacy is associated with your insurance plan. Be aware, however, that some Internet drugstores are bogus. The Mayo Clinic website notes that in some cases prescriptions have “turned out to contain no active ingredient or to contain the wrong medicine.”

Order only from pharmacies based in the United States, since it is illegal to import non-FDA-approved drugs. Before ordering, run the pharmacy’s name through

Do not use Canadian virtual drugstores. The National Association of Boards of Pharmacy notes that some source their meds from countries where standards may be lax and counterfeit pills more common.

One last tip

When you’re in financial crisis it’s tempting to ignore your body’s calls for help. Don’t tough it out: Pay attention to small health issues so they don’t become big problems.

A relative’s husband ignored an infection and it landed him in the hospital on an antibiotic IV drip. Far better to go to the public health clinic than to wind up in the emergency room.


Read more: How to tell if your doctor is being paid to steer you to certain drugs

(Excerpted from “Your Playbook For Tough Times: Living Large On Small Change, For The Short Term Or The Long Haul,” by Donna Freedman – a book that Clark says “can inspire hope if you feel that you’ve reached a personal or financial dead end.”)

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