Healthcare Cost Assistance: Programs Most People Miss
Healthcare costs are among the most destabilizing financial burdens. What most people do not know: significant help is available, and much of it is unused.
The Healthcare Cost Problem
Healthcare costs are unique among household expenses in their potential to be both unpredictable and catastrophic. Even households with insurance face substantial out-of-pocket costs when healthcare needs are significant. And households without insurance face even greater challenges. The good news: a substantial infrastructure of assistance exists specifically for healthcare costs, and most of it is significantly underused because people are not aware of it.
Medicaid: Broader Than Many People Think
Medicaid provides free or very low-cost health coverage to income-eligible individuals and families. The Affordable Care Act expanded Medicaid eligibility significantly in most states, making it available to many working adults who previously did not qualify. In states that have adopted the expansion, Medicaid is generally available to adults with income up to 138 percent of the federal poverty level.
Many people who qualify for Medicaid are not enrolled — often because they do not know they qualify or have not applied since the eligibility changes. If your income is limited and you do not have health coverage, checking your Medicaid eligibility is the highest-priority healthcare cost management action available.
Hospital Financial Assistance Programs
Hospitals are required by law (under Section 501(r) for nonprofit hospitals) to have financial assistance programs for income-qualified patients. These programs — sometimes called charity care — can provide significant reduction or elimination of hospital bills for qualifying patients. The programs are often not proactively offered; patients who request financial assistance are more likely to receive it. If you receive a hospital bill that you cannot pay, contact the hospital’s billing department and ask specifically about financial assistance programs.
Prescription Cost Programs
Prescription drug manufacturers offer patient assistance programs that provide free or reduced-cost medications to qualifying patients. The NeedyMeds and RxAssist databases provide searchable information about available programs. GoodRx and similar services provide discount pricing at participating pharmacies independent of insurance. State pharmaceutical assistance programs provide additional help in many states, particularly for seniors on fixed incomes.
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