Accessing Cancer Care If You Don't Have Insurance

Author: Christina Bach, MBE, MSW, LCSW, OSW-C
Last Reviewed: January 30, 2023

An estimated 28 million Americans do not have health insurance. While this number has dropped a great deal since the passing of the Affordable Care Act (the ACA or “Obamacare”), there are still many people without health insurance. And yes, these people still get cancer. Lack of health insurance is a barrier to getting cancer care.

If you don’t have insurance and have a medical emergency, go to the emergency room. You cannot be turned away because of your immigration status or ability to pay.

Healthcare Marketplace

If you are a US citizen, or lawfully present in the US, you may be able to purchase health insurance through the healthcare marketplace. You can buy a plan through www.healthcare.gov.

  • During open enrollment, which begins November 1st every year. The deadline to enroll varies depending on what state you live in. You can learn more about enrollment deadlines here.
    • When your coverage begins depends on when you enroll. If you enroll by December 15th, your coverage will begin on January 1st. If you enroll by January 15th, your coverage will begin February 1st.
  • During a special enrollment period. If you have a “qualifying life event” you may be able to buy a plan through the healthcare marketplace at a different time of the year. These events include:
    • You lose your health insurance.
    • There are changes in your household: you got married, divorced, or had a child.
    • There are changes in where you live: you move to another residence, zip code, or county. This also applies to students and seasonal workers.
    • You have a change in income (making more or less can impact eligibility for premium tax credits and cost-sharing).
    • You become a citizen.
    • You are released from prison/jail.
    • You become a member of a federally recognized tribe or recipient of Alaskan Native Settlement Claims act.
    • AmeriCorps members starting/ending service.

Learn more about the ACA and purchasing a plan in our OncoLink Health Insurance Webinar Series here.

Medicaid

  • Medicaid provides full health care coverage to individuals and families who meet income criteria.
  • However, each state has different rules for eligibility and different types of Medicaid plans available.
  • Contact your county assistance office to get more information about eligibility and how to apply. You can find contact information for your county/state here.

Children’s Health Insurance Plan (CHIP)

  • Provides health insurance for children who are uninsured and not eligible for Medicaid.
  • Your child can keep the coverage until they are 19 years old.
  • You must be a US citizen or meet immigration requirements.
  • Each program is run by the state, so eligibility and plans may be different from state to state.
  • Learn how to apply for CHIP here.

Charity Care/Hospital-Based Financial Assistance

As part of the Patient Protection and Affordable Care Act (ACA), non-profit hospitals are required to provide free or discounted care to patients who cannot afford to pay. Each hospital has different guidelines for eligibility. Ask to speak to someone at your hospital about financial assistance programs and how to apply. Your social worker can also help you with this.

Federally Qualified Health Centers (FQHC) / Community Health Centers

FQHCs are community health clinics that provide general health care services. For most people, there is no charge for a visit with a provider, and all lab work and medications are free. Community health clinics are located in both urban and rural areas. They may also be able to refer you to partner facilities for specialized care. To find a center near you, go to https://findahealthcenter.hrsa.gov/

Hill-Burton Programs

Some hospitals receive funding through a federal program called Hill Burton. These facilities must give an amount of free or low-cost healthcare to people who cannot pay and don’t have insurance. For a list of these facilities see Hill-Burton Facilities/HRSA click here.

If You are a Veteran

You may be able to access healthcare services through the Veteran’s Administration (VA). What kind of care and where you can get it may be related to your level of service connection (if you have illness/injury due to service/combat). You may also qualify for healthcare services if you were honorably discharged or retired from military service. To learn more about VA coverage and eligibility visit: https://www.va.gov/health-care/#get-va-health-care

If You Live in Texas

If you don’t qualify for Medicaid in Texas, you may be eligible for County Indigent Care to access healthcare services. You must live in Texas and meet income and asset guidelines. Learn more about this program here: https://www.hhs.texas.gov/services/health/county-indigent-health-care-program

If You are Undocumented / Not Lawfully Present

If you are not a US Citizen or lawfully present in the US, you may have a hard time accessing healthcare and insurance. DACA recipients are not able to buy insurance through the healthcare marketplace and may not be eligible for Medicaid. Your immigration status impacts what options you have. It also depends on where you are in the US. Some states have more coverage for individuals who are not lawfully present.

Some states have programs available to help certain groups of immigrants, such as pregnant women, even if they are undocumented. The National Immigration Law Center has information on programs available by state, visit this link to learn more.

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