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- You can go to any hospital without insurance
- In the United States, every hospital is required to treat you even if you do not have any health insurance
- You may be responsible for paying the full price of your bill if you do not have health insurance
- In some cases, if you are a low-income individual and qualify for Medicaid, the hospital will enroll you in Medicaid on the spot
- You do not always have to go to the hospital unless it is an emergency, there are other ways to receive healthcare when you are uninsured
- If you do not have health insurance, you may be responsible for paying the individual mandate penalty fine
Can I go the hospital if I do not have health insurance?
Hospitals in the United States of America are required to provide service to anyone in the case of an emergency so you can go to any hospital. However, you may be responsible for covering the entire cost of this visit which can be expensive.
It is important to not put off an emergency visit due to the expense because you are putting your health at risk.
If you meet the income requirements, some hospitals might enroll you in Medicaid when you are there for your medical visit. Medicaid will then help cover the costs of the services at the hospital.
Medicaid will also pay for treatment of a serious medical emergency for those who meet Medicaid requirements but do not have the required immigration status to enroll in Medicaid.
States that did not expand their Medicaid program under the Affordable Care Act may have different requirements for enrollment than states that did. This information could be subject to change if the Affordable Care Act is repealed.
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What is Medicaid?
Medicaid is a public health insurance program for low-income individuals and families. Benefits and eligibility factors can vary depending on the state you live in. However, there are certain regulations that all states must comply with.
All states must cover certain low-income families and children, pregnant women in most cases, and anyone that receives supplemental social security.
Under the Affordable Care Act, Medicaid must cover all ten of the essential health benefits as well. The 10 essential health benefits categories include:
- Ambulatory services
- Hospitalization and emergency services
- Maternity care
- Prescription drug coverage
- Mental health services
- Rehab devices
- Laboratory tests
- Pediatric services
All health care plans available for purchase on the health care exchange marketplace and Medicaid must cover dental and vision services for children, although it is not a required benefit for adults.
Preventive and wellness services must also be covered by all of these plans with limited out-of-pocket costs. This includes immunizations and annual check-ups with your primary care physician.
If you live in a state that expanded Medicaid, you can qualify for Medicaid if your income is less than 138 percent of the federal poverty level. If your state did not expand Medicaid, you might still qualify with this income level but other factors will impact your eligibility. You should apply for Medicaid regardless.
Although some hospitals may automatically enroll you in Medicaid if you meet coverage requirements, it is a good idea to apply on your own if you do not have health insurance and think that you might qualify.
Mediciad Application Process
You can apply for Medicaid in one of two ways. You can fill out an application through the Healthcare Exchange Marketplace. The Marketplace will then forward your information to your local Medicaid agency who will contact you about your eligibility and enrollment.
You will need your personal information, such as name, address, income, and the number of people currently residing in your household. When you apply through the Marketplace, you will also find out if you are eligible for a plan with significant savings and tax subsidies even if you are not directly eligible for Medicaid.
The other way you can apply is through your state’s Medicaid agency. You can find the contact information for your particular state online. You can also apply by going to your state’s office in person and speaking to a representative.
If you are looking for free or low-cost health insurance for your children but your income is just over the federal poverty level, you should consider applying for the Children’s Health Insurance Program.
The program works closely with state Medicaid offices and offers similar benefits. You can apply for the Children’s Health Insurance Program in the same way that you would apply for Medicaid.
Are there other medical providers that will see me at their offices if I do not have health insurance?
If you are experiencing a serious or emergency medical condition, you should go to a hospital for help. Keep in mind that a hospital can not turn you away in an emergency and you should not put off medical help because of the costs.
However, if you need medical help for a less severe condition, there are other doctor’s offices that you can go to that might cost less than a hospital visit.
Some primary care providers will let you pay a monthly fee in cash that allows you to see them in their office at regular intervals. This option is often more affordable than you think. Urgent care centers are another viable option. They often charge a similar price to primary care providers which is much cheaper than a typical hospital.
Many urgent care centers have equipment that is similar to what you might find in a typical emergency room including x-rays, which makes them a reliable and most cost-effective hospital alternative.
Walk-in clinics, which are often small offices found in larger pharmacies or supermarkets, can also be helpful if you are just looking for a common vaccination or treatment for a minor illness or infection that requires antibiotics. Walk-in clinics are often significantly cheaper than your local medical provider.
If you are really worried about cost, you should look into a community health clinic in your area. Many of these clinics offer services for free or on a low-cost sliding scale depending on your income. They can be particularly helpful for vaccinations, prenatal care, and preventive services.
If you are a student, you should see if your school has an on-campus clinic. Although they do not have the same equipment that you might find in an emergency room, they are often suitable, affordable options for minor illnesses.
What is the individual mandate penalty fine?
If you do not have health insurance, keep in mind that you may be responsible for paying the individual mandate penalty fine. The fine for not having insurance is calculated either as a percentage of your income or as a flat fee.
Not having health insurance will cost either $695 per every uninsured adult in your household and $347.50 per uninsured child with a maximum set to $2,085 or 2.5 percent of your household income.
You will pay whichever of the two is greater. If you only went without health insurance for a short period of time that was less than three full months, you might qualify for a short coverage gap exemption and will not have to pay the fine.
What hospitals can I visit without insurance?
In the United States, a hospital cannot turn you away during a medical emergency. However, it can be expensive to pay out of pocket at a hospital so if it is not a true medical emergency, you may want to consider a cheaper option such as a community health clinic.
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