How to Get Free or Low-Cost Healthcare Without Insurance
About 28 million Americans are uninsured. A lot of them are also eligible for free coverage and do not know it — or they know about Medicaid but nothing else. Beyond Medicaid, there are federally funded clinics that charge based on income, manufacturer programs that provide brand-name drugs for close to nothing, and Marketplace plans that cost under $20/month after subsidies for many low-income households. Here is what exists and how to access it.
Medicaid: the first place to check
If your income is below roughly 138% of the federal poverty level and you live in a state that expanded Medicaid (41 states plus DC as of 2024), you likely qualify for Medicaid — free health coverage with no premiums and very low copays.
Apply through your state's Medicaid agency or through Healthcare.gov. You can apply at any time of year; Medicaid does not have an open enrollment period. If you are approved, coverage typically starts the month you apply or the month before.
CHIP for children
Children up to 19 years old in households that do not qualify for Medicaid may be eligible for CHIP — the Children's Health Insurance Program. CHIP covers families with income up to 200-300% FPL in most states, at low premiums and small copays. Like Medicaid, CHIP applications are accepted year-round.
If your children do not have health coverage, CHIP should be your first call. Apply through your state Medicaid agency or at insurekidsnow.gov.
Federally Qualified Health Centers (FQHCs)
Federally Qualified Health Centers are community health clinics that receive federal funding to serve low-income patients regardless of insurance status or ability to pay. FQHCs charge on a sliding fee scale based on income — patients at the lowest income levels pay very little or nothing.
There are approximately 1,400 FQHCs operating more than 14,000 service sites across the country. Find the nearest one at findahealthcenter.hrsa.gov. FQHCs provide primary care, dental, mental health, and prescription services.
Free clinics
Beyond FQHCs, free clinics operated by nonprofits and volunteers provide basic medical care at no cost. These are often operated by medical schools, faith organizations, or volunteer networks. Care quality and available services vary significantly. The National Association of Free and Charitable Clinics (nafcclinics.org) maintains a directory.
Free clinics typically cannot provide complex specialty care, surgery, or hospitalization. They are best for primary care, basic prescriptions, and referrals.
Prescription assistance programs
Most major pharmaceutical companies have patient assistance programs that provide free or reduced-cost medications to uninsured or low-income patients. These programs have income requirements and require an application, but they can cover brand-name medications that are otherwise unaffordable.
NeedyMeds.org and RxAssist.org maintain comprehensive directories of manufacturer assistance programs. Community health centers can also help navigate these programs.
ACA Marketplace subsidies if your income is above Medicaid limits
If your income is above the Medicaid limit (138% FPL in expansion states) but below about 400% FPL, you may qualify for significant subsidies on Marketplace health insurance. Many people in the 200-300% FPL range can get coverage for $10-50/month after subsidies.
Open enrollment runs November 1 through January 15 in most states. If you lose job-based coverage, become eligible for subsidies, or experience a qualifying life event, you have a 60-day special enrollment period.