Last week, I got a call from a 40-year-old woman who wanted help to understand what she could do as she had no healthcare insurance and was recently diagnosed with Uterine Cancer. She told me that she started bleeding and went to the ED, where she was evaluated. The exam showed a mass in her abdomen, so she was admitted to the hospital, and a surgeon was called in. She was taken to the OR and had a hysterectomy. Post-operatively, she was seen by case management and financial services at the hospital because she had no insurance. She did not work as she was taking care of her parents, who both had medical problems. Her father was also having memory loss issues.

She was worried as she was starting to get bills from various providers. The financial people told her they would take care of her hospital bill, but she would need to pay for the multiple providers participating in her care. Specifically, she was worried about how she would be able to see her oncologist and get the lab work; the doctor said she would need to watch to ensure the cancer was eradicated and did not return.

Her oncologist said she did not need any more surgery or even chemo, but he wanted to watch her for the next few months to ensure the cancer did not return. She was worried about how she would get continued care with no insurance.

This is just one of many calls I receive from people who are unsure where to turn when they cannot afford healthcare Insurance or have high deductibles and have no funds to pay bills when they come in. We discussed some ideas she might consider, and I told her to call me if I could help.

Here are some strategies I suggested:

One was to ask her parents to see if they could set up a plan to pay her for taking care of them. As an only child, they depend on her.

Secondly, I gave her a contact I had who works with low-income people to apply for Medicaid or use Healthcare.gov to see if she would qualify for subsidies to help her with coverage costs. Unfortunately, she lives in Florida, which has not expanded Medicaid, so the threshold to qualify is low. She has some savings and was told they may disqualify her from Medicaid. I told her she might need to spend her savings to get care.

Last, I told her she needed to consider returning to work. She realizes she is in a challenging position that does not have a lot of options.

The Reality of the Situation

According to Forbes, health insurance is a vital part of financial planning that helps pay for people’s healthcare. This can include doctor and hospital bills, annual doctor visits, specialist visits, prescription drugs, mental health services, dental care, eye care, and other medical-related expenses.

Today, many Americans struggle to afford the cost of health insurance. According to the Kaiser Family Foundation, 64.2% of uninsured non-elderly adults (between ages 18 and 64) report that the top reason why they don’t have health insurance is because the cost is too high.

The main reasons people give for not having health insurance include the following:

• The average annual single premium per enrolled employee for employer-based health insurance in the U.S. is $7,590/year, with employees contributing $1,637 and employers contributing $5,953 annually.
• The average annual deductible per enrolled employee in employer-based health insurance is $3,811/year for families and $1,992/year for single coverage.
• The average monthly cost of a PPO plan in the ACA marketplace for a 30-year-old adult is $512, while the same plan costs $1,224 for a 60-year-old adult.
• Many employers cannot afford to provide healthcare insurance for employees, a trend we see continuing.

So, what do we do when we get these calls? In this article, I will share some strategies to consider if you receive this call.

1. Does the person qualify for Medicaid? People accustomed to using computers can check this online, but many might need help navigating the system. Find people in your community who can assist those who need help.
2. Ask if the person was ever in the military. If so, they have some retirement benefits.
3. Do they qualify for disability insurance? Disability insurance pays money for people who are disabled medically or mentally. Generally, the person must have worked a certain number of quarters to qualify. If the person does not qualify for Social Security Disability, they might qualify for SSI. I use Allsup to help me with these types of patients as this is what they specialize in and give accurate information. https://www.allsup.com
4. Visit Healthcare.gov. This government website allows you to view various types of health insurance coverage and apply for subsidies if you are not offered insurance through your employer or cannot afford what they offer.
5. If you can’t afford any health plan and don’t qualify for coverage through Medicaid and the Children’s Health Insurance Program (CHIP), you can get low-cost health care at a Community Health Center in your area. How much you pay depends on your income. Community Health Centers are located in both urban and rural areas. Community Healthcare Centers provide various services for people and their families. Locate a community health center near you.

6. Have the patients talk to their doctors to see if they work with indigent people as part of their practice or if they will give them lower rates.
7. Visit the Emergency Department: Anyone can go into an emergency department to be evaluated and receive care. Once there, the ED case manager may have additional resources for people with limited income who require medications and follow-up care.
8. Work within your community to find resources to help people with minimal or no coverage. You may be surprised at the variety of resources available.
9. Talk to your federal or state legislative leaders to share your concerns and how policy decisions impact your communities’ health and welfare.

It is not easy to help people without medical insurance. Unfortunately, nurse case managers will see these cases more often, so you and your teams must assemble a list of resources for these situations.

If you have any ideas on how to help uninsured people, please share them in the comment section or email me at allewellyn48@gmail.com. I will share them in a future post. 

Thank you for reading, and have a good week!

Reference: Forbes Health Insurance Facts and Stat for 2025: https://www.forbes.com/advisor/health-insurance/health-insurance-statistics-and-facts