How to get free or low-cost health care, regardless of your insurance coverage

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Avoiding the doctor because you simply can’t afford it? If so, you're not alone, as 1 in 4 Americans report they or a family member has skipped getting medical attention due to its cost, per a new survey by Bankrate.

"I did not anticipate so many people would skip medical care, especially those who have insurance through their employer, but still can’t afford the costs," Robin Saks Frankel, credit card analyst at Bankrate told Mic. The fact that 8% of older Americans are not seeing the doctor because of expense also surprised Frankel, considering a number of government programs are available to provide assistance.

Yet millennials are the biggest generational group avoiding the doctor — 31% told Bankrate costs were too high. "I have been surprised by how expensive things can be even when you have insurance," Elizabeth Rene, a 26-year-old Washington, D.C., communications professional, told Bankrate. "Things like urgent care — I’ve been able to pay out of pocket, but I thought insurance would cover more of it."

This trend is a problem because skipping even routine health care can end up hurting your body and costing you more money in the long term, since preventative screenings for conditions like high cholesterol, for example, can help you ward off serious illnesses or incidents (like heart attacks) in the future.

Despite findings in a 2016 Commonwealth Fund study reporting a decrease in the number of people who avoid medical treatment due to cost, health care expenses continue to be a profound concern for many. At least 56% of the Bankrate respondents expressed worry about having affordable health coverage in the future, with 35% saying they were very worried.

Americans have good reason to fret over health care costs: Seventy-three percent of those who found it challenging to pay their medical bills in a 2017 in a Kaiser Family Foundation report said they had to reduce spending on food, clothing or basic household items in order to pay their bills, with some draining their savings account or taking a second job.

As the future of U.S. health care hangs in the balance, what options are currently available that provide cost relief? There's no need to skip the doctor: Here are three affordable alternatives to help you get the medicine and health care appointments that you need.

1. Community health centers

Regardless of your ability to pay, community health centers see more than 24 million patients per year and are generally represented across every state, according to the Bureau of Primary Health Care. In addition to standard medical care, some community health centers offer pharmacy, substance abuse and oral health services, depending upon service accessibility within that geographic location.

About 89% of community health centers across the country offer mental health services, Jennifer Joseph, the director of the office of policy and program development at BPHC, told Mic. "We want to focus on integrating a full range of services, which also includes services like oral and vision care too."

Payment for services is determined on a sliding scale, accounting for factors such as the patient’s income and family size. "The important thing to note is that no one is turned away based on their ability to pay," Joseph said. "Fees are based on what you can afford to pay, regardless of whether you have insurance coverage or not."

2. Planned Parenthood

Another option you have is Planned Parenthood, and not just if you are a woman. Many locations offer free or low-cost medical services and general health care for people of all genders. Best of all, 62% of Planned Parenthood locations offer same day appointments and 78% centers have evening and weekend hours, according to research by the Guttmacher Institute.

Fees are charged on a sliding scale, with locations offering a cost calculator to determine your individual expenses. While Planned Parenthood accepts many major insurance carriers, a federal funding program called Title X supplements some costs for uninsured patients. Patients are asked to provide proof of income in order to qualify for discounted sliding scale payments under Title X.

The need for reduced cost care is on the rise. Guttmacher found a 5% increase in the need for publicly funded family planning services among women between 2010 and 2014. Maintaining funding for Planned Parenthood is vital to the continuation of low-cost medical services, especially for women of reproductive age on Medicaid, who would be hit hardest without funding.

Planned Parenthood has said the organization provided publicly funded family planning services to prevent two million pregnancies in 2010; without this assistance, the group estimates that abortion and unintended pregnancy rates would have been 68% higher.

3. Nurse practitioners

Demand for affordable primary care is expected to rise over the next five years, according to a Kaiser Family Foundation study, which makes visiting a nurse practitioner an attractive option for affordable health care. Nearly 90% of nurse practitioners are prepared to deliver primary care and 80% to 90% of the same care provided by physicians can typically be substituted by nurse practitioners, Kaiser reports.

While it's always best to see a fully-licensed doctor for serious ailments, nurse practitioners can provide preventative medical care and do have advanced training in diagnosis and treatment of many diseases and illnesses. Patients for outpatient services can save an estimated 29% by seeing a nurse practitioner as opposed to a primary care physician, according to a 2015 study.

A growing number of states are granting nurse practitioners the ability to practice without being managed by a physician, which means expanded coverage, especially in areas where access to a primary physician is sparse.

Want more help getting the health care you need — without overpaying? Here are Mic's guides to saving money on care and fighting back against surprise medical bills or an insurance company that is giving you trouble.

Sign up for The Payoff — your weekly crash course on how to live your best financial life. Additionally, for all your burning money questions, check out Mic’s credit, savings, career, investing and health care hubs for more information — that pays off

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Gina Ragusa

Gina is a personal finance writer for Mic who resides in South Florida. Gina can be reached at gina@mic.com.

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