Not insured? You still have healthcare options

Since the implementation of the Affordable Care Act in 2009, the number of Americans without health care coverage has decreased. In Illinois, the uninsured rate fell from nearly 14% in 2010 to 7.5% in 2019.

That’s the good news. The bad news is that nearly one million Illinois residents are still uninsured. And the number has been growing since 2020 due to job losses and other factors. People of color and those with low incomes are most likely to be uninsured.

According to a Kaiser Family Foundation report, 73% of uninsured people cited cost as the reason they don’t have coverage, and more than 20% (likely young adults) said they didn’t have coverage. didn’t need or want coverage. This is concerning for several reasons.

First, without health care coverage, a person is less likely to treat chronic health conditions, such as diabetes or hypertension, which will cost more in the long run. A study by the Transamerica Institute reported that 66% of uninsured people have a chronic condition and that 90% of the $4 trillion the United States spends annually on health care is due to chronic conditions and to mental health problems.

Second, uninsured people will incur more costs when they eventually need medical care. Medical debt is the most common reason for personal bankruptcy, which will affect your credit report for years to come.

So my main recommendation is to try to get some sort of coverage. Although the annual ACA enrollment period has passed, you can enroll at any time if you experience a life change, such as unemployment, or if you become eligible for the Illinois Medicaid expansion in because of low income, disability or your age. The Children’s Health Insurance Program, or CHIP, provides free or low-cost coverage for children in families with certain incomes. In Illinois, CHIP also covers pregnancy.


Let’s say you can’t afford to cover yourself or you’re not eligible, or you’ve made the choice (unwise in my opinion) to go without insurance. What can you do when medical needs arise? Here are some options.

• Are you eligible for financial assistance? Hospitals that accept federal money must provide a certain amount of free or reduced-cost care. Check with the hospital’s financial aid department to see if you qualify.

• Can you pay in advance? If surgery or hospitalization is required, speak with the hospital’s billing department beforehand about the total cost for a self-paid patient and get it in writing. Sometimes a hospital discounts the bill for a patient who pays upfront.

• Can you ask for help? I recommend people ask their church if they can help with medical bills. There are also county social service agencies that can help you find resources. According to the Illinois Association of Free and Charitable Clinics (, more than 40 free medical clinics operate in Illinois, many of them in the suburbs. Its website contains a directory.

• Can you afford a monthly supply? The number of “boutique” or “concierge” health practices has increased, run by physicians who provide coordinated care in exchange for a monthly deposit instead of accepting insurance. But if you can afford a retainer, you can probably afford an insurance premium that will provide broader coverage.

• Do you need medication? Go generic whenever it’s available. GoodRx ( lets you see what nearby pharmacies charge for your medications, and the discounts can be substantial. A new company, DiRX (, offers deeply discounted generics by mail order.

• Do you need expensive drugs? A number of pharmaceutical companies have Patient Assistance Programs (PAPs) to help eligible people pay for the expensive brand-name drugs they need. RxAssist ( maintains a directory of these programs.

• Do you have or think you have COVID? Under the HRSA COVID-19 Reimbursement Program, providers can bill the federal government for COVID-19 services to uninsured people so you don’t incur any out-of-pocket costs. Tests, treatments and vaccines are included in the services covered, but be sure to ask your provider if they participate in the program.

It takes time and you have to ask lots of questions, but being uninsured or underinsured doesn’t necessarily mean you have no access to health care. The options are limited, but still worth exploring.

• Teri Dreher is a Board Certified Patient Advocate. A critical care nurse for over 30 years, she is the founder of NShore Patient Advocates ( She offers a free telephone consultation to readers of the Daily Herald; call her at (847) 612-6684.

About Antoine L. Cassell

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