Your Action Plan: Affording Healthcare Coverage

Check Medicaid eligibility first. In states that have expanded Medicaid under the ACA, adults earning up to 138% of the Federal Poverty Level can qualify. Note: as of 2026, 10 states have not expanded Medicaid. If your state has not expanded, different income thresholds apply, and you may qualify for Marketplace subsidies instead. Medicaid coverage can be retroactive for up to 90 days, meaning it can potentially cover medical bills you have already received. However, some states have limited retroactive coverage through federal waivers — check with your state Medicaid agency about whether retroactive coverage is available in your state. You can check eligibility and apply at your state Medicaid agency or through Healthcare.gov.

If you recently lost coverage, check whether you are within a special enrollment period. Losing employer coverage or other qualifying life events trigger a 60-day special enrollment period during which you can sign up for an ACA Marketplace plan outside of open enrollment. Visit Healthcare.gov to see your options and estimated costs after subsidies.

Compare COBRA with Marketplace plans. If you lost employer coverage, COBRA allows you to continue your employer plan for up to 18 months, but you pay the full premium (typically 102% of the total cost, including the portion your employer previously covered). ACA Marketplace plans with premium subsidies are often significantly cheaper. Compare both options before deciding.

Find a community health center (FQHC) near you. There are over 1,400 HRSA-funded health center organizations operating more than 15,000 service delivery sites across the country. They provide primary care, dental care, mental health services, and prescriptions on a sliding-scale fee based on your ability to pay. They serve patients regardless of insurance status or ability to pay. Find one at findahealthcenter.hrsa.gov.

If you have existing medical bills, check whether the provider is a nonprofit hospital. Under ACA Section 501(r), nonprofit hospitals are required to offer Financial Assistance Programs (FAPs) to patients who cannot afford care. Many patients earning up to 300–400% of the Federal Poverty Level qualify for free or discounted care. Dollar For (dollarfor.org) is a free nonprofit that helps patients apply.

Know that the Emergency Medical Treatment and Labor Act (EMTALA) guarantees that hospital emergency departments must evaluate and stabilize you regardless of your ability to pay or insurance status. This does not eliminate any resulting bill, but it means you cannot be turned away from emergency care.

Contact the Patient Advocate Foundation (800-532-5274) for free case management if you have a chronic condition or ongoing healthcare needs. They specialize in helping patients navigate coverage options, financial assistance, and billing issues at no cost.

Look into prescription assistance programs if medication costs are a concern. Many pharmaceutical manufacturers offer patient assistance programs for expensive medications. NeedyMeds (needymeds.org) and RxAssist (rxassist.org) maintain searchable databases of these programs.