Accessing needed health care is just one of the many challenges you face when you are homeless, but there are options to ensure you get the care you need.
First, understand that you are not alone: more than half a million people in the United States do not have access to reliable housing. Whether you’re going through this for the first time or it’s something you’ve faced before, it can be difficult to know where and how to get medical treatment.
For many, the solution is a visit to their local emergency room. Homeless patients are three times more likely to visit the ER than other Americans, and ER use by homeless people has increased 80% over the past decade.
There are also community health centers. Medicaid and Medicare also play a role.
Your housing status should not prevent you from getting primary care. It’s important to have a primary care doctor no matter where you live so you can get vaccinations, screenings for cancer and other conditions, and disease management.
Emergency rooms aren’t the only place you can get care. The federal government funds homeless health care projects in every state, serving more than one million people a year. In addition to primary care and mental health treatment, these centers have also provided testing and vaccinations for COVID-19 since the start of the pandemic.
“Homeless health care centers are a vital safety net for this population,” says Anna Bailey, JD, senior policy analyst at the Center on Budget and Policy Priorities. “They specialize in serving homeless people and they really understand all the challenges. In addition to providing clinical services, many of them also provide behavioral health care, and they usually work closely with homelessness providers in their community.
Homeless health care centers receive special federal funding specifically for treating people who are homeless. These centers are part of a larger network of clinics that includes community health centers and migrant health centers, all of which operate in and for underserved communities.
These centers provide emergency health care, treatment for chronic conditions, mental health care and preventive care on a sliding scale. Those whose income is below the poverty line ($12,800 for an individual) pay nothing for their care.
You can get information on where to find these health centers from any organization that serves the homeless or by using this tool from the US Department of Health and Human Services. Some communities also have mobile health centers that provide care to people living on the streets or in shelters.
Having insurance can facilitate access to health care. For homeless people, Medicaid – the state-run insurance program for low-income people – is the best route to insurance.
“Many low-income and underserved populations feel like the ER is the only place they can go because they don’t have the resources to go anywhere else,” says Craig Kennedy, President and CEO from Medicaid Health Plans of America. “The intent of Medicaid is to say, ‘You are insured. You may not have the money to pay for a doctor’s visit, but please go to the doctor.
Medicaid facilities can provide services beyond those found at many community health centers. These services typically include surgery, skilled nursing, and some behavioral health treatments.
You don’t need a permanent address to get a Medicaid policy. But you will need to purchase insurance from the state where you live. If you move to another state, you will need to get Medicaid from that state, although coverage from one state transfers to another for short-term visits.
Community health centers can help you enroll in Medicaid if you are homeless. Or you can complete an application online through the Health Insurance Marketplace or your state Medicaid agency. Find contact details for this agency here.
Community clinics and public hospitals in the city provide primary care (preventive care) to homeless people and others without insurance. There are social workers at these facilities who can help you complete Medicaid and/or Medicare applications.
“We really want to see people go to these facilities and enroll in Medicaid and have this insurance that can allow them to have a regular source of care,” Kennedy said.
To find accommodation
Many of the medical issues affecting homeless people reflect broader issues created by homelessness, Bailey says. Along with higher rates of disease, homeless people die an average of 12 years earlier than Americans with adequate housing. When you don’t have a home, there are often daily crises and challenges that make it much more difficult to manage chronic conditions.
“There are a lot of things that can and should be done to try to meet the urgent health care needs of homeless people,” says Bailey, “but none of this replaces housing, to make sure people have a strategy to meet their needs. basic needs and start prioritizing their health.