Services for the Uninsured or Under-Insured

Caring for a child with special health care needs or can sometimes be financially overwhelming. Funding for evaluations, treatments, and/or equipment for people that are uninsured and/or undocumented is challenging. If your health insurance coverage does not cover what is needed, or your family has no insurance at all, the resources listed below may help with the cost of health care.

Finding Services

The help of a care coordinator, social worker or family advocate to look at options and guide families in applying for appropriate programs, appealing denials, researching charitable foundations and potential fund raising ideas is useful. For example many hospitals have financial assistance programs that you can apply for to help cover needed medical services. Talk to a social worker in the hospital to help with the application process.
Specific requests can be made for donated services (e.g., home oxygen) through some of the home care/health care organizations based upon need. Families may be able to get formula and food supplements by calling the company representatives for donations. Medicaid may be available for undocumented people for medical emergencies.

Finding Health Insurance

There are some options when a person has inadequate or no health insurance coverage as follows:

Health Insurance Marketplace

Also known as the health insurance exchange, the Health Insurance Marketplace helps uninsured people find health coverage that meets their needs and budget and is part of the Affordable Care Act: Health Insurance Marketplace (HealthCare.gov).

Medicaid

A federal program, administered by individual states, that covers the cost of some medical care. To qualify for Medicaid benefits, income and assets must be below a certain level. Contact your State Medicaid agency with questions about eligibility guidelines and categories, coverage and services, application process, and finding a provider: Medicaid.

Medicaid Waiver

These programs are for people with disabilities and/or special health care needs who would otherwise be ineligible to receive Medicaid benefits because of income and assets. In addition to medical coverage, waiver programs may cover a number of other services and supports not traditionally covered by Medicaid. For more information about Home and Community Based Services waivers in each state: Home & Community-Based Services (Medicaid).

Medicare

A government program available to people over the age of 65 or with specific disabilities, such as chronic renal disease. A person can receive Medicare benefits if they have worked enough to be covered by Social Security Disability Insurance, or if they have a parent who is already receiving Social Security: Medicare

Social Security Administration Supplemental Security Income (SSI) Non-Medical Benefits

SSI benefits are available to children with disabilities, under the age of 18, whose disability is expected to last more than 12 months or result in death, and whose parents' income and resources are limited. When a child reaches 18, he or she then needs to qualify based on his or her own income and assets and must meet the required guidelines.

Social Security Disability Insurance (SSDI)

SSDI benefits are payable to children, under the age of 18, if they have a parent who qualifies for or is collecting Social Security Retirement or Social Security Disability Insurance. If a parent has died, children under the age of 18 may collect dependent SSDI benefits on the parent's record if qualified. These payments are available to all children, regardless of whether the child has a disability. SSDI benefits from a parent's Social Security can continue to be paid into adulthood, if the child has a disability that began prior to the age of 22.

Community Health Centers

Community clinics who provide quality healthcare services including medical, dental, and behavioral health, particularly for low-to-moderate income, uninsured or underinsured individuals who might otherwise not have access to healthcare. To locate a community clinic, check Community Clinics (see NM providers [142]).

Free and Low Cost Clinics

There are a number of free clinics that provide free medical services for uninsured and low income families and individuals.

Resources

Information & Support

For Parents and Patients

Family-to-Family Health Information Center (F2F) or Family Voices Affiliate Organization (FVAO)
Family-to-Family Health Information Centers are nonprofit, family-staffed organizations that assist families of children and youth with special health care needs (CYSHCN). Locate state-based F2F HICs, providing support, information, resources, and training.

Medicaid and CHIP Coverage by State
Medicaid and CHIP offer free or low-cost health insurance for kids and teens; find information on health insurance programs and dental providers in your state by clicking on your state in the map.

The National Association of Free & Charitable Clinics
Free and charitable clinics and pharmacies across the U.S. provide health care access to medically underserved people in their communities.

Find a Health Center
Health centers are community-based and patient-directed organizations that deliver comprehensive, culturally competent, high-quality primary health care services to vulnerable individuals and families, including people experiencing homelessness, agricultural workers, residents of public housing, and veterans.

Mouth Healthy (ADA)
Helpful resources for finding dental care assistance programs; American Dental Association.

Services for Patients & Families in New Mexico (NM)

For services not listed above, browse our Services categories or search our database.

* number of provider listings may vary by how states categorize services, whether providers are listed by organization or individual, how services are organized in the state, and other factors; Nationwide (NW) providers are generally limited to web-based services, provider locator services, and organizations that serve children from across the nation.

Authors & Reviewers

Initial publication: September 2016; last update/revision: October 2020
Current Authors and Reviewers:
Author: Gina Pola-Money
Reviewer: Tina Persels