How to Pay for Medical Care: A Guide for Americans

In this post I review how people pay for their healthcare. In the U.S., medical care financing includes employer-provided insurance, Medicaid, Medicare, the Affordable Care Act, and COBRA. Eligibility for these programs varies based on income, age, and employment status. Additional financial assistance exists through Medicare Savings Programs and nonprofit organizations, helping manage medical bills and related expenses.

This information is current as of the date of original publication or update. It may have changed by the time you read this. I invite you to fact-check what you read here.

Please do not use this information for diagnosis or treatment purposes. Before making health decisions, discuss with your physician or other qualified healthcare provider.

This content is for your “information and inspiration”, and does not imply my endorsement or recommendation.

How do you pay for your medical care?

We do not have “socialized” medicine or “universal” health care in the United States —or do we?

The government may not directly pay for healthcare but it is involved through taxes we pay and for tax deductions available for insurance premiums and certain medical expenses. Most people still pay out of pocket for at least some if not most of their healthcare.

Multiple sources confirm that at least half of the population is eligible for health insurance coverage through an employer. The rest may be eligible for coverage through one or more options discussed below.

Healthcare payment options

Government programs can help pay for medical care. Depending on the program, you may also be eligible for help with vision and dental care. Your income, age, employment status, and qualifying health issues will determine your eligibility. These programs include:

Medicaid and the Children’s Health Insurance Program (CHIP)

You may qualify for Medicaid or long-term, depending on your situation. These are both joint ventures of the federal and state governments so eligibility may differ depending on where you live. They may even have different names. In my state, Oklahoma, it’s called SoonerCare.

Unfortunately, Medicaid funding is in jeopardy due to proposed cuts in funding by Congress. Americans living in rural communities throughout the country could see their access to health care diminish if Congress changes eligibility for Medicaid or significantly reduces its federal funding.

Medicaid cuts rippling through rural America could bring hospital closures, job losses

Medicare

Everyone is eligible for Medicare at the age 65 years, and sometimes younger if you have a permanent disability. It may also depend on whether or not you are still covered under an employer-provided plan.

The Affordable Care Act (ACA) / Health Insurance Marketplace

This is still sometimes referred to as ObamaCare since Congress passed the act when he was president. The current president has said he intends to end it but so far it is still law. This basically covers people who don’t have insurance through an employer or qualify for Medicare.

Premiums for marketplace plans may increase if federal subsidies are allowed to expire.

Oklahomans using ACA health insurance plans could see higher premiums, official warns

Consolidated Omnibus Budget Reconciliation Act

You may think you have never heard of this but it is better known as COBRA. (yes, pronounced like the snake.) If you have a “qualifying life event” and are no longer employed, you may be able to continue on your employer’s insurance plan.

The catch is, you have to pay for it. Paying for this type of plan can be quite expensive, but may be necessary if you have medical issues that can’t be delayed. If you will soon start a new job offering a health plan it may be worth considering this temporarily.

Learn how these programs work, find out if you are eligible, and see how to apply.

Veterans and Military Healthcare

Those currently serving in the Armed Forces and their dependents can receive healthcare through the Tricare program of the Department of Defense.

Military Veterans can receive care through hospitals and clinics of the Veterans Administration Health systems. Dependents of some veterans, usually those with service-connected disabilities may be eligible for CHAMPVA-Civilian Health and Medical Plan.

Photo by George Pak on Pexels.com

Help with medical bills beyond insurance

Medicare Savings Programs

There are 4 Medicare Savings Programs that may be able to help with Part A and Part B premiums, deductibles, coinsurance, and copayments. You’ll apply for Medicare Savings Programs through your state. When you apply, your state determines which program(s) you qualify for. Even if you don’t think you qualify, you should still apply.

Medicare Extra Help

This program can help you pay Medicare Part D costs that cover prescription drugs. Find out if you qualify for Extra Help and apply.

Financial Assistance Programs

If you still need help with medical bills after health insurance or Medicaid payments have been applied, a financial assistance program may assist you with the remaining costs. In most cases, you can apply through a doctor or hospital where you are seeking medical treatment.

Learn more about these options here.

Some non-profit medical facilities provide medical care free or at a reduced price. Patient advocacy organizations for various chronic conditions may offer financial assistance.  

Get help paying medical bills through debt management

Despite using insurance and extra sources of help you may find yourself forced to deplete savings. You may owe more money than your budget allows you to pay regularly. You are in debt.

You may be able to get help paying your medical bills with a debt management plan. This involves a payment schedule that a credit counselor develops based on your situation.

When you pay, your money is deposited into an account with the credit counseling organization, which then pays your debt. You may be able to get lower interest rates and certain fees waived to help make it easier to pay off your medical debt. 

Learn more about debt management and how it works.

The Pexels images in this post are for illustration only and do not depict real medical situations.

Exploring the HEART of Health

I hope you learned something here that helps you or someone else. Please forward it to a friend or share on social media.

In another piece, I will discuss obtaining medicines and vaccines.

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Medical stethoscope and heart on a textured background

Dr Aletha

How to be Aware and Prepared for Measles

My home state Oklahoma confirmed its first two measles cases on March 11, 2025, linked to outbreaks in neighboring Texas and New Mexico. This is added to outbreaks in at least 12 other states. Viruses don’t recognize state lines or international borders, so everyone needs to be aware and prepared for its arrival.

I live in Oklahoma, and depending on where you live you may or may not know where that is.

My state lies in the south-central part of the United States, often called the Plains. You may be familiar with Texas, a large state that shares its southern border with Mexico.

Oklahoma shares its southern border with Texas. We also border five other states-Colorado, Kansas, Missouri, Arkansas, and New Mexico.

With measles cases reported in Texas and New Mexico, it’s not surprising it has crossed over into Oklahoma. Rather, people infected with the measles virus have crossed over.

According to the CDC,

“As of March 6, 2025, a total of 222 measles cases were reported by 12 jurisdictions: Alaska, California, Florida, Georgia, Kentucky, New Jersey, New Mexico, New York City, Pennsylvania, Rhode Island, Texas, and Washington.”

Why should you care? Lots of people will travel over Spring Break, which starts here next week. In two months schools close for the summer and families travel on vacations. When people travel, the viruses they carry go with them.

More states, and maybe countries, may join the list of measles outbreaks. Here is the report from Oklahoma Voice about the infections in my home state.

First measles cases reported in Oklahoma, but public health officials remain mum on details

by Emma Murphy, Oklahoma Voice
March 11, 2025

OKLAHOMA CITY — State health officials on Tuesday ( March 11, 2025) said they’ve confirmed the first two cases of measles in Oklahoma amid an ongoing outbreak in Texas and New Mexico.

But Oklahoma State Health Department officials did not share where in Oklahoma those cases were diagnosed or how old the individuals are.

They said they believe the exposures were associated with the outbreak in Texas and New Mexico, which is confirmed to have killed one child and sickened over 250 people.

Erica Rankin, a spokesperson for the state health department, said Oklahoma’s two cases present “no further risk to public safety.” The agency only releases geographic information about measles cases when there is a “public health risk” and all potential exposures cannot be identified. Three or more related cases is considered an outbreak, she said. 

It was unclear Tuesday afternoon whether the individuals were vaccinated against the measles.

Health officials did say the two cases are unrelated to an erroneous report of measles in Bartlesville on March 4. The two confirmed cases have been reported to the Centers for Disease Control and Prevention and are under investigation.

With outbreaks in neighboring states, the Oklahoma Health Department, or OSDH, has been on “high alert” and monitoring for cases in the state, according to a statement from the department. 

“If a measles case is identified, the OSDH team will work with the individual on next steps and guidance to mitigate the spread and protect others. If there is a risk of spread to the public, the OSDH will notify the public and share any information necessary to protect the health of Oklahomans.”

“These cases highlight the importance of being aware of measles activity as people travel or host visitors. When people know they have exposure risk and do not have immunity to measles, they can exclude themselves from public settings for the recommended duration to eliminate the risk of transmission in their community.”

per Kendra Dougherty, the Health Department’s director of Infectious Disease Prevention and Response

Prevention

Measles can be prevented with an MMR vaccine which is recommended for children at 12 to 15 months of age and again at 4 to 6 years old. Receiving two doses of the vaccine is about 97% effective at preventing measles, and one dose is about 93% effective, the Health Department reported in a statement. 

Almost 92% of Oklahoma kindergartners were up to date on their MMR vaccines, according to the 2023-24 Oklahoma Kindergarten Immunization Survey. 

The department recommended that individuals with known exposure to measles who are not immune through vaccination or prior infection consult with a health care provider and “exclude themselves from public settings for 21 days unless symptoms develop.” 

To confirm a report of measles, the case must show symptoms and have a test confirming the diagnosis. 

This story is republished under Creative Commons license CC BY-NC-ND 4.0.

Oklahoma Voice is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Oklahoma Voice maintains editorial independence. Contact Editor Janelle Stecklein for questions: info@oklahomavoice.com.

Measles elsewhere

Here are links to stories about the ongoing outbreaks of measles in New Mexico and Texas.

https://sourcenm.com/2025/03/07/growing-nm-measles-cases-not-a-rapidly-expanding-outbreak-doh-says/
Texas Measles Outbreak Nears 100 Cases, Raising Concerns About Undetected Spread

CDC Key Points about Measles

  • Measles is very contagious and can be serious.
  • Anyone who is not protected against measles is at risk.
    • Two doses of MMR vaccine provide the best protection against measles.
Measles is highly contagious.

Exploring the HEART of Health

I’d love for you to follow this blog. I share information and inspiration to help you transform challenges into opportunities for learning and growth.

Add your name to the subscribe box to be notified of new posts by email. Click the link to read the post and browse other content. It’s that simple. No spam.

I enjoy seeing who is new to Watercress Words. When you subscribe, I will visit your blog or website. Thanks and see you next time.

Dr. Aletha

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