Financial Help for the Underinsured — When Your Coverage Is Not Enough
Being underinsured is different from being uninsured — but the financial result can look a lot the same. You have a policy. It just doesn't cover what you actually need, or the bills it leaves behind are more than you can manage. A $5,000 deductible on a marketplace plan, a specialty drug that costs $800 a month after coverage kicks in, or an out-of-network specialist bill that comes back at full price — any of these can derail a household budget just as badly as having no coverage at all.
The resources on this page are specifically for people in that situation. If you have no health insurance at all, a different set of options applies — the programs designed for the fully uninsured, including free clinics, Medicaid, and national nonprofits, are covered on our medical care for the uninsured page.
Start Here: Hospital Charity Care — Even With Insurance
Most people don't realize this: nonprofit hospitals are required by law to offer charity care programs, and most of those programs don't automatically exclude you just because you have insurance. A high deductible you haven't met, a large co-insurance requirement, or an out-of-pocket maximum you can't reach can all qualify you for help — even with an active policy.
The right person to talk to is in the hospital's patient financial services or billing department, not the insurance window. Ask to speak with a financial counselor. Tell them what you owe and what you can realistically pay. Bring recent pay stubs or a tax return if you have one. Hospitals can reduce bills, convert balances to interest-free payment plans, or write off portions of what's owed for patients who qualify — and qualifying often depends on income and documented hardship rather than insurance status alone. See our guide to how hospitals are required to reduce or forgive your bill if you cannot afford it — here is how to apply.
Never assume the first bill is the final number. Our guide to how hospital financial assistance and charity care works walks through what to ask, what documents help, and what most patients don't know to request.
One more thing: if a claim was denied by your insurer, you have the right to appeal. Plans are required to explain the denial and describe the appeal process. Many denials — particularly for specialty drugs and treatments deemed "not medically necessary" — are overturned when a physician provides supporting documentation. Pursue an appeal before paying the bill or applying to assistance foundations, since foundation funds are limited and intended for those who have already exhausted other options.
Who These Programs Are For
The co-pay foundations and disease-specific funds below require that you already have health insurance, whether through an employer, the ACA Marketplace, or Medicare. They cover what your plan assigns to you: deductibles, co-insurance, co-pays, and the cost of treatments your policy doesn't fully cover.
Most programs set income eligibility somewhere between 200% and 500% of the federal poverty level — a wider band than most people expect, covering many working families who wouldn't qualify for Medicaid. You don't have to be in poverty to get help here.
Apply before or during treatment, not after. Almost no program is retroactive. And if a fund for your condition shows as "closed," that means the current grant cycle's money has run out — funds reopen when new donations come in, and you can set up alerts to be notified the moment one opens.
How to Track Which Funds Are Currently Open
One of the biggest practical problems for underinsured patients is that assistance funds open and close based on available donations, often with little warning. Checking each foundation's website individually is slow and unreliable.
FundFinder (website: https://fundfinder.panfoundation.org/), a free tool developed by the PAN Foundation, solves this by tracking the open or closed status of more than 200 assistance funds across nine major charitable foundations in one place. You sign up for free, select the conditions that apply to you, and receive email or text alerts the moment a relevant fund opens. For patients managing chronic or serious conditions, this is the most practical way to catch application windows before they close. There is no cost to use it.
Co-Pay and Disease-Specific Foundations
Several large national foundations manage grant programs that pay a patient's share of treatment costs directly — the portion insurance assigned to you. Most are organized by diagnosis. Here is what's currently operating:
The Patient Access Network Foundation (website: https://www.panfoundation.org/) operates more than 80 disease-specific assistance funds covering specialty medications, co-pays, premiums, and treatment-related travel for patients with chronic, life-threatening, or rare conditions. Since 2004, PAN has provided over $4.5 billion in assistance to more than 1.2 million patients. Apply online at panapply.org or by phone at 1-866-316-7263. Note: PAN and the Patient Advocate Foundation announced a strategic merger in March 2026. Both programs continue to operate normally for patients — call the same number and apply through the same portal.
The Patient Advocate Foundation's Co-Pay Relief program (website: https://copays.org/) provides direct financial grants to insured patients for pharmaceutical costs and is organized by disease fund, similar to PAN. Applications can be approved the same day in many cases. Their case management team can also help resolve insurance disputes and prior authorization issues separately from the grant program. Call 1-866-512-3861.
The HealthWell Foundation (website: https://www.healthwellfoundation.org/) is known specifically for accepting applicants at higher income levels than most similar programs — up to around 500% of the federal poverty level in many funds. They cover medication costs, insurance premiums, and cost-sharing for people with chronic or life-altering conditions. Call 1-800-675-8416. For a closer look at how HealthWell's funds work and how to apply, our detailed guide to the HealthWell Foundation covers the process step by step.
The Assistance Fund (website: https://tafcares.org/) is one of the largest disease-specific co-pay foundations in the country, managing nearly 100 disease programs that cover all FDA-approved treatments for each condition rather than limiting assistance to specific drugs. Since 2009, TAF has helped over 210,000 patients with co-pays, coinsurance, deductibles, and other health-related costs. Call 1-855-845-3663.
Good Days (website: https://mygooddays.org/), formerly the Chronic Disease Fund, provides grants for specialty medications and in some cases treatment-related travel for patients with chronic conditions. Call 1-877-968-7233.
Accessia Health (website: https://accessiahealth.org/), formerly Patient Services Inc., coordinates financial assistance for co-pays, premiums, and health-related expenses for people with chronic illnesses, with a focus on connecting patients to multiple programs simultaneously. Call 1-800-366-7741.
The National Organization for Rare Disorders (website: https://rarediseases.org/) provides assistance for patients with rare conditions that often fall outside standard disease fund coverage — including help accessing treatments, diagnostic testing, and travel to specialists who focus on rare diseases. Call 1-800-999-6673.
For patients with blood cancers, Blood Cancer United (formerly the Leukemia and Lymphoma Society) at https://bloodcancerunited.org/ coordinates co-pay assistance, premium help, and medication grants for leukemia, lymphoma, and myeloma patients. Call 1-877-557-2672.
CancerCare's Co-Payment Assistance Foundation (website: http://cancercare.org/copayfoundation) covers co-pays specifically for cancer medications, with same-day approvals in many cases and a notification system for closed funds that are expected to reopen. Call 1-866-552-6729.
For patients with chronic conditions who are unsure which foundation to approach, PhRMA's Medicine Assistance Tool at https://americasmedicines.com/ searches across manufacturer programs and foundation funds simultaneously by drug name.
Medicare and the Underinsured
Medicare covers a great deal, but the gaps it leaves — Part B premiums, Part D drug costs, the 20% co-insurance that has no cap in original Medicare, and the annual deductible — can add up to serious money for people on fixed incomes.
Medicare Savings Programs, run through state Medicaid agencies, can pay some or all of these costs for low-income Medicare beneficiaries. There are four tiers: the Qualified Medicare Beneficiary (QMB) program is the most comprehensive, covering Part A and B premiums plus deductibles and co-insurance; SLMB and QI help with Part B premiums; QDWI assists disabled working people under 65. Apply through your state's Medicaid agency — the details for each state are in our state program pages below. The federal information hub at https://www.medicare.gov/basics/costs/help explains all four programs.
The Medicare Extra Help program, also called the Low Income Subsidy, reduces Part D prescription drug costs for Medicare beneficiaries with limited income and resources — in some cases to just a few dollars per prescription. Apply through the Social Security Administration at https://www.ssa.gov/medicare/part-d-extra-help or by calling 1-800-772-1213.
The Medicare Prescription Payment Plan, which lets Part D enrollees spread their annual out-of-pocket drug costs across monthly payments rather than paying the full amount early in the year. This doesn't reduce the total you pay, but it prevents the cash flow problem that causes many patients to delay or skip medications in January and February when costs spike. Enroll through your Part D plan during open enrollment each fall.
For free, unbiased help understanding Medicare options — including Savings Programs, drug plans, and supplemental coverage — every state has a State Health Insurance Assistance Program (SHIP). SHIP counselors don't sell insurance. Find your state's SHIP program through the federal SHIP locator at http://shiphelp.org or call 1-800-677-1116.
Prescription Help When Co-Pays Are the Problem
When insurance covers a drug but the co-pay or co-insurance is still unaffordable, several types of help exist specifically for people who have coverage.
Manufacturer co-pay assistance programs — offered directly by pharmaceutical companies — are often the fastest solution for commercially insured patients. Pfizer RxPathways (website: https://www.pfizerrxpathways.com/), AbbVie's myAbbVie Assist (abbvie.com/patients), and similar programs from most major manufacturers can reduce out-of-pocket costs to near zero for qualifying patients on their specific drugs. These programs generally cannot be used with Medicare or Medicaid — they are for commercial (employer or marketplace) insurance only. Your doctor's office typically processes the application.
NeedyMeds (website: https://needymeds.org/) searches across manufacturer programs, charitable foundations, and state assistance programs simultaneously by drug name, showing every option that applies including income thresholds and current status. Their helpline is 1-800-503-6897.
State pharmaceutical assistance programs provide an additional layer for certain populations — particularly seniors and people with specific chronic conditions. Many are separate from Medicaid and available to people who otherwise don't qualify for public programs. The individual state pages below note what's available in your state.
Dental and Vision — The Gaps Most Plans Don't Cover
Dental and vision coverage are excluded from most health insurance plans, which makes them a gap even for people who are otherwise well-covered. For dedicated options and a further explanation of vision care, see the free or low-cost eyecare programs page.
The Dental Lifeline Network (website: https://dentallifeline.org/) connects disabled adults, elderly patients, and medically fragile individuals with volunteer dentists who provide comprehensive free dental care. This program doesn't means-test in the traditional sense — it's designed for those who have no realistic way to pay. Call 303-534-5360. Our broader guide to free dental care resources covers additional options, including what community health centers offer on a sliding-fee basis.
Dental schools at accredited universities provide cleanings, fillings, root canals, extractions, and sometimes dentures and implants at dramatically reduced prices compared to private practices. Work is done by dental students under direct faculty supervision and tends to be thorough, though appointments take longer than a typical office visit. The American Dental Association lists all accredited programs at https://www.ada.org/topic/Dental-School. Our directory of dental school clinic locations helps narrow down programs by region.
Vision USA (website: https://www.aoa.org/healthy-eyes/caring-for-your-eyes/charitable-programs), run by the American Optometric Association, provides free eye exams to low-income underinsured working adults and their families. Call 1-800-766-4466.
EyeCare America (website: https://www.aao.org/eyecare-america), a program of the American Academy of Ophthalmology, provides medical eye exams at no out-of-pocket cost to underinsured adults 65 and older, with up to a year of follow-up care for any condition diagnosed during the exam. Call 1-800-222-3937. Additional options for free eye exams and prescription eyewear assistance are covered in our guide to low-cost vision and glasses programs.
New Eyes for the Needy (website: https://new-eyes.org/) provides vouchers redeemable for prescription eyeglasses for adults and children with documented financial need. Call 1-973-376-4903.
Starkey Cares (website: https://www.starkey.com/starkeycares) provides hearing aids at no cost to U.S. residents who cannot afford them through any other means. Proof of financial need and an application are required. Call 1-800-328-8602. Our guide to hearing aid assistance programs covers additional options including state vocational rehabilitation programs, which in many states will fund hearing aids for people whose hearing loss affects their ability to work.
Community Health Centers as a Cost Alternative
If your insurance has a high deductible you haven't yet met, there's a practical option most underinsured patients don't think to use: federally qualified health centers (FQHCs) charge on a sliding-fee scale based on income — meaning even with insurance, the amount you pay at a community health center may be less than what your plan would charge against an unmet deductible at a private practice.
FQHCs provide primary care, dental care, behavioral health services, and pharmacy services on this sliding-fee basis. The HRSA health center locator at findahealthcenter.hrsa.gov searches by ZIP code and shows all participating centers in your area. Call 1-877-464-4772. A broader directory of free and low-cost clinics, including both FQHCs and volunteer-staffed free clinics, is also available on this site.
State-By-State Programs for the Underinsured
State programs — Medicaid expansions, Medicare Savings Programs, cancer screening programs, HIV drug assistance, and others — serve the underinsured as well as the fully uninsured. If your coverage leaves significant gaps, your state may have a program that fills them directly. Select your state for a full guide to what's available where you live
Alabama
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Nevada
New Jersey
New York
North Carolina
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington DC
West Virginia
Wisconsin
A note about this information: NeedHelpPayingBills.com is not a medical provider and does not offer medical advice. The health care information on this site is provided for informational purposes only, to help people locate assistance programs and understand what may be available to them. Program eligibility rules, income limits, and enrollment periods change regularly — sometimes more than once a year. Always verify current details directly with the program before applying or making any health care decisions
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