Getting necessary health care is just one of the many challenges you face when homeless, but there are options to ensure you get the care you need.
First, know that you are not alone: more than 500,000 people in the United States lack access to reliable housing. Whether this is your first time experiencing this condition or you’ve dealt with it before, figuring out where and how to get medical treatment can feel overwhelming.
For many people, the solution is to go to their local emergency room. Homeless patients are three times more likely than other Americans to visit the emergency room, and homeless emergency room use has increased 80% over the past decade.
There are also community health service centers. Medicaid and Medicare also play a role.
Your housing situation should not prevent you from getting primary care. No matter where you live, it’s important to have a primary care doctor so you can get vaccines, cancer and other disease screenings, and disease management.
The emergency room isn’t the only place you can get care. The federal government funds homeless health care programs in every state, serving more than 1 million people annually. In addition to primary care and mental health treatment, the centers offer infectious disease testing and vaccinations.
“Homeless health care centers are an important safety net for this population,” said Anna Bailey, J.D., senior policy analyst at the Center on Budget and Policy Priorities. “They specialize in serving the homeless, and they truly understand all of the challenges. In addition to providing clinical services, many of them also provide behavioral health care, and they often work with homeless people in the community cooperate closely.
Homeless health care centers receive special federal funding specifically to treat people without housing. These centers are part of a larger network of clinics, including community health centers and immigrant health centers, all of which operate in underserved communities.
The centers provide emergency medical care, chronic disease treatment, mental health care and preventive care on a sliding fee scale. People with incomes below the poverty level ($15,060 for an individual) do not have to pay any medical costs.
You can get information about where to find such health centers from any organization that provides services to the homeless or by using this tool from the U.S. Department of Health and Human Services. Some communities also have mobile medical centers that provide treatment to people living on the streets or in shelters.
Having insurance makes it easier to get health care. For homeless people, Medicaid — the state insurance program for low-income people — is the best way to get coverage.
“Many low-income and underserved populations feel the emergency room is the only place they can go because they don’t have the resources to go elsewhere,” said Craig Kennedy, president and CEO of Medicaid Health Plans. “The purpose of Medicaid is to say, ‘You have insurance. You may not have money in your pocket to see a doctor, but please see a doctor.
Medicaid facilities can provide many services outside of community health centers. Such services often include surgery, skilled nursing care, and some behavioral health treatments.
You do not need a permanent address to obtain a Medicaid policy. But you need to get insurance through the state where you live. If you move to another state, you will need to get Medicaid from that state, although coverage for short-term visits does transfer from one state to the other.
If you are homeless, community health centers can help you enroll in Medicaid. Or you can fill out an application online through the health insurance marketplace or your state’s Medicaid agency. Find the agency’s contact information here.
Community clinics and public city hospitals provide primary care (preventive care) to the homeless and other uninsured people. Social workers at these agencies can help you fill out your Medicaid and/or Medicare applications.
“We really want to see people go to these facilities and sign up for Medicaid and have insurance that allows them to get regular care,” Kennedy said.
Many of the medical issues affecting homeless people are reflective of broader problems caused by homelessness, Bailey said. In addition to higher prevalence rates, homeless people die on average 12 years earlier than Americans with adequate housing. When you are unhoused, you encounter daily crises and challenges that make managing chronic illness more difficult.
“A lot can and should be done to address the emergency health care needs of homeless people, but none of these can replace housing to make sure people have a strategy to meet their basic needs and start prioritizing them,” Bailey said. Consider their health.
