How US healthcare works, for newcomers
Most US healthcare is paid through insurance: from a job, the Marketplace (HealthCare.gov) with income-based help, or Medicaid and CHIP if you qualify; rules for immigrants vary. Without insurance, community health centers charge based on income. Use a regular doctor for checkups, urgent care for minor problems and the ER for serious emergencies; ERs must help anyone in an emergency. Ask for a free interpreter, and ask about costs and financial assistance.
Your checklist
- Know your coverage options
- No insurance? Try a community health center
- Know regular doctor vs urgent care vs ER
- Know ERs must help in emergencies
- Ask for a free interpreter
- Ask prices and about financial help
Rather read it? Here’s the whole thing.
How it’s paid
Most care in the US is paid through health insurance, plus your share of costs like premiums, deductibles and copays.
Ways to get covered
- Through a job.
- The Marketplace (HealthCare.gov or your state’s site), with tax credits based on income.
- Medicaid and CHIP for people with low incomes and children, if eligible. Rules for immigrants vary by status and state.
Without insurance
Federally funded community health centers see patients regardless of insurance and charge on a sliding scale based on income.
Where to go
- Regular (primary care) doctor: checkups and ongoing care.
- Urgent care: minor injuries and illnesses when your doctor isn’t available.
- Emergency room: serious emergencies. Usually the most expensive.
- 911: life-threatening situations.
Emergencies
Hospital emergency rooms must screen and stabilize anyone with an emergency, regardless of ability to pay. You may be billed later; ask about financial assistance.
Language help
Many healthcare providers must offer free interpreters. Ask, and avoid relying on children to interpret.
Avoid surprises
Ask prices before non-emergency care, ask for itemized bills, and ask about financial assistance.
Official sources, and where to look
- HealthCare.gov: coverage for immigrantshealthcare.gov
- HRSA: find a health centerfindahealthcenter.hrsa.gov
- HHS: language access in health carehhs.gov
find a health center near me HRSA[your state] Medicaid immigrant eligibility
Common questions
Can I see a doctor without insurance?
Yes. Community health centers charge based on income, and many clinics and hospitals offer self-pay prices and financial assistance. More ›
Will using healthcare affect my immigration case?
Rules on this have changed over time. Ask a trusted immigration attorney or accredited representative about your situation. More ›
How does health insurance work in the US?
You pay a monthly premium, then share costs through deductibles, copays and coinsurance. Insurance pays the rest for covered care, often within a network of doctors. More ›
What is a community health center?
A federally funded clinic that serves everyone, with or without insurance, and charges based on income. More ›
When should I go to urgent care instead of the ER?
For minor injuries and illnesses like sprains, small cuts or fevers. For chest pain, trouble breathing or severe injuries, go to the ER or call 911. More ›
Can a hospital refuse emergency care if I can’t pay?
No. Hospital emergency rooms must screen and stabilize anyone with an emergency medical condition, regardless of ability to pay. More ›
Find health insurance and care help
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Not yet reviewed by an expert. Last checked 2026-10-29. This is general help, not legal, medical or professional advice. Rules are different in every state.