# 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. - URL: https://explained.page/how-us-healthcare-works - Language: en - Last checked: 2026-10-29 - Watch the 1-minute animated guide: https://explained.page/watch?start=how-us-healthcare-works ## Step by step 1. **New to US healthcare?** It works differently than in many countries. Most care is paid through insurance, and costs can surprise you. Here’s the basics. 2. **Ways to get coverage.** Through a job, the Marketplace with help based on income, or Medicaid and CHIP if you qualify. Rules for immigrants vary, so check your options. 3. **No insurance? Try a community health center.** Federally funded health centers see patients with or without insurance and charge based on income. 4. **Know where to go.** A regular doctor for checkups, urgent care for minor problems, and the emergency room for serious emergencies. ER visits usually cost the most. 5. **In an emergency, hospitals must help.** Hospital emergency rooms must check and stabilize anyone with an emergency, regardless of ability to pay. You may get a bill later; ask about financial help. 6. **Ask for a free interpreter.** Many doctors and hospitals must offer free language help. Don’t rely on your children to interpret medical information. 7. **Ask about costs.** Ask what something costs before non-emergency care, ask for an itemized bill, and ask hospitals about financial assistance. ## 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 ## 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. ## 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. Source page: https://explained.page/how-us-healthcare-works/questions/can-i-see-a-doctor-without-insurance ### 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. Source page: https://explained.page/how-us-healthcare-works/questions/will-using-healthcare-affect-my-immigration-case ### 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. Source page: https://explained.page/how-us-healthcare-works/questions/how-does-health-insurance-work-in-the-us ### What is a community health center? A federally funded clinic that serves everyone, with or without insurance, and charges based on income. Source page: https://explained.page/how-us-healthcare-works/questions/what-is-a-community-health-center ### 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. Source page: https://explained.page/how-us-healthcare-works/questions/when-should-i-go-to-urgent-care-instead-of-the-er ### 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. Source page: https://explained.page/how-us-healthcare-works/questions/can-a-hospital-refuse-emergency-care-if-i-cant-pay ### Do I have a right to an interpreter at the doctor? Many health providers that get federal funding must offer free language help. Ask for an interpreter. Source page: https://explained.page/how-us-healthcare-works/questions/do-i-have-a-right-to-an-interpreter-at-the-doctor ### Can immigrants get Medicaid? Some can, depending on immigration status, time in the US and state rules. Many states cover more children and pregnant people. Check with your state. Source page: https://explained.page/how-us-healthcare-works/questions/can-immigrants-get-medicaid ## Official sources - [HealthCare.gov: coverage for immigrants](https://www.healthcare.gov/) - [HRSA: find a health center](https://findahealthcenter.hrsa.gov/) - [HHS: language access in health care](https://www.hhs.gov/) To find your local office, search for: - "find a health center near me HRSA" - "[your state] Medicaid immigrant eligibility" --- General information, not legal or professional advice. Rules differ by state. From explained.page (www.explained.page). Life’s stuff, explained simply.