Health Care for Broke People: Where to get Cheap Medical Care in New York City without Insurance

Vol. 1 Issue 36

If you are a non-citizen living in New York City chances are you don’t have very good health insurance, still, it is possible to find treatment whether you’re here lawfully or unlawfully. You do not have to writhe away in pain and sickness. It takes a lot of work to find these places but I’ve done most of that work already. Hopefully my legwork will connect at least a few people in need with the appropriate help.

#1- Proving your Broke- The most important thing to getting any form of decent care is to prove that you have no money and no income, so even if you are working for minimum wage part-time, like I was, they will consider you not broke (even if you are). Medical Case Managers will want to see a bank statement proving that you have no income. If you want to get treatment for a reasonable fee, this is essential.

If your main bank account shows your glorious monthly income of $400 they will declare you “not broke,” so the best way around this is to have a separate bank account with very little money, into which you never receive deposits from a job. Use this back account a few times a month for small purchases to maintain it. It must look like it is your active account otherwise there will be a barrage of questions and you will have explain how you live on an account that hasn’t been used in months. Once you have this nearly empty ($100-4000), legit-looking account almost any questions regarding how you pay you bills, rent, or buy food can be answered by saying you use credit, savings, or by borrowing money from others. Just to be clear, you should try to prove your broke if your actually broke. If it seems like a major chore to set up this bank account, well, that’s because it is, but once the account is setup all you have to do is maintain it. This way you will always have the proof you need to qualify as being broke. If you have money and are just looking for a deal, do not try to use this method. That would be fraud.

If you are in NYC unlawfully you cannot get a bank account thanks to the Patriot Act. This is an atrocity of a law that inconveniences many people. It creates the need to get false identities with fake IDs, and/or jobs that pay only cash which are usually exploitive. Obviously the plight of the unlawful citizen goes way beyond just being denied a bank account, but a bank account is very important to a leading a structured, secure life. If you cannot get a bank account then obviously none of my bank account info applies to you. I guess you would have to claim you don’t use banks, or be honest and tell the Case Manger your reasons for being in the US, and how you are surviving. All ERs in New York except undocumented individuals but I have no knowledge of how far up the medical ladder they are allowed to go.

If you have managed to unlawfully open an account through your own ingenuity this is illegaal (and bad mmmkay), but good for you. In theory you could always just open a second account at your same bank and maintain that as you “broke account”...In theory.

#2- Where To Go in an Emergency- If you get sick or injured any emergency room will take you and treat you. Some will give you a discount and reduce their fee to almost nothing. Public Hospitals- Any of the public hospital will take you, and if you prove that you’re broke they’ll reduce all visits to $10 after the fact. I’ve been to the ER at Bellevue and Harlem Hospitals and both of the ERs treated me and charged me $10 after. Going to an ER is the best way to get referred into a clinic at a public hospital if you have a condition that requires further care. Harlem hospital had the longest ER wait time, but had the most considerate doctors.

Private Hospitals- Because they are private and expensive you’d think they’d be better but I found both Columbia Presbyterian and Brooklyn Hospital’s ERs to be worse that the public ones. The waits were just as long (3-5 hours for a non-life threatening emergency) and the doctors were no better.  I waited 5 hours, saw a Dr. Breen and all she gave me was OTC pills; I waited 5 hours for Naproxen! After I proved that I was broke they dropped the fee to $10, but at the private hospitals they double bill- once for the doctor, once for the hospital. It’s literally twice the price, and only the hospital will lower their fee. So you either need to pay the doctor’s fee of $350 for a single ER, visit or ignore the bill.

#3- Non- Emergency Care- Hospital Clinics/Specialists- If you want to see any kind of specialist for a serious or ongoing condition you will likely need to get referred to them either through the ER, or through another outside medical clinic (most hospital clinics do not accept outside referrals. Make sure to check before you waste time getting one). Public hospitals have most specialists but the wait times to get appointments are long, like 3 months long.

I would not recommend going to Bellevue for any reason other than an extreme emergency. The waits are long, the staff rude, and the doctors unsympathetic and unhelpful. I wanted to get an MRI, which they do provide to broke people for $150, but before I could get it that I had to go ER and I was then referred to the General Clinic. The General Clinic then made me go through Physical Therapy. This Physical Therapy was a complete waste of time. My therapist was hot though.

After having struggled through the sliding-scale fee public health care system for a few years, I recently shelled out cash for a few appointments with a specialist at NYU, Dr. Wayne Stokes. He is a nice guy and the first doctor I’ve seen that suggested treatments to actually fix the problem. Too bad I had to take my medical records and all his good ideas and go find a more affordable doctor. This NYU practice was charging over 2K for some simple anesthetic injections. I will admit that this private clinic was far nicer than any other clinic I’ve been to, but they were not breaks in the fees whatsoever.  

Some of the private hospitals offer a reduced fee for visits to clinic specialists. Both New York Presbyterian and NYU do not, but Brooklyn does. I am I the process of dealing with Brooklyn Hospital’s Pain Clinic and Neurosurgery department and will have a better review to write after the appointments have taken place. Even thought theses are private hospitals the wait times to get appointments are still long, like 2 months long.

Financial Services-  (718) 250-8080.  

Primary Care Physician/General Practitioners- So if you are not in urgent need of care, and you don’t need any kind of specialist your in luck because there are many places that except non-insured patients for simple things like antibiotics, birth-control, etc. If you are in serious pain do not go to these clinics. They will NOT help with pain management. You will be turned away empty-handed and in pain. You will only have wasted 2-3 hours of your life.

New York Presbyterian has various outpatient clinics around New York. They except un-insured, broke people for $10 a visit. I’ve visited two locations, The Washington Heights Family Center at 181^st st and The Charles Rangel Health Center on 135^th st. -(212) 491-2300- Be prepared to spend at least two, if not three hours per visit. The clinics are tidy, but full of families and pandemonium. I was very unsatisfied with these clinics because I was trying to get help for pain and these doctors were totally unwilling to help. They will try to refer you to outside hospital clinics which are not part of your $10 deal.

The Institute for Family Health on 16^th st in Union Square - (212) 633-0800- offers a similar sliding fee scale and they offer a lot of services e.g. Medical, Mental Health, Acupuncture, and Osteopathic Manipulation. The price for broke people is $15 a visit.  There is a reason the price is so low.

The office is a mismanaged disaster. Certain appointments are hard to book (Osteopathic manipulation is only booked through one person and she does not have a voicemail). Referrals are never made, or in the rare cases that they are, the wait times for outside procedures are months long. The doctors themselves here have ranged from decent to very good in quality. Do not try to get pain meds here. It’s a lost cause.

The Ryan Center on W 97^th st - (212) 740-1820- offers many of the same services, but they also have cheap dental. I recently had a cleaning and a check-up, with X-rays, for $35. The dental waiting list is long so book well in advance. I have never used this facility for medical reasons but I imagine it would be much the same as the two facilities I described previously. One tip to having a smoother transaction here is to arrive very early on your first day and be the first in line. The registration process is excruciatingly slow as there are only two attendants to help long lines of people. Once you’ve registered you do not have to go through the process again for a year. On a bad day expect to wait 1-2 hours for a Case Worker to register you.

#4 Mental Health­- If you need broad information about mental health providers you can call 1800- LIFE NET. The Life Net operators are kind and compassionate but generally unhelpful if your looking for long term placement; however, if you are having a mental crisis and need immediate help, they would be the ones to call.

As far as long-term providers there tons of places around New York were you can have talk therapy twice a week with monthly psychiatric visits, all for cheap. The catch is that the therapists are usually grad students, not doctors, and it is a requirement that you attend their talk therapy. In other words, you cannot just see a psychiatrist.

New York Presbyterian Out-Patient Psychiatry- (212) 305-5977offers therapy and psychiatry for $10 a visit. The condition at this clinic is that you sign-up for a full year at a time with a grad student. These student therapists range in quality from poor to great, but the best thing about this clinic is they have a great psychiatrist, Dr. Garza. He is available to see patients of the clinic once a month for $10.

Both the Institute for Family Health and the Ryan Center have Mental Health services. At the Institute for Family Health it is possible to see only a psychiatrist and not be in therapy. After proving you’re broke each visit is $35.

In Brooklyn there is place call CABS -(718) 388-0390- that offers cheap care, but you must participate in the talk therapy/psychiatry combo. No psychiatry only.

#5 MRI- If you need an MRI it is possible to get them done for between $150-200 at the Ryan center, or through a referral to Bellevue. However once you’re at Bellevue you will have to jump though a ridiculous series hoops. This can take months and even then it’s serious gamble. I decided to pay an extra $325 and get the MRI done myself.  

I got an MRI done with Remake Health http://remakehealth2.3dcartstores.com, (877) 537-6253- for $525 all fees included. Since NYU offered me a cash only discount of $2200, the generous bastards, when I saw this deal I thought it was a scam. It seemed too good to be true, but it is true, and a great deal. It is a legitimate offer and the service is great. If you can spare the extra couple hundred bucks to get this done you will save months of waiting and headaches that you would otherwise surely suffer trying to get this done at a public facility.