Navigating Healthcare
The American healthcare system is confusing even for the people who work in it. Nobody hands you a map, and the cost of guessing wrong is measured in thousands of dollars and months of waiting.
This is the map. Every level of care, what each one is good for, what it costs, how to get in the door, and where HAVEN sits among them.
Where to Go for Care
Seven levels, from the emergency room to your neighborhood
Knowing where to go saves time, money, and stress. Tap any level to see what it is best for, what it costs, and how to get care there.
For life-threatening situations only. Emergency rooms must treat anyone, but the bills are the largest in the system.
Best for
Chest pain, trouble breathing, severe bleeding, signs of a stroke, serious injuries, or anything that feels life-threatening. For a mental health crisis, call or text 988.
Cost
Emergency rooms treat anyone with a medical emergency, regardless of insurance or ability to pay. If you are billed afterward, Yale New Haven Health's Free Care program is charity care: anyone can apply regardless of insurance status, approval is based on your household income, and immigration status does not disqualify you. Ask about it before you leave, or apply later for a bill you already have.
How to get care
Call 911 or go to the nearest emergency department. Open 24 hours a day, 7 days a week. Never wait on cost in an emergency.
For problems that cannot wait for an appointment but are not emergencies. Far cheaper than an emergency room.
Best for
Sprains, minor cuts, fevers, urinary infections, rashes, and flu-like illness that gets worse over a weekend or an evening.
Cost
Usually a flat visit fee, often between $100 and $200 without insurance. Much less than an emergency room, but not free, and YNHH Free Care only applies at Yale New Haven Health locations. Ask the price before you are seen.
How to get care
Walk in, or check the location's website for a wait time. Cornell Scott-Hill Health Center runs a convenient-care walk-in service for its patients.
Your main doctor for everyday health. Manages ongoing conditions, prescriptions, and referrals.
Best for
Checkups, chronic conditions like diabetes and high blood pressure, prescription management, preventive screening, and being the person who knows your history.
Cost
Depends entirely on where you go. With Medicaid/HUSKY, most primary care is free. At a community health center, fees run on a sliding scale. At HAVEN, it is free.
How to get care
You establish care with one practice and stay with it. Having a primary care provider is the single thing that makes the rest of the system navigable.
Doctors focused on one area of medicine. Almost always require a referral, and usually insurance.
Best for
Cardiology, orthopedics, gastroenterology, endocrinology, and anything needing equipment or expertise beyond primary care. HAVEN runs its own dermatology, nephrology, and neurology clinics on select Saturdays.
Cost
Expensive without coverage, which is exactly the problem HAVEN's referrals team works on. Through our partnership with the YNHH Free Care office we can often secure specialist appointments at no cost or greatly reduced cost. You need a Free Care application on file first.
How to get care
You need a referral from a primary care provider. If HAVEN is your provider, tell your care team and see our referrals page for how the process works.
Full-service primary care for everyone, open during the week, priced on what you earn.
Best for
Ongoing primary care, especially if you have insurance, need care more often than once a week, or are not eligible for HAVEN. They also offer dental and behavioral health.
Cost
Fair Haven Community Health Care and Cornell Scott-Hill Health Center welcome patients regardless of insurance or ability to pay. Both charge on a sliding scale based on your income, so what you pay depends on what you earn.
How to get care
Call the health center directly to become a patient.Fair Haven: (203) 777-7411Cornell Scott: (203) 503-3000
Free primary care every Saturday. No insurance needed. A bridge to the rest of the system, not a permanent home.
Best for
Uninsured adults aged 18 to 65 in Greater New Haven who have not been seen previously by a local community health clinic and meet our eligibility criteria.
Cost
Free care for uninsured adults, always. Your visit costs nothing. Medications are the one place you may be asked to pay: you cover anything priced under $25, and for medications at or above $25 we screen for your ability to pay and work with you on the cost. Nobody is ever denied a medication because they cannot pay.
How to get care
Check your eligibility, then call (203) 200-0673 and leave a voicemail. Please allow at least 48 hours for a return call. Our clinic runs Saturday mornings, and the Compass Program works with you toward permanent coverage and a weekday provider you keep after us.
Food, housing, utilities, transportation, legal aid. Not healthcare, but they shape your health more than most appointments do.
Best for
Anything outside the exam room that is making it harder to stay healthy: running out of food, losing housing, no ride to an appointment, an eviction notice.
Cost
Free. Connecticut 211 is a free, confidential referral service available 24/7 for every category above.
How to get care
Dial 2-1-1 or visit 211ct.org. If you are a HAVEN patient, our social services team will make the connection with you.
How Care Gets Paid For
Three different things get confused with each other constantly. Insurance, charity care, and sliding-scale pricing are not the same, and you can use more than one.
Medicaid / HUSKY Health
What it is
Connecticut's Medicaid program. Free or very low-cost comprehensive coverage for people who qualify based on income and household size.
What it covers
Real insurance you can use anywhere that accepts it, including specialists and pharmacies.
How to get it
Apply through Access Health CT, the state marketplace. HAVEN's insurance counseling team can help you determine eligibility and complete the application at no cost.
YNHH Free Care
What it is
Yale New Haven Health's financial assistance program. Charity care, not insurance: there is no card and it applies only at YNHH facilities.
What it covers
Covers hospital and YNHH-affiliated bills, including ones you already have. Immigration status does not disqualify you.
How to get it
Apply with proof of income and renew about every 6 months. See our step-by-step Free Care guide, which walks the form section by section.
Sliding scale fees
What it is
Community health centers set what you pay based on your income and household size, often down to a small flat fee.
What it covers
Applies to primary care, dental, and behavioral health at federally qualified health centers.
How to get it
Ask about the sliding scale when you call to become a patient, and bring proof of income to your first visit.
You do not have to work this out on your own. HAVEN's insurance counseling team sits with patients every Saturday to figure out which of these applies and to fill out the paperwork together.
Words You Will Run Into
Most of the confusion in American healthcare is vocabulary doing the work of a barrier. Here is the vocabulary.
- Premium
- The amount you pay every month to have insurance, whether or not you use it.
- Deductible
- What you pay out of pocket before insurance starts paying. A high deductible plan can still leave you with big bills.
- Copay
- A fixed amount you pay at a visit, like $25 to see a doctor, on top of any premium.
- Referral
- A primary care provider's formal request that a specialist see you. Most specialists will not schedule you without one.
- Prior authorization
- Insurance approving a test, procedure, or medication before it will pay. It causes most of the waiting you will experience.
- Charity care
- A hospital covering your bill because you cannot afford it. YNHH Free Care is charity care. It is not insurance.
- Sliding scale
- A fee set by your income rather than a fixed price. Common at community health centers.
- FQHC
- Federally qualified health center. A clinic funded to serve everyone regardless of insurance, on a sliding scale.
Where to Go From Here
If you are uninsured, between 18 and 65, living in Greater New Haven, and have not been seen before by a local community health clinic, start with us.