By Suzanne Barnecut
Wherever you fall in the debate over health-care reform, it’s a thing that’s happening. And soon. In case you missed it, Peter Lawrence Kane recently wrote about what every young San Franciscan should know about Obamacare.
If you already have health insurance, either privately or through a corporate benefits plan, you don’t need to sweat the Affordable Care Act deadlines. Many San Franciscans, however, will be impacted, because San Francisco, like any metropolitan area, is home to a great lot of artists — musicians, writers, painters, photographers, performers, and so on — as well as large numbers of inspired and hardworking individuals in the retail, restaurant, and hospitality industries. Many are cobbling together a living from multiple part-time shifts or are taking on freelance work or projects that have unpredictable time frames, leaving them without steady, reliable income. Considering the steep local inflation San Francisco has seen over the past few years, the prospect of paying for health insurance is as daunting as it ever has been. Not to mention that many of the currently uninsured are also undocumented immigrants, whom the health reform does not include.
If any of this describes you, we aim to help. If you cannot afford health insurance and are willing (or must) pay the tax penalty, or if you’re looking for something outside a traditional HMO or PPO, here are a few options for seeking medical treatment and advice.
Healthy San Francisco (also known as Healthy SF) is not going away once Obamacare goes into effect. It’s important to note, however, that current participants who become eligible for the expanded Medi-Cal program or financial assistance through Covered California will no longer be eligible for Healthy SF.
No. Healthy SF is a San Francisco–specific “health access program” through which participants may pay modest fees for treatments or access a reimbursement fund set up through their employer. Healthy SF is open to all city residents regardless of immigration status, employment status, or preexisting medical conditions, provided you meet the eligibility requirements.
Some Healthy SF participants may pay a Quarterly Participant fee and a Point-of-Service fee based on their income level. See the sliding-scale fee schedule here.
✓ Primary & preventative care
✓ Urgent & emergency care
✓ Mental health services
✓ Alcohol & drug treatment
✓ Lab services
✓ Pharmacy
✓ Ambulance & hospital care
✓ Family planning
✓ Medical equipment
✓ Specialty care
Healthy SF matches participants with a Medical Home, which are participating clinics (through the San Francisco Department of Public Health or the San Francisco Community Clinic Consortium) or a San Francisco campus of an organization such as Kaiser Permanente. While there are many possible medical homes, participants typically visit a single site.
Perhaps you’ve received marketing materials for One Medical via snail mail. I know I have, but because it always seemed like some mysterious medical place that wasn’t where I was insured, I never paid attention. The truth is, they’re kind of intriguing. One Medical is intended for individuals both with and without health insurance. They’re a little more tech savvy than city-based free clinics, offering same-day appointments that are scheduled online and in large-enough blocks of time so that you’re guaranteed a by-the-clock experience, with most follow-ups handled online. But despite their glamour, membership is open to anyone willing to pay the fees.
No. One Medical can be viewed as either an add-on or an alternative to health insurance. An annual membership fee allows members to access care at flat rates and either apply their health insurance or pay out of pocket. A bonus is that One Medical offers traditional primary care in addition to integrative medicine that typically isn’t covered by insurance.
Members pay $149 annually. Costs after that are based on the fee schedule. Uninsured members will pay $150 for their first doctor visit and $100 for each subsequent visit, for example. Insured members may choose to pay fees out of pocket or apply their insurance and pay only their standard co-pays and deductibles.
✓ Primary & preventative care
✓ Integrative medicine
✓ Lab services
✓ Women’s health
✓ Traveler’s health
One Medical is a national organization, but there are 11 locations in San Francisco as well as six others around the Bay Area. They boast same-day, on-time appointments and as much online service as possible in order to provide easy access for working professionals.
The San Francisco Department of Public Health offers a network of primary-care clinics, affiliated partners, and fee-for-service clinics around the city. Click here for a directory of clinics or health centers, and for information about clinic hours and drop-in care or to schedule an appointment.
No. These are free clinics and community-based health clinics meant to serve the underserved of San Francisco.
Mostly free, although some specialty clinics offer services for a modest fee.
✓ Primary & preventative care
✓ Urgent, acute, & emergency care
✓ Specialty care
✓ Home care
✓ Dental services
✓ Youth services
✓ Breast & cervical-cancer services
✓ Transgender services
✓ Housing & urban-health services
✓ Women’s health
✓ Immunization & travel services
Each primary-care clinic operates individually, and several are located at San Francisco General Hospital. Here’s a list: Castro-Mission Health Center, Children’s Health Center at SFGH, Chinatown Public Health Center, Curry Senior Center, Family Health Center at SFGH, General Medical Clinic at SFGH, Maxine Hall Health Center, Ocean Park Health Center, Potrero Hill Health Center, Silver Avenue Family Health Center, Southeast Health Center, and STD Clinic on 7th Street station (PEP).
The SFCCC is a nonprofit organization comprised of community-based partner clinics created for underserved neighborhoods and for low-income, uninsured, or homeless individuals to receive medical treatment. Click here for a directory of clinics and for instructions on hours for drop-in care or to schedule an appointment.
No. These are free or low-cost clinics intended for those who cannot afford to pay much or at all.
Services are free for those who cannot pay, and they are offered on a sliding scale for those who are able to.
✓ Primary & preventative care
✓ Urgent & emergency care
✓ Mental health services
✓ Health promotion & disease-prevention education
✓ Dental services
Each partner clinic operates as a stand-alone clinic. Rather than specialize, most of the clinics offer “one-stop shopping” and service in multiple languages. Clinics include the following: Glide Health Services,HealthRIGHT 360, Lyon-Martin Health Services, Mission Neighborhood Health Center, Native American Health Center, North East Medical Services, Saint Anthony Free Medical Clinic, San Francisco Free Clinic, South of Market Health Center, Street Outreach Services and Women’s Community Clinic.
The consortium website clearly lists the mission, target population, services, and programs for each clinic.
MusiCares provides a safety net for uninsured musicians in times of need, including help with financial, medical, and personal emergencies.
No. This is a grant-based program in which qualifying musicians (uninsured and without means to pay for coverage, and able to document at least five years of employment in the music industry or credits on six commercially released tracks) can apply for assistance for specific (and confidential) issues.
Free
✓ Primary care
✓ Specialty care
✓ Emergency care
✓ Addiction resources
✓ Dental services
✓ Other: basic living needs, equipment replacement, funeral/burial assistance, psychotherapy, etc.
Medical-network providers are located in the eastern, southern and western United States. Providers donate their time and expertise to provide services that range from general medical and dental to audiology, surgery, physical therapy, optometry, and so on at specific locations. All appointments must be made through MusiCares.
HINT stands for the Health Insurance Navigation Tool, which provides free support and advice to musicians who need information about health insurance.
No. This is an advice service for musicians provided by health-insurance experts who are also musicians. The aim is to provide information and to relieve confusion.
Thirty-minute appointments (by phone) are free and confidential.
✓ Information
✓ Advice
Musicians anywhere nationwide can request an appointment online. At the time of this article, calls are scheduled on Monday evenings, Eastern Standard Time.
The AHIRC helps connect artists, craftspeople, and entertainment-industry workers around the country to affordable health insurance, including alternative routes to coverage as well as local resources for care for small businesses, performers, visual artists, stagehands, filmmakers, musicians, artisans, and other self-employed and episodic workers.
No. This is an outreach and advocacy service that aims to provide access to help, and to help various artists make informed decisions.
Free
✓ Information & resources
✓ Individual consultations
✓ Education — seminars and tutorials
✓ Community outreach
✓ Advocacy
There are offices in New York and Los Angeles, but consultations are also handled by phone and email.
Family PACT is a program aimed specifically at family planning. It helps eligible Californians prevent pregnancy when they are not ready for it.
No. This is a limited-benefits program open to California residents (low-income men, women, and teens) who meet the eligibility requirements. Oftentimes, other sources of health coverage do not include family planning or pregnancy.
All services are covered during the valid enrollment period. Enrollment is good for one year and can be renewed.
✓ Birth control
✓ Emergency contraceptive pills
✓ Prevention, screening, and treatment for STDs
✓ HIV testing & counseling
✓ Limited cervical-cancer screening
Care is provided by a wide variety of providers. Search by ZIP code here for a list of providers near you (many of which are SFCCC partner clinics).
Not to worry, Planned Parenthood, the leading sexual and reproductive health-care provider and advocate — through which many uninsured women have been receiving routine exams and birth control — is not going away. The organization will continue to serve women (and men) who are both insured and uninsured.
No.
Health insurance is applied wherever possible, but Planned Parenthood will continue to provide free or low-cost services to the uninsured.
✓ General health care
✓ Women’s health
✓ Men’s sexual health
✓ Birth control
✓ Pregnancy & infertility
✓ Abortion
✓ Emergency contraceptive pills
✓ Prevention, screening, and treatment for STDs
✓ Help with body image issues
✓ Help with sexual orientation and gender questions
Planned Parenthood locations include the San Francisco Health Center at 1650 Valencia Street or the Wohlford Family Clinic at the Good Samaritan Family Resource Center at 1294 Potrero Avenue.
Health insurance is applied wherever possible, but Planned Parenthood will continue to provide free or low-cost services to the uninsured.
RotaCare offers free clinics for the uninsured in the greater Bay Area. The organization is largely volunteer driven and is supported completely by grants and donations.
No.
Free, including medical exams, diagnostic testing, lab testing, and most pharmaceuticals.
It’s really important to note that services vary by location, so be sure to carefully read the website for information about clinics near you to determine whether they will be able to accommodate your needs.
Clinics are located in Concord, Daly City, Gilroy, Half Moon Bay, Monterey, Mountain View , Pittsburg ,San Jose, San Leandro, San Rafael, and Santa Cruz, are open one to three evenings per week. Due to high demand, clinics sometimes take patients using a lottery system or on a first-come-first-serve basis until they’re full. Many of the clinics have to turn away patients each week.
There are a number of dentistry schools in San Francisco that offer clinics open to the public at reduced rates. Dental work is performed by students under the supervision of resident or faculty dentists.
No.
Fees are based on the service performed. The clinics also accept dental insurance.
Services vary by location, so be sure to carefully read the website for information about clinics near you to determine whether they will be able to accommodate your needs. In general, there are clinics for the following:
✓ General dental services
✓ Oral surgery
✓ Endodontics (root canals)
✓ Orthodontics
✓ Pediatric dental services
✓ Periodontics (gums)
✓ Prosthodontics (dentures)
Check out the UCSF School of Dentistry, which operates a variety of clinics. Another option is the University of the Pacific Arthur A. Dugoni School of Dentistry. Clinics for both schools are located in San Francisco.
