Financial Help During Serious Illness in the US

The financial impact of a serious diagnosis in the United States is often as significant as the medical one. Health coverage decisions, treatment costs, income gaps, housing pressures, and accumulating debt all arrive at once. This guide maps the main sources of financial help and explains how they interact. If you'd rather have a plan built around your situation, answer a few questions and we'll build one around you →

Medicare — what it covers and what it costs

Medicare provides health coverage for people 65 and older and, after a waiting period, for people receiving Social Security Disability Insurance. See US guide page 1 for the three pathways to early Medicare eligibility — SSDI 24-month rule, ESRD, and ALS. This section focuses on what Medicare actually pays for serious illness and what it does not.

Part A — hospital coverage

Part A covers inpatient hospital care, skilled nursing facility (SNF) care following a qualifying hospital stay (three consecutive inpatient days), hospice care, and some home health services. Most people with sufficient work history pay no Part A premium — it is funded through years of payroll taxes.

Cost-sharing under Part A is structured by benefit period (which begins when you are admitted and ends 60 days after discharge). Medicare sets the precise amounts annually; check medicare.gov for current figures. The key structure:

• Each benefit period has a hospital deductible you pay once, regardless of how many days you stay in that period
• Days 1–60 in the hospital have no additional coinsurance after the deductible
• Days 61–90 carry a daily coinsurance amount; beyond 90 days you draw on a 60-day lifetime reserve at a higher daily rate
• Skilled nursing facility care after a qualifying hospital stay is covered with no coinsurance for days 1–20; a daily coinsurance applies from day 21 through day 100
• Hospice care is covered with small copays for prescription drugs for pain and symptom management and for inpatient respite care; there is no deductible for hospice

If you are admitted to a hospital, confirm that you are admitted as an inpatient rather than placed on "observation status." Observation status is billed as outpatient (Part B), which can significantly affect your cost-sharing and your eligibility for subsequent Medicare-covered SNF care. You have the right to be notified in writing of your patient status (the Medicare Outpatient Observation Notice, or MOON, is required by law).

Part B — outpatient and medical coverage

Part B covers physician services, outpatient hospital services, diagnostic tests, durable medical equipment, outpatient surgery, preventive services, and some home health services. Most cancer treatments delivered in outpatient settings — infusion chemotherapy, radiation therapy, immunotherapy, targeted therapies — are covered under Part B. Inpatient chemotherapy falls under Part A.

Part B has a monthly premium — the standard amount is set annually by CMS; higher-income beneficiaries pay more through an Income-Related Monthly Adjustment Amount (IRMAA) surcharge. An annual deductible applies, after which Medicare pays 80% of approved costs and you pay the remaining 20% coinsurance with no annual out-of-pocket cap. For expensive cancer drugs or prolonged treatment, 20% of costs with no cap can represent tens of thousands of dollars — which is where Medigap becomes essential.

Part D — prescription drugs

Part D provides prescription drug coverage through private insurance plans approved by CMS. Each plan has its own formulary (list of covered drugs), tiers, and cost-sharing. When you or your oncologist adds a new medication, verify it is on your Part D plan's formulary; if not, your physician can request a formulary exception. Starting in 2025, the Inflation Reduction Act caps Medicare out-of-pocket drug costs at $2,000 per calendar year — a significant protection for patients on high-cost oncology drugs or specialty medications. Confirm the current cap at medicare.gov.

Extra Help (Low Income Subsidy, or LIS): if your income and resources are below specified thresholds, you may qualify for Extra Help — a federal program that substantially reduces Part D premiums, deductibles, and copayments. Apply through SSA at 1-800-772-1213 or ssa.gov.

Medicare Advantage vs. traditional Medicare for serious illness

Medicare Advantage (Part C) plans bundle Parts A, B, and usually D into a single private insurance plan. They typically have lower monthly premiums than traditional Medicare plus Medigap, and they do have annual out-of-pocket maximums (which traditional Medicare Part B lacks). However, they operate through provider networks (HMO or PPO), and access to specialists, cancer centers, or academic medical centers may be restricted or require prior authorization.

If you have a serious diagnosis that requires treatment at a specific hospital or specialist center — a National Cancer Institute-designated Comprehensive Cancer Center, for example — verify that the facility is in-network before relying on a Medicare Advantage plan. Switching from Medicare Advantage back to traditional Medicare can be done during defined enrollment periods, but Medigap insurers in most states are not required to sell you a supplemental policy outside of guaranteed-issue periods, and your health status may affect your ability to obtain Medigap coverage if you wait.

Medigap — filling Medicare's cost-sharing gaps

Medigap (Medicare Supplement Insurance) policies, sold by private insurers, cover some or all of the cost-sharing that traditional Medicare Parts A and B leave to you — including the Part A hospital deductible, skilled nursing facility coinsurance, and the 20% Part B coinsurance. For someone undergoing expensive cancer treatment, Medigap can convert potentially unlimited out-of-pocket exposure under Part B into predictable monthly premiums.

Medigap plans are standardized and labeled A through N (with some exceptions in Massachusetts, Minnesota, and Wisconsin). Plan G is the most comprehensive plan available to new Medicare beneficiaries since 2020; it covers the Part A hospital deductible, Part A and B coinsurance amounts (including 365 additional hospital days after Medicare coverage ends), and foreign travel emergency care. You pay the Part B deductible yourself. Plan N is similar but with small copays for office visits and emergency room visits, at a lower premium. Plan premiums vary by insurer, your age, and your state — compare plans at medicare.gov or through your State Health Insurance Assistance Program (SHIP).

The critical rule: Medigap insurers must sell you any plan without medical underwriting during your 6-month Medigap Open Enrollment Period — which begins the month you are both age 65 and enrolled in Part B. After this window closes, insurers in most states can reject your application or charge higher premiums based on health status. If you become eligible for Medicare before age 65 through SSDI, your state may or may not extend guaranteed-issue Medigap rights to under-65 beneficiaries — check with your state's insurance department. Contact your SHIP counselor (medicare.gov/plan-compare) for free, personalized guidance.

Medicaid — eligibility and what it covers

Medicaid covers health services for people with low income and, in expansion states, for adults with income up to 138% of the federal poverty level regardless of disability status. A serious diagnosis that reduces your income — through job loss, reduced hours, or inability to work — may make you newly eligible for Medicaid even if you had not previously qualified.

Medicaid covers services that Medicare does not, including long-term care in nursing facilities, personal care and home health aide services, dental and vision care (varies by state), and non-emergency medical transportation. Benefit coverage beyond federally required minimums varies significantly by state.

Dual eligible — Medicare and Medicaid together

If you qualify for both Medicare and Medicaid — called "dual eligible" — Medicaid can dramatically reduce your costs under Medicare. For people who are fully dual eligible, Medicaid pays Medicare premiums (Parts A and B), deductibles, and coinsurance amounts; this means out-of-pocket costs approach zero for most covered services. Medicaid also pays the Part D premium and cost-sharing for dual eligible beneficiaries through the Low Income Subsidy (Extra Help) program.

Not all dual eligible individuals receive the same level of assistance — "partial dual eligible" categories (QMB, SLMB, QI) cover Medicare premiums but not all cost-sharing. SSA and your state Medicaid agency can determine which category applies to your situation.

Apply for Medicaid through Healthcare.gov (for expansion states), which screens for both marketplace eligibility and Medicaid eligibility simultaneously, or directly through your state's Medicaid agency. In some states, Medicaid eligibility can be backdated up to three months before the application date — ask about retroactive eligibility when you apply.

ACA Marketplace — special enrollment and subsidies

If you lose employer-sponsored health coverage, the ACA marketplace provides an alternative. Loss of job-based coverage is a qualifying life event that triggers a 60-day Special Enrollment Period (SEP) — you can enroll in a marketplace plan during this window even outside the annual Open Enrollment Period (November 1 through January 15 in most states). COBRA expiration is a separate qualifying event that triggers its own 60-day SEP.

Premium Tax Credits

If your household income falls between 100% and 400% of the federal poverty level (FPL) — and, under extensions enacted through legislation, at incomes above 400% FPL with no hard upper cap — you may qualify for premium tax credits (PTCs) that reduce your monthly marketplace plan premium. PTCs cap your premium contribution at a percentage of your income based on where you fall in the FPL scale; the marketplace calculates your credit when you apply. Check Healthcare.gov for current income limits, as the ARP/IRA extensions have been subject to Congressional renewal.

PTCs are available only for ACA marketplace plans — not for COBRA or employer coverage. You cannot receive PTCs if you are enrolled in Medicare. If your income drops during the year, report the change through your Healthcare.gov account — you may qualify for a higher credit or transition to Medicaid mid-year.

Cost-Sharing Reductions

Cost-sharing reductions (CSRs) are available to marketplace enrollees with household income between 100% and 250% of the FPL — but only if you enroll in a Silver plan. CSRs reduce your deductibles, copayments, and annual out-of-pocket maximum, and can make a Silver plan's effective coverage comparable to a Gold or Platinum plan at a much lower premium. If your income qualifies, a Silver plan with CSRs is generally the most cost-effective marketplace option. Choosing a non-Silver plan forfeits CSR eligibility.

Comparing COBRA and marketplace plans

When you lose job-based coverage, you face a choice between COBRA and a marketplace plan. Under COBRA, you pay the full employer-group premium (often much more than you were paying as an employee) plus a 2% administrative fee — this can amount to $600–$1,500 or more per month for a single person, depending on your employer's plan. A marketplace plan with PTCs may cost substantially less, particularly if your income has dropped. However, COBRA keeps you on your existing plan — same network, same doctors, same in-progress authorizations — which matters if you are mid-treatment. If continuity of care is critical, compare both your network needs and your premium costs before deciding. You can elect COBRA now and switch to a marketplace plan during your SEP, or decline COBRA and go directly to a marketplace plan — but once you elect COBRA, you generally cannot switch to marketplace coverage until your COBRA coverage period ends or you have another qualifying event.

Your SSDI and SSI income

SSDI benefit amounts are based on your lifetime average indexed monthly earnings covered by Social Security; they vary significantly by work history. The average SSDI benefit is roughly $1,500 per month, though higher earners receive more. Check your estimated benefit at my.ssa.gov — your Social Security statement shows projected disability benefit amounts based on your actual earnings record.

The federal SSI monthly benefit is set annually by SSA — check ssa.gov for the current figure. Many states supplement the federal SSI payment with an additional state payment; your local SSA office can tell you what applies in your state.

Back pay: when SSDI is approved, SSA pays retroactively from your established disability onset date, minus the 5-month waiting period. The total can amount to months or even years of benefits paid as a lump sum. SSI back pay runs from the application date (no waiting period, but no retroactivity before application). If you also have an attorney or representative who worked on contingency, the attorney's fee — capped by SSA — is paid directly from the back-pay award before the remainder is disbursed to you.

Once you receive SSDI and the 24-month waiting period is complete, Medicare enrollment begins automatically. During the waiting period, you remain without Medicare; this is where Medicaid (if income-eligible), COBRA, or a marketplace plan is critical. If you are a full dual eligible (on both SSDI/Medicare and Medicaid), Medicaid covers your Medicare cost-sharing and effectively eliminates most out-of-pocket medical expenses.

COBRA — cost and when it makes sense

COBRA allows continuation of your employer's group health plan for up to 18 months after job loss or qualifying event, or up to 36 months in cases involving disability determination, death of the covered employee, divorce from the covered employee, or a dependent child losing dependent status. You pay the full group premium plus a 2% administrative fee — typically a significant increase from what you were paying as an employee, since most employers subsidize a substantial portion of the group premium.

COBRA makes most financial sense when:

• You are in the middle of active treatment with in-network providers and changing plans mid-course would disrupt care or require re-authorization of ongoing treatment
• Your income remains high enough that marketplace PTCs would be minimal
• Your employer plan's network includes specialist centers or physicians not available on marketplace plans in your area

You can use existing HSA funds to pay COBRA premiums while unemployed — COBRA premiums are a qualified HSA expense for unemployed individuals, which reduces the after-tax cost of COBRA. LIHEAP you cannot pay marketplace plan premiums with HSA funds directly (with exceptions for Medicare premiums and some other specific circumstances), but COBRA premiums while unemployed qualify.

Contact your employer's benefits administrator within the 60-day election window. Even if you wait until near the end of the window to elect COBRA, coverage is retroactive to the date your employer coverage ended — meaning there is no coverage gap as long as you pay the premiums from that original termination date.

Medical debt — charity care, negotiating bills, and credit reporting

Hospital financial assistance programs

Under Section 501(r) of the Internal Revenue Code — enacted as part of the ACA — nonprofit hospitals (the majority of US hospitals) are required to maintain a written financial assistance policy (FAP), commonly called charity care. The law requires them to:

• Make the FAP widely available and post it prominently (including in patient intake and billing areas and on the hospital's website)
• Screen patients for financial assistance eligibility before referring unpaid bills to collections
• Limit charges to FAP-eligible patients to amounts no greater than the amounts generally billed to insured patients (not the higher chargemaster rates)
• Not engage in extraordinary collection actions — wage garnishment, liens, lawsuits — without first notifying patients of the FAP and allowing a reasonable period to apply

Federal law does not set a minimum income threshold for FAP eligibility — hospitals set their own thresholds, which vary widely. Many nonprofit hospitals provide full forgiveness for patients at or below 200% FPL and sliding-scale reductions up to 300–400% FPL or higher. To apply: contact the hospital's financial counselor or patient financial services department; ask specifically about "financial assistance," "charity care," or "the financial assistance policy." You can apply retroactively — you do not need to apply before treatment.

For-profit and government hospitals are not bound by Section 501(r) but many have their own financial assistance programs. Ask regardless of hospital type.

Negotiating and disputing bills

Request an itemized bill for any hospital stay or major procedure — billing errors (duplicate charges, incorrect codes, charges for services not received) are common. Compare the itemized bill against your insurer's Explanation of Benefits (EOB), which shows what your insurer paid and what they say you owe. Discrepancies warrant a formal dispute with the hospital billing department in writing.

Before a bill goes to collections, contact the billing department directly to ask about interest-free payment plans. Hospitals generally prefer structured payment arrangements over unpaid debt sent to collections. Negotiating before a bill is sold to a collection agency gives you the most leverage; after that point, the hospital is no longer party to the negotiation.

Medical debt and credit reporting

Medical debt rules on credit reports have changed significantly in recent years. In 2022, the three major credit bureaus (Equifax, Experian, and TransUnion) agreed to extend the period before unpaid medical debt appears on credit reports from 6 months to 12 months, and to remove paid medical debt immediately. In 2023, they removed medical collections under $500 from credit reports entirely. The CFPB has subsequently finalized rules to remove medical debt from consumer credit reports more broadly — check cfpb.gov for the current status of these rules and any legal challenges.

Even if medical debt does not appear on your credit report, it can still result in lawsuits and wage garnishment if ignored. Address it directly: apply for financial assistance, set up a payment plan, or seek help from a nonprofit credit counselor or legal aid organization. Do not let it age into a judgment against you.

Your HSA — spending and carrying forward

If you have funds in a Health Savings Account, you can use them without tax or penalty for any expense that qualifies as a medical expense under IRC Section 213(d). For people in active treatment, this includes:

• Deductibles, copayments, and coinsurance under any qualifying health plan
• COBRA premiums while you are receiving unemployment compensation
• Medicare premiums (Parts A, B, C, and D) once you are enrolled in Medicare
• Long-term care insurance premiums up to age-based annual limits
• Prescription drugs, including specialty and oncology drugs
• Medical equipment, prosthetics, and durable medical equipment not covered by insurance
• Transportation to and from medical appointments (mileage at the IRS medical rate, or actual costs)
• Over-the-counter drugs and feminine hygiene products (post-CARES Act 2020)
• Mental health treatment, including therapy

HSA funds carry forward indefinitely — there is no "use it or lose it" rule. You also have the right to reimburse yourself from the HSA at any future date for qualified expenses incurred after the account was established, as long as the expense preceded the reimbursement. This means if you are paying cash for qualified expenses now and prefer to let the HSA balance grow, you can reimburse yourself years later — retain all receipts. Once you enroll in Medicare, you can no longer contribute to an HSA, but existing funds can be used for qualified expenses at any time, including Medicare premiums.

Retirement accounts — early access rules

Early withdrawal from retirement accounts before age 59½ normally triggers a 10% federal penalty in addition to ordinary income tax on pre-tax amounts. Several exceptions reduce or eliminate the penalty for people facing serious illness. These were covered in detail in US guide page 1; the key provisions relevant to financial distress:

• Terminal illness — SECURE 2.0 Act (2022): if a physician certifies that you have a terminal illness expected to result in death within 84 months (7 years), penalty-free withdrawals are available from 401(k), 403(b), governmental 457(b), and IRA accounts. Ordinary income tax still applies to pre-tax amounts; qualified Roth distributions may be tax-free.
• Unreimbursed medical expenses: withdrawals from IRA accounts used to pay unreimbursed medical expenses exceeding 7.5% of your adjusted gross income are exempt from the 10% penalty. This does not apply automatically to 401(k) plans — check your plan terms.
• Rule of 55: if you separate from your employer in or after the calendar year you turn 55, distributions from that employer's 401(k) are penalty-free. Does not apply to IRAs.
• 72(t) / SEPP distributions: substantially equal periodic payments taken over at least five years or until age 59½ (whichever is later) allow penalty-free access to IRA funds using IRS-approved calculation methods. Modifying the payment schedule before the required period ends triggers retroactive penalty — this method requires careful planning and professional guidance.

Before tapping retirement accounts, exhaust other options — financial assistance programs, grants, and payment plans do not reduce retirement security. The long-term cost of early withdrawal, accounting for lost compounding, substantially exceeds the face amount withdrawn. A fee-only financial advisor (find one through NAPFA, napfa.org) can model the true cost and explore alternatives.

Mortgage and rent assistance

Talking to your mortgage servicer

If you are struggling to make mortgage payments, contact your servicer before you miss a payment if possible — or immediately after. Servicers are required by CFPB regulations to evaluate homeowners for loss mitigation options before pursuing foreclosure. Options that may be available depending on your loan type:

• Forbearance — temporary suspension or reduction of payments while you cannot pay. Interest generally continues to accrue during forbearance. When forbearance ends, the servicer must offer repayment options: a lump-sum reinstatement, a repayment plan, loan modification, or payment deferral (for Fannie Mae/Freddie Mac loans). You are not required to repay all forborne amounts at once in most programs.
• Loan modification — permanent change to your loan terms to reduce the monthly payment, typically through a lower interest rate or extended loan term.
• Deferral — moves missed payments to the end of the loan as a balloon payment due at sale, refinance, or payoff. Available for some Fannie Mae and Freddie Mac loans.

The options available to you depend on who owns your loan (FHA, VA, USDA, Fannie Mae, Freddie Mac, or a private investor). When you call your servicer, ask specifically what programs are available for your loan type and your situation.

Free housing counseling

HUD-approved housing counselors provide free or low-cost assistance navigating mortgage servicers, understanding your options, and avoiding foreclosure. They are federally approved, independent of your servicer, and serve your interests. Reach them at 1-800-569-4287 or find an approved counselor at consumerfinance.gov/find-a-housing-counselor. Local nonprofit housing agencies, community action programs, and legal aid organizations often also provide free foreclosure prevention services.

Renters

If you rent, contact your landlord early and explain your situation. Formal legal protections for renters facing illness-related financial hardship vary widely by state and municipality. Check whether your state or local government has an emergency rental assistance program — many were established during the COVID-19 pandemic and some remain funded. Your state's housing authority website is the starting point. If you have a housing voucher (Section 8), contact your local public housing authority about any hardship provisions. Legal aid organizations can advise on tenant protections and dispute eviction proceedings.

Utility assistance — LIHEAP

The Low Income Home Energy Assistance Program (LIHEAP) is a federally funded block grant program administered by states, territories, and tribes. It provides financial assistance with home heating and cooling costs, utility bills, and emergency energy-related needs (such as restoration of shutoff service or repair of a furnace). Income eligibility is generally set at up to 60% of your state's median income or 150% of the federal poverty level, whichever is higher — but each state sets its own specific thresholds.

To apply for LIHEAP, contact your state or local LIHEAP agency. Find your state's contact information through the Administration for Children and Families at acf.hhs.gov/ocs/programs/liheap. Program funding is seasonal — heating assistance applications typically open in fall and may close before spring; cooling assistance programs are separate. Apply early, as funds can be exhausted.

Beyond LIHEAP, contact your utility company directly. Most large utilities have low-income customer assistance programs, medical baseline rates (reduced rates for customers dependent on medical equipment), budget billing to smooth out seasonal payment variation, and payment arrangement options. In many states, utilities are prohibited from disconnecting service to customers in life-threatening medical circumstances — ask about your rights when you call.

The Lifeline program, administered by the FCC, provides monthly discounts on phone or internet service for eligible low-income households. Apply through your phone or internet provider or at lifelinesupport.org.

Grants and financial assistance programs

Several nonprofit organizations provide direct financial assistance to people facing serious illness — for copayments, premiums, transportation, lodging, household bills, and other costs not covered by insurance. Availability depends on your diagnosis, income, insurance status, and current fund status, which can change quickly. Apply as soon as possible after diagnosis:

• CancerCare (cancercare.org or 1-800-813-4673) — provides limited financial assistance grants for cancer patients for copayments, home care, child care, and transportation, as well as free professional counseling and navigation services.
• Patient Advocate Foundation Co-Pay Relief Program (patientadvocate.org/copay-relief) — provides direct financial assistance with copayments and coinsurance for eligible patients who cannot afford out-of-pocket treatment costs; disease-specific funds.
• HealthWell Foundation (healthwellfoundation.org) — assistance with insurance premiums, copayments, coinsurance, and deductibles for people with chronic or life-altering conditions; disease-specific funds that open and close based on available funding.
• PAN Foundation (panfoundation.org) — helps underinsured patients afford out-of-pocket costs for FDA-approved medications; disease-specific programs.
• NeedyMeds (needymeds.org) — free searchable database of patient assistance programs, pharmaceutical manufacturer programs providing free or reduced-cost medications (PAPs), and disease-specific financial assistance resources. Start here if you don't know what programs exist for your specific condition.
• Disease-specific foundations — the American Cancer Society, Leukemia & Lymphoma Society, National MS Society, Muscular Dystrophy Association, and many others have financial assistance programs, transportation grants, and lodging assistance for patients who must travel for treatment. Search by your specific diagnosis.
• American Cancer Society Hope Lodge — free lodging for cancer patients and their caregivers who must travel from home for treatment; facilities in major cities with treatment centers. Find locations at cancer.org/hopeodge.
• Pharmaceutical patient assistance programs — most major drug manufacturers provide medications free or at substantially reduced cost to patients who cannot afford them. NeedyMeds and RxAssist (rxassist.org) list programs by drug name. Apply directly through the manufacturer or through your physician's office, which often has experience with specific programs.
• Social Security Extra Help — reduces Medicare Part D premiums, deductibles, and copays for people with limited income and resources; apply through SSA at 1-800-772-1213 or ssa.gov/extrahelp.
• Benefits.gov — official federal tool that screens for eligibility across all federal benefit programs based on your specific circumstances.

Managing debt

If medical bills, credit cards, or other debts are becoming unmanageable, free professional help is available — reach out before the situation escalates to lawsuits or wage garnishment.

The National Foundation for Credit Counseling (NFCC) is the largest nonprofit credit counseling network in the country. NFCC member agencies offer free or low-cost budget counseling, debt management plans (which consolidate unsecured debts into a single monthly payment at reduced interest rates), and financial education. Reach the NFCC at 1-800-388-2227 or nfcc.org to find a member agency near you.

Legal Aid organizations provide free legal representation and advice to low-income individuals. For medical debt, legal aid can help you understand your rights, dispute unfair collection practices, navigate negotiations with hospitals and collection agencies, and advise on whether bankruptcy protection is appropriate. Find your local legal aid organization through lawhelp.org or your state bar association's lawyer referral service.

Medical debt collectors must comply with the Fair Debt Collection Practices Act (FDCPA), which prohibits harassment, false statements, and unfair practices. You have the right to request written verification of any debt, dispute debts you believe are inaccurate, and limit contact from collectors. File complaints about unfair collection practices with the CFPB at consumerfinance.gov or 1-855-411-2372.

Bankruptcy is a last resort but a legitimate legal tool. Chapter 7 bankruptcy can discharge most unsecured debts, including medical debt; Chapter 13 creates a court-supervised repayment plan. Bankruptcy does affect credit. Consult a bankruptcy attorney — many offer free initial consultations — before filing; they can help you assess whether bankruptcy is necessary or whether alternatives (financial assistance applications, payment plans, NFCC debt management) can address the situation without the long-term credit consequences of a bankruptcy filing.

Key contacts

• Social Security Administration (SSA) — 1-800-772-1213 or ssa.gov. SSDI/SSI applications, Medicare enrollment, Extra Help for Part D, Social Security statements.
• Medicare — 1-800-633-4227 (1-800-MEDICARE) or medicare.gov. Plan comparison, enrollment questions, billing disputes, appeals, SHIP counselor referrals.
• Healthcare.gov — healthcare.gov. ACA marketplace enrollment, Medicaid/CHIP screening, Special Enrollment Periods.
• Patient Advocate Foundation — 1-800-532-5274 or patientadvocate.org. Free case management for insurance navigation and medical debt; Co-Pay Relief financial assistance program.
• HUD Housing Counselors — 1-800-569-4287 or consumerfinance.gov/find-a-housing-counselor. Free, HUD-approved housing counseling for mortgage forbearance, foreclosure prevention, and housing stability.
• NFCC — 1-800-388-2227 or nfcc.org. Nonprofit credit counseling, debt management plans, budget help.
• NeedyMeds — needymeds.org. Searchable database of patient assistance programs, prescription cost-reduction programs, and disease-specific financial assistance.
• CFPB — consumerfinance.gov or 1-855-411-2372. Medical debt, credit reporting rights, debt collection complaint filing.
• LIHEAP — find your state agency at acf.hhs.gov/ocs/programs/liheap. Energy bill assistance and utility shutoff prevention.