Healthcare Access in Chicago
Healthcare System & the Safety Net
Healthcare: Healthcare refers to the organized system of services, resources, and professionals involved in promoting, maintaining, and restoring the health and well-being of individuals and communities.1
Safety Net Healthcare Providers: Safety net healthcare providers are those providers that organize and deliver a significant level of healthcare and other related services to uninsured, Medicaid, and other vulnerable patients. Safety net providers include some hospitals (e.g., public, children’s, teaching, and community hospitals serving low-income individuals), community health centers, Federally Qualified Health Centers (FQHCs),* migrant health centers, health services programs for the homeless or public housing residents, school-based clinics, and some home health agencies.3
Safety Net Facilities & Access in Chicago
Safety Net Hospitals (SNH): Safety net practices are defined by the Institute of Medicine (IOM) as those providers that organize and deliver a significant level of health care and other needed services to uninsured, Medicaid and other vulnerable patients.4 In Illinois, the Illinois Department of Health and Family Services (ILHFS) designates safety net hospitals on an annual basis, available here.
Designated Safety Net Hospitals in Chicago
- Ann & Robert H Lurie Children's Hospital
- Community First Medical Center
- Holy Cross Hospital
- Insight Hospital
- Jackson Park Hospital
- La Rabida Children's Hospital
- The Loretto Hospital
- Mount Sinai Hospital
- Humboldt Park Health
- Ascension Saint Mary & Elizabeth Hospital
- Roseland Community Hospital
- Saint Anthony Hospital
- South Shore Hospital
- St. Bernard Hospital
- Swedish Covenant Hospital
- Thorek Memorial Hospital
- Thorek Memorial Hospital - Andersonville
- University of Chicago Medicine
- Weiss Memorial Hospital
Non-designated Safety Net Hospitals: All hospitals are required to treat emergency medical conditions via the Emergency Medical Treatment and Labor Act (EMTALA). EMTALA ensures public access to emergency services regardless of ability to pay. Section 1867 of the Social Security Act imposes specific obligations on Medicare-participating hospitals that offer emergency services to provide a medical screening examination (MSE) when a request is made for examination or treatment for an emergency medical condition (EMC), including active labor, regardless of an individual's ability to pay. Hospitals are then required to provide stabilizing treatment for patients with EMCs. If a hospital is unable to stabilize a patient within its capability, or if the patient requests, an appropriate transfer should be implemented.5
State/County Hospitals: The state of Illinois funds local hospitals to ensure residents have access to health care services regardless of ability to pay. The intergovernmental healthcare facilities have unique insurance programs that are partnered with Managed Care Organizations, so Illinoisans can access care.
Federally Qualified Healthcare Centers (FQHC): Federally Qualified Health Centers (FQHCs)—often referred to as community health centers (CHCs)—are nonprofit, community-directed health care providers serving low income and medically underserved communities. Created by Congress, the national network of community health centers provides high-quality, affordable primary and preventive care for those whom other providers do not serve, regardless of an individual's ability to pay.6 There are 22 FQHCs with 150+ locations in Chicago. Find a Free & Charitable Clinic near you
Chicago-Based Federally Qualified Health Centers
- Access Community Health Network
- AHS Family Health Center
- Alivio Medical Center
- American Indian Health Service of Chicago
- Aunt Martha's Health & Wellness
- Beloved Community Family Wellness Center
- Chicago Family Health Center
- Christian Community Health Center
- Erie Family Health Centers
- Esperanza Health Centers
- Friend Health
- Hamdard Center for Health & Human Services
- Heartland Alliance Health
- Howard Brown Health
- IMAN Community Health Center
- Lawndale Christian Health Center
- Mile Square Health Center
- Near North Health Service Corporation
- PCC Wellness Center
- PrimeCare Community Health
- Tapestry360 Health
- TCA Health
FQHC Look-Alikes: community-based health care providers that meet the requirements of the HRSA Health Center Program, but do not receive Health Center Program funding. They provide primary care services in underserved areas, provide care on a sliding fee scale based on ability to pay and operate under a governing board that includes patients.7 Find a FQHC Look-Alike near you
Free & Charitable Clinics: Free and charitable clinics provide medical, dental and pharmaceutical services for free or at a nominal fee to low-income individuals without health insurance. Some clinics will provide services to individuals who have insurance but cannot find a doctor or cannot afford the deductibles.8 Clinic Directory
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Insurance Coverage and Pathways to Care
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Health Insurance 101
- Health Insurance: Health insurance is a legal right to payment or reimbursement for your healthcare costs, usually under contract with a health insurance company. CMS.gov
- Health Insurance provides financial protection in case you have an accident or become sick, and it may help pay for doctor's services, medications, hospital care, and special equipment when someone is sick or injured, often in exchange for a monthly premium.
- Health Insurance is divided into two categories: private and public.
- Most individuals in the U.S. have private insurance which often comes from an employer or directly from an insurance company.
- Public insurance is through government programs such as Medicare, Medicaid, the Health Insurance Marketplace, and the Veteran's Health Admin.
Medicaid
- Medicaid: Medicaid is a healthcare insurance program for families or individuals with low income and limited resources. What is Medicaid?
- It is a jointly funded state and Federal program that pays for medical assistance services for eligible individuals.
- Who is eligible?
- To be eligible for Medicaid, you must be a resident of the state of Illinois, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income. You must also be on of the following:
- Pregnant, or be responsible for a child 18 years of age or younger, or blind, or have a disability or a family member in your household with a disability. Be 65 years of age or older
- To be eligible for Medicaid, you must be a resident of the state of Illinois, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income. You must also be on of the following:
- How do I apply?
- Use to apply online
- Find local help in your area.
- You can apply in person at certain Illinois Department of Human Services locations called Family Community Resource Centers (FCRC). Use the online DHS Office Locator at www.dhs.state.il.us/page.aspx to find the nearest FCRC.
- Over the phone
- You can apply over the phone by calling the DHS Help Line at 1-800-843-6154
Marketplace
Marketplace: The Health Insurance Marketplace (also known as the “Marketplace" or “exchange”) is federally operated and provides health plan shopping and enrollment services through websites, call centers, and in-person help. What is the Marketplace?
- When you apply for individual and family coverage through the Health Insurance Marketplace, you'll provide income and household information to find out if you qualify for:
- Premium tax credits and other savings that make insurance more affordable
- Coverage through the Medicaid and Children's Health Insurance Program (CHIP) in your state
- Who is eligible for the Marketplace?
- To be eligible to enroll in health coverage through the Health Insurance Marketplace you must:
- Live in the United States (U.S.)
- Be a U.S. citizen or national, or be lawfully present non-citizen in the U.S.
- Not be incarcerated
- To be eligible to enroll in health coverage through the Health Insurance Marketplace you must:
- When can you apply for health insurance?
- November 1: Open Enrollment starts for health coverage for the next plan year — first day you can enroll in, renew, or change health plans through the Marketplace. Coverage can start as soon as January 1.
- December 15: Last day to enroll in or change plans for coverage to start January 1.
- January 1: Coverage starts for those who enroll in or change plans by December 15 and pay their first premium.
- January 15: Open Enrollment ends — last day to enroll in or change health plans for the year. After this date, you can enroll in or change plans only if you qualify for a Special Enrollment Period.
- A Special Enrollment Period is a time outside the yearly Open Enrollment Period when you can sign up for health insurance. You qualify for a Special Enrollment Period if you've had certain life.
- You are eligible for health coverage or can change your current health coverage if you qualify for:
- A Special Enrollment Period due to a life change
- A Special Enrollment Period due to a recent loss of Medicaid or Children's Health Insurance Program (CHIP) Coverage
- Medicaid, CHIP, or a new Special Enrollment period based on income
- Check your eligibility and options here: Eligibility
- Piña IL, Cohen PD, Larson DB, Marion LN, Sills MR, Solberg LI, Zerzan J. A framework for describing health care delivery organizations and systems. Am J Public Health. 2015 Apr;105(4):670-9. doi: 10.2105/AJPH.2014.301926. Epub 2014 Jun 12. PMID: 24922130; PMCID: PMC4358211.
- https://www.cdc.gov/dhdsp/health_equity/health-care-access.htm#availability
- National Research Council and Institute of Medicine Committee on Children, Health Insurance, and Access to Care, Edmunds M, Coye MJ, eds. America's Children: Health Insurance and Access to Care. National Academies Press; 1998.
- https://www.ahrq.gov/topics/safety-net.html#:~:text=Safety%20net%20practices%20are%20defined,Medicaid%20and%20other%20vulnerable%20patients.
- https://www.cms.gov/medicare/regulations-guidance/legislation/emergency-medical-treatment-labor-act
- https://www.iphca.org/starting-an-fqhc/
- https://www.hrsa.gov/opa/eligibility-and-registration/health-centers/fqhc-look-alikes
- https://www.illinoisfreeclinics.org/clinic-search/whats-a-free-charitable-clinic/#:~:text=Free%20and%20charitable%20clinics%20provide,or%20cannot%20afford%20the%20deductibles
Healthcare Provider Quick Links
Public Health vs. Healthcare
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