Understood Care
Community health centers are neighborhood clinics that provide comprehensive primary care and related services to people in areas with limited access to health care. Many of these clinics are part of the federal Health Center Program and are recognized as Federally Qualified Health Centers, or FQHCs. They are community based and patient directed, with boards where at least half of the members are patients themselves.
Health centers that are part of this program receive federal funding under Section 330 of the Public Health Service Act. In return, they must meet strict standards for quality, access, and financial protections for patients, including offering a sliding fee discount program and serving everyone regardless of ability to pay.
You might hear several terms used for these facilities:
They are often described as one stop shops because many offer primary care, basic mental health services, dental care, OB GYN services, pharmacies, lab testing, and sometimes imaging in one building or across a small network of sites in your county.
If you are watching an Understood Care video about these services, you may hear your advocate describe having worked in community health centers for years and seeing personally how they help people of all income levels get care that would otherwise be out of reach. That experience shapes the guidance in this article.
Community health centers are designed for people who might otherwise fall through the cracks of the health care system. According to federal data and national organizations that support the Health Center Program:
Research from large networks of community health centers shows that middle aged and older adults who receive care there often have several chronic diseases at once. These clinics play a central role in tracking those conditions, preventing complications, and coordinating care.
If you are an older adult, a caregiver, or managing several health issues at once, a community health center can become your medical home. That means one place knows your full history, coordinates with your specialists, and follows you over time.
Not every health center offers every service, but the federal Health Center Program requires participating clinics to provide comprehensive primary care and many related supports.
Here are common services you may find.
Most community health centers provide:
Clinicians often include physicians, nurse practitioners, physician assistants, and nurses who are experienced in managing complex health needs in resource limited settings.
Many health centers operate dental clinics that provide:
Dental services are particularly important for people who have gone years without routine care. You may find that dental visits at a community health center are significantly more affordable than private dental offices, especially if you qualify for the sliding fee scale.
Community health centers often provide:
Some centers have midwives or OB GYNs on site. Others partner closely with hospitals for higher risk pregnancies and procedures.
Many health centers integrate behavioral health directly into primary care. You may have access to:
Integrated care helps your team see the full picture of your health and adjust medical and behavioral treatments together.
In the video script you heard that community health centers often include pharmacies, laboratory services, and basic radiology under one roof. In practice, you may see:
Having these services in one place can reduce extra trips and make it easier to complete tests your clinician orders.
Health centers must offer enabling services that address common barriers to care. These can include:
If organizing all these pieces feels overwhelming, Understood Care advocates can provide additional support through Care Coordination and Appointments.
A central idea in the video script is that community health centers are partially federally funded and designed to keep care affordable, whether or not you have insurance.
If you do not have health insurance, health centers must still see you. They use a sliding fee discount program that adjusts charges based on your household income and family size, using the federal poverty guidelines that are updated each year.
In practical terms, this usually means:
If you qualify for public programs but have not enrolled yet, many centers have staff who can help you apply.
Most community health centers accept:
For Medicare, FQHCs are paid under a special prospective payment system. In general, Medicare pays the clinic, and you are responsible for a coinsurance amount, often around 20 percent of the approved charge for most non preventive services. For certain preventive services at FQHCs, the Part B deductible and coinsurance may be waived.
The key point is that health centers can use their sliding fee policies to reduce or even waive what you owe if paying the full 20 percent would be a hardship. Some centers have policies that allow them to waive all or part of the coinsurance for patients with low incomes.
If you have private insurance, the center typically bills your plan, then applies the sliding fee discount to your remaining share, depending on your income.
In the video, your advocate explains that community health centers have access to special prescription pricing that can make medications extremely inexpensive. This is closely tied to the federal 340B Drug Pricing Program and related discount arrangements.
At many health centers:
If you are on multiple medications, especially for chronic conditions, these discounts can make a major difference in your monthly budget.
Many older adults and people with disabilities rely on community health centers as their main source of care. Research shows that patients in these clinics often have several chronic diseases that accumulate over time.
If you are managing conditions such as:
a health center can help with:
Federal quality programs encourage health centers to track performance on chronic disease measures such as blood pressure, blood sugar, and preventive screenings. Many clinics have participated in national collaboratives that improved outcomes for conditions like diabetes and heart disease.
If you are an older adult, your health center team can also help you:
If you would like someone outside the clinic to help coordinate across different doctors and settings, an Understood Care advocate can do that through Care Coordination.
You deserve care that feels organized and respectful, no matter your income or insurance. Here are ways to use a community health center effectively.
If organizing these calls feels like too much, Understood Care can help identify good options and schedule visits through the Appointments service.
To make the most of your visit, bring:
You can also invite a trusted family member or caregiver to come with you for support.
During your visit, consider asking:
If you feel rushed or overwhelmed, it is okay to pause and say, “Can you explain that in a different way?” or “Can we write that down so I remember later?”
After your appointment:
If keeping track of all these steps is difficult, an Understood Care advocate can help you understand the plan, follow up with the clinic, and keep appointments organized through Appointments and Care Coordination.
The federal Health Resources and Services Administration (HRSA) maintains an online Health Center locator where you can search by address, city, state, or ZIP code to find HRSA funded health centers across the United States and territories.
When you search, you can:
If you live in a rural community, you can also learn more from the Rural Health Information Hub, which explains how FQHCs operate in rural settings and how they complement rural health clinics.
If you prefer not to search online:
Understood Care advocates can also help you identify health centers suited to your needs and location, and then help you get appointments.
If you watched the video script that inspired this article, you heard your advocate say, “We can help you find one of these centers, get you appointments, and match you with the facilities that fit your needs.”
In practice, that can look like:
If you are unsure whether a community health center is a good fit, an advocate can talk with you about your health concerns, your insurance, and your budget, then help you weigh your options.
Not exactly, but the terms overlap. Community health center is a broad term for local clinics that focus on primary care and serve people with limited access to health care.
Federally Qualified Health Centers are specific types of community health centers that meet detailed federal requirements. They must:
Because of these requirements, FQHCs receive enhanced reimbursement from Medicare and Medicaid, as well as access to programs like 340B drug discounts.
Yes. Health centers are open to everyone, regardless of insurance status. Many of their patients are insured through Medicare, Medicaid, or commercial plans.
If you have:
If paying your share under Medicare or private insurance would be hard, ask the clinic if their sliding fee scale can reduce what you owe.
Sliding fee discount programs at health centers are governed by federal rules. They must:
In day to day life, that usually looks like:
You can ask the front desk or financial counselor to explain their specific sliding fee policy and how often you need to reapply.
Community health centers are rarely completely free, but they are designed to be affordable. Fees are typically:
Federal guidance emphasizes that any nominal charge for the lowest income patients must still be affordable and must not reflect the true cost of care.
If cost is still a barrier, ask if the clinic has charity care policies, payment plans, or partnerships with local foundations.
You can search for HRSA funded health centers using the federal Health Center locator, which lets you enter your address or ZIP code and see clinics on a map.
If you prefer phone support:
Understood Care advocates can also do this research with you and help set up visits.
Community health centers are built for patients with complex medical and social needs. Studies of large health center networks show that many middle aged and older patients there have several chronic diseases and face social challenges like limited income, unstable housing, or transportation barriers.
Clinics respond by:
If coordinating between your community health center, specialists, hospitals, and home health agencies feels overwhelming, an Understood Care advocate can help you manage that bigger picture through Care Coordination.
This content is educational and is not a substitute for medical advice. Always consult your healthcare provider for personalized care.
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