By the end of June, we’ll reach the middle of the so-called “gap year” — meaning that roughly six months will remain before the Affordable Care Act kicks in and America begins an unprecedented experiment with universal health care coverage. Maybe that’s not such a big deal if you have great health insurance thanks to a job, or an employed spouse.
But for millions of people, it might feel a bit like playing Russian roulette. Roughly one in three Americans, including those 18-30, put off medical care for themselves or their family in 2012 due to the cost, according to a Gallup poll released in December. That’s the highest level since Gallup started tracking such figures in 2001, when the level was just 19 percent. What’s more, an estimated 50 million Americans no longer have health insurance.
If you’re one of those uninsured folks, you may feel as though any kind of health care remains out of reach financially. When I was laid off in 2009, for example, I ruled out paying hefty sums to keep up my employer’s health insurance, via so-called COBRA benefits (named for the Consolidated Omnibus Budget Reconciliation Act, which created them). If you’re uninsured today, other options might sound equally unattractive: buying short-term plans or catastrophic-only coverage, seeking state policies, buying plans through professional organizations or, in many cases, simply gambling that you can get through 2013 without coverage.
But rather than gamble on a healthy, lucky year, you can opt instead for check-ups and treatment via the steadily growing numbers of in-store health clinics.
The principle behind in-store clinics — commonly found at pharmacy chains and big-box stores such as Target and Walmart — is simple. Not every ailment requires a trip to the emergency room, or even a doctor. Typically, these clinics are staffed by physician assistants, or nurse practitioners (nurses who have advanced degrees) and are situated to treat conditions such as ear infections and strep throat, or provide vaccinations for illnesses such as influenza, tetanus and pneumonia. They’re also viewed as a valuable option in helping to fill the primary care void in some rural areas of the country.
They could also prove a boon if you don’t have insurance, but need an exam or checkup. Summer’s coming, and in-store clinics can provide physicals for sports leagues. And if you’re interested in screenings or monitoring for diabetes, blood pressure or cholesterol, clinics provide those as well. They can also help give you referrals for area doctors, and some services you might not expect, such as acne treatment.
Here’s the key for those with little or no insurance: Clinics provide basic health care services at a lower cost than a doctor. This price list from the Walgreens Take Care clinic represents what you’ll pay there without insurance; a blood pressure screening and counseling runs $65, while Hepatitis B series vaccines run $114.99 per dose for a three-dose series. Their stores accept cash, credit cards and debit cards; members of the Walgreens Prescription Savings Club get 10% off all Take Care services (though this can’t be used with insurance).
Walgreens operates 370 such clinics, but if you don’t have a Walgreens near you, they’re still getting easier to find. At least 14 new clinics in Target stores will open in the next few months across the country, bringing the total number to 68. New players such as Safeway are getting into the game — yet Walmart, which had once taken a bullish position on in-store clinics, has experienced sluggish expansion in this area. It operates about 150 clinics in its stores across the U.S. That puts it well behind Walgreens and CVS, which plans to open 500 of its MinuteClinics over the next five years.
According to Merchant Medicine, which tracks the growth of retail medical care services, there are currently 1,427 retail clinics operating in 39 states, up from 1,355 in 2011. The most explosive growth occurred between October 2006 and April 2008, when clinics nearly quadrupled in number from 200 to almost 1000. Early 2009 and late 2011 saw the growth level off, though about 200 more clinics were added in the last half of 2011.
Yet walk-in health options that don’t require a doctor’s attention only promise to grow in the months ahead. PhysBizTech reports that on-site health clinics for employers with 5,000 or more workers jumped from 32 percent of companies to 37 percent. In addition, another 15 percent of companies this size are considering adding their own health clinics in the next two years. And in terms of urgent care, Reuters reports that at least a dozen private equity firms have in the last few years plowed millions of dollars into urgent care clinics, which have become popular with people who do not have regular doctors, or who simply like the convenience.
Is an in-store clinic right for you? Convenience, cost, proximity and the nature of your health need all play roles in making that call. But most of us can and should take advantage of what they have to offer — regardless of whether we have insurance. Keep in mind though that if you’re uninsured, a few well-timed clinic visits could keep you healthy through the rest of 2013, while keeping your out-of-pocket costs under control.
And as with so many consumer quandaries, the larger issue involves changing habits. Shopping for health care at the same place where you get your greeting cards or salad fixings might seem strange at first. But if it keeps you and your wallet in fighting trim, it’s definitely worth considering — not just this year, but next year and beyond.
Have you been to an in-store health clinic? How was your experience?