I. Getting Help

What to Consider When Choosing a Rehab Center

As you weigh your treatment center options, this list of questions can help you make the right choice for your personal circumstances:

The severity of your addiction, your personal finances, and your individual situation will all inform the choice you make.

For more information on how to make these decisions, read our guide to Choosing the Right Rehab.

II. The Best Rehabs in New York City, NY

The cost of rehab can be high, depending on your needs and location. However, you can receive help to break free of your addiction, whether or not you have insurance. According to the Substance Abuse and Mental Health Administration (SAMHSA), there are 489 substance abuse treatment centers within 25 miles of New York City. Many of these organizations place providing care before making a profit, so it is possible to find help regardless of your financial status. Out of these 489 rehabs, Odyssey House, Inc. Outpatient Services has received the highest overall scores based on our five core metrics.


We used these five core metrics to evaluate the quality of each facility. For more information, please view the full breakdown of our filtering process and ranking methodology.

1. Odyssey House, Inc. Outpatient Services

Odyssey House, Inc. Outpatient Services, which scored 7 out of 10 overall points, offers a wide variety of alcohol and opioid substance use disorder treatment options for both adolescent and adult patients from many walks of life. The center offers specialized programs for pregnant women, victims of abuse, members of the LGBTQ community, and more.

Odyssey House is known for medication-assisted rehabilitation, offering Acamprosate for the treatment of alcoholism, Naltrexone for alcohol and opioid addiction, and Buprenorphine as replacement treatment to withdraw users from more dangerous opioids like heroin. Medication for co-occurring mental health conditions is also available.

All of these rehabilitation services would not be complete without accompanying counseling-based treatment approaches, such as trauma-informed counseling and cognitive behavioral counseling among several others, that strive to meet clients’ behavioral and psychological needs as they present themselves. Patients will also find help with concerns not directly related to the primary addiction, such as job skills training, HIV/AIDS support, health screenings, tobacco cessation, transportation services, and much more. In all, this center offers 33 ancillary services. Since Odyssey House accepts many forms of private and government insurance and aid, customers are able to avoid paying some or all fees out of pocket.

  • Rehabilitation Services Provided: 5.67
  • Treatment Approaches: 8
  • Cost: 7.77
  • Special Programs for Unique Demographics: 7.08
  • Ancillary Services: 6.9

2. Start Treatment and Recovery Centers: East New York

The East New York location of Start Treatment and Recovery Centers, which scored 6.7 out of 10 possible points, is one of seven clinics operated by Start in the New York City area. This center focuses on holistic care for those addicted to opioids. Its outpatient programs blend proven medication-assisted rehabilitation services with physical healthcare and education, psychological care for co-occurring mental illnesses, HIV/AIDS counseling and care, and many other ancillary services. A variety of treatment approaches inform patients’ recovery plans, including cognitive behavioral therapy, anger management, 12-step programs, and more. With so many options, this clinic truly treats the whole person.

Start’s East New York location offers two specialized programs for unique needs: one for adult women and one for victims of trauma. However, many treatment centers offer at least ten specialized programs, so this center had a low score in this category due to its limited options. Walk-in appointments to begin the evaluation and admission process are welcome, and payment options include Medicaid and Medicaid-managed care, as well as private insurance and cash payments on a sliding scale.

  • Rehabilitation Services Provided: 8.82
  • Treatment Approaches: 8
  • Cost: 6.66
  • Special Programs for Unique Demographics: 1.18
  • Ancillary Services: 5.4

3. Argus Community, Inc. Elizabeth L. Sturz Outpatient Center

The Argus Community, Inc. Elizabeth L. Sturz Outpatient Center scored 6.1 out of 10 points using our ranking system. The Outpatient Center is a flexible rehabilitation program open seven days a week so that patients can receive counseling services while maintaining a normal family or work schedule. Methadone, Buprenorphine, and Naltrexone are used at this center to aid detoxification, and psychiatric medications are also prescribed to patients as needed.

Eleven different treatment approaches are employed to meet a variety of client needs. Options include anger management, motivational interviewing, trauma-related counseling, and rational emotive behavioral therapy, to name just a few. After-school counseling is offered for teenagers.

Patients who utilize this center can benefit from a variety of ancillary services, such as health screenings, assistance with obtaining social services, family counseling, employment counseling, gym and recreation opportunities, and more. This center strives to make its services available to everyone, and the cost can often be covered by Medicaid, managed Medicaid, or private insurance. A sliding scale payment system is also available to those without insurance. Lack of ability to pay will not exclude anyone from the program.

  • Rehabilitation Services Provided: 4.41
  • Treatment Approaches: 8
  • Cost: 6.66
  • Special Programs for Unique Demographics: 5.31
  • Ancillary Services: 6.9
Top-Rated, Low-Cost Treatment Centers in New York City
RankRehabTotal ScoreContact Information
#1Odyssey House Inc. Outpatient Services7.03428, 953 Southern Boulevard, Suite 301 Bronx, NY 10459 Main Tel: 866-888-7880
#2Start Treatment and Recovery Centers – East New York6.7494 Dumont Avenue Brooklyn, NY 11207 Main Tel: 718-385-4235 x 4118 Intake Tel: 718-345-1178 x 4110
#3Argus Community, Inc. Elizabeth L. Sturz Outpatient Center6.1760 East 160th Street Bronx, NY 10456 Main Tel: 718-401-5700 Intake Tel: 718-401-5726
#4Creedmoor Addiction Treatment Center6.080-45 Winchester Boulevard Building 19-CBU-15 Queens Village, NY 11427 Main Tel: 718-264-3740 Intake Tel: 718-264-3742
#5NYC Health + Hospitals/Kings County Adult Behavioral Health Outpatient Program5.8451 Clarkson Avenue Brooklyn, NY 11203 Main Tel: 718-245-3131 Intake Tel: 718-245-3325
#6Bronx Addiction Treatment Center5.81500 Waters Place, Building 13 Bronx, NY 10461 Main Tel: 718-904-0026 x 300
#7South Beach Addiction Treatment Center5.7777 Seaview Avenue, Building 3 Staten Island, NY 10305 Main Tel: 718-667-2867 Intake Tel: 718-667-2551
#8Argus Community, Inc. Adult Resocialization Unit Outpatient Program5.7507 West 145th Street New York, NY 10031 Main Tel: 718-401-5700 Intake Tel: 212-234-1660
#9Kingsboro Addiction Treatment Center5.7754 Lexington Avenue Brooklyn, NY 11221 Main Tel: 718-453-3200
#10NYC Health + Hospitals/Jacobi Comprehensive Addiction Treatment Center5.51400 Pelham Parkway South Building 1, Floor 9 West 2 Bronx, NY 10461 Main Tel: 718-918-4465

Finding a Substance Abuse Treatment Center in New York City

Start by determining your coverage

As you determine your best options for a treatment center, your first step should be learning about your health coverage. You can speak with your private or healthcare marketplace insurance provider to find out which centers you can utilize. To learn if you are eligible to receive low-income Medicaid services, visit this site and reach out to the contact most appropriate to your situation. No matter the type of coverage you have, public and private insurance companies must cover substance abuse treatment for qualified individuals.

Use our database to find a treatment center near you

The tool below lists all of the treatment centers in the state of New York recognized by the Substance Abuse and Mental Health Services Administration (SAMHSA). Input your zip code and select the filter icon to find relevant treatment centers near you.

Schedule an assessment

After you understand your coverage options, scheduling an assessment with a therapist or counselor will be your next step in pursuing treatment covered by insurance. Most facilities provide assessments, or your primary care provider may be able to refer you. Contact companies in our database above to find out if they will provide this service.

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Type Of Care
Treatment Apporaches
Service Setting
Age Groups Accepted
Ancillary Services
Facility Operation
Facility Smoking Policy
Gender Accepted
Language Services
License Certification Accreditation
Payment Assistance Available
Payment Methods and Insurance Accepted
Special Programs Groups Offered

    What to Expect in Rehab

    Addiction treatment is a multifaceted industry, and numerous techniques and philosophies regarding treatment exist. As a result, the science of studying addiction is constantly shifting and improving. However, the core elements of rehabilitation are very similar.


    For more on what to expect in rehab, read our guide on the addiction rehabilitation process 

    III. Finding Aftercare in New York City

    The rehabilitation process can be a lifelong venture, and without proper aftercare upon release from a rehab facility, the chances of relapse increase. Many different aftercare options provide flexibility to the community, such as follow-up visits for continued therapy, sober living homes, and group therapy. Research shows that long-term participation in aftercare activities dramatically improves the outcome of rehabilitation efforts.

    The 12-step process for recovering from alcohol addiction was created by Alcoholics Anonymous, a nationwide addiction support group. Many other organizations now follow a similar path, including NA, or Narcotics Anonymous, which helps those who struggle with drug addiction.


    Contact the appropriate local organization to find an AA or NA meeting near you

    See our directory tool below to find local organizations that can help you find your local Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) group meetings. Meeting times and locations change periodically, it is best to call ahead to make sure the online information is accurate.

    Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) Database

    NameCityProgramTelephoneSpanish Hotline
    24 Hour Answering ServiceLakewoodAA(716) 488-2233N/A
    ABCD Region NAABCD RegionNA(888) 399-5519N/A
    Alcoholics Anonymous Hotline/Utica, NYUticaAA(315) 732-6880N/A
    Answering Service Of St. Lawrence CountyPotsdamAA(315) 268-0120N/A
    Bath Area IntergroupHammondsportAA(877) 700-4199N/A
    Berkshire County Area NABerkshire County AreaNA(413) 443-4377N/A
    Bronx Area NABronx AreaNA(212) 929-6262N/A
    Brooklyn Area NABrooklyn AreaNA(212) 929-6262N/A
    Brooklyn IntergroupBrooklynAA(718) 851-3039N/A
    Buffalo Area NABuffalo AreaNA(716) 878-2316N/A
    Buffalo Central OfficeSloanAA(716) 853-0388N/A
    Capital District Central OfficeAlbanyAA(518) 463-0906N/A
    Central Service Intergroup Of Orange CountyGoshenAA(845) 534-8525N/A
    Champlain Valley Area NAChamplain Valley Area (Plattsburgh)NA(866) 580-8718;(802) 862-4516N/A
    Chatauqua Area NAChatauqua Area (Jamestown)NA(716) 240-5983N/A
    City of Oneida 24 Hr Answering ServiceOneidaAA(315) 533-1227N/A
    Columbia County Answering ServiceHudsonAA(518) 463-0906N/A
    Corning Answering ServiceCorningAA(877) 501-1249N/A
    Corning IntergroupCorningAA(607) 368-9155N/A
    Cortland Homer IntergroupHomerAA(607) 753-1344N/A
    Dist 10 Plattsburgh Answering ServicePlattsburghAA(518) 561-8444N/A
    Dist 10 Saranac Lake Answering ServiceSaranac LakeAA(800) 281-1190N/A
    Dist. 13 Answering ServiceQueensburyAA(518) 793-1113N/A
    Dist. 4-Gloversville, Johnstown & Amsterdam Answering ServiceGloversvilleAA(518) 736-2644N/A
    Dutchess County Dist. 11 Central OfficePoughkeepsieAA(845) 452-1111N/A
    Eastern Long Island Area NAEastern Long Island Area (Suffolk County)NA(631) 689-6262N/A
    Eastern New York Region NAEastern New York RegionNAN/AN/A
    Elmira IntergroupElmiraAA(607) 737-6733N/A
    Finger Lakes Area Answering ServiceGenevaAA(315) 789-5955N/A
    Finger Lakes Area NAFinger Lakes AreaNA(877) 266-3660N/A
    Genesee Wyoming IntergroupStaffordAA(888) 854-8322N/A
    Greater New York Region NAGreater New York Region (Manhattan)NA(212) 929-6262N/A
    Green Mountain Area NAGreen Mountain AreaNA(802) 773-5575N/A
    Greene County Answering ServiceCatskillAA(518) 625-2002N/A
    Heart of NY Area NAHeart of NY Area (Syracuse)NA(315) 472-5555N/A
    Inter-Group Association of A.A. of New York, Inc.New YorkAA(212) 647-1680N/A
    Ithaca IntergroupIthacaAA(607) 273-1541N/A
    Jefferson County IntergroupWatertownAA(315) 788-2280N/A
    Kings Bay Area NAKings Bay AreaNA(212) 929-6262N/A
    Livingston Area IntergroupGeneseoAA(585) 245-4440N/A
    Mid Hudson Area NAMid Hudson Area (Sullivan, Ulster, Dutchess and Green Counties)NA(845) 431-9011N/A
    Mohawk River Area NAMohawk River AreaNA(888) 399-5519N/A
    Nassau Area NANassau AreaNA(516) 827-9500N/A
    Nassau IntergroupWest HempsteadAA(516) 292-3040;(516) 292-3045N/A
    New York City Area NANew York City AreaNA(212) 929-6262N/A
    Niagara Falls Area NANiagara Falls AreaNA(716) 304-6880N/A
    Niagara IntergroupNiagara FallsAA(877) 270-5303N/A
    Niagara-Orleans Area NANiagara-Orleans Area (Lockport)NA(716) 478-6992N/A
    NY-Penn IntergroupOleanAA(716) 372-4800N/A
    Oficina Central Hispana De A.ANew YorkAAN/A(212) 348-2644
    Oficina Central Hispana de BrooklynBrooklynAAN/A(347) 932-5485
    Oficina De Intergrupo De SuffolkBrentwoodAAN/A(631) 639-4181
    Old Forge 24 Hour Answering ServiceOld ForgeAA(800) 765-8338;(315) 369-2281N/A
    Open Arms Area NAOpen Arms Area (Orange, Sullivan, Ulster and Dutchess Counties)NA(800) 498-5224N/A
    Queens Area NAQueens AreaNAN/AN/A
    Queens Intergroup Of A.A.Forest HillsAA(718) 520-5021N/A
    Rochester Area Intergroup Inc.RochesterAA(585) 232-6720N/A
    Rochester Area NARochester AreaNA(585) 235-7889N/A
    Rockland Area NARockland AreaNAN/AN/A
    Rockland County IntergroupWest NyackAA(845) 352-1112N/A
    Rome 24 Hour Answering Service District 12RomeAA(315) 210-6644N/A
    Saratoga 24 Hour Answering ServiceSaratoga SpringsAA(518) 587-0407N/A
    Sayre-Waverly Valley IntergroupWaverlyAA(800) 233-3840N/A
    Seaway Trail Area NASeaway Trail AreaNAN/AN/A
    Staten Island Area NAStaten Island AreaNA(212) 929-6262N/A
    Suffolk Area NASuffolk AreaNA(631) 689-6262N/A
    Suffolk Intergroup AssociationPatchogueAA(631) 669-1124;(631) 654-1150N/A
    Sullivan County Intergroup Assoc.LibertyAA(845) 234-4841N/A
    Syracuse Service Center IntergroupSyracuseAA(315) 463-5011N/A
    Tioga County IntergroupOwegoAA(800) 307-4285N/A
    Triple Cities Area NATriple Cities Area (Binghamton)NA(607) 762-9116N/A
    Triple Cities IntergroupBinghamtonAA(607) 722-5983N/A
    Ulster County Answering ServicesKingstonAA(845) 331-6360N/A
    Utica 24 Hour Dist 9 Answering ServiceUticaAA(315) 732-6880N/A
    Western New York Region NAWestern New York RegionNAN/AN/A
    Western Queens Area NAWestern Queens Area (Astoria, Queens, Brooklyn, Bronx)NA(718) 962-6244N/A

    Sober Living Homes

    Sobriety, societal function, and independence are the foundation upon which sober living homes, or recovery residences, are built. These homes blend encouragement with challenges, safety with growth, and practical help with high expectations. Research supports the effectiveness of integrating recovering addicts into communities such as these that reward productivity and cultivate both employment and interpersonal skills. In short, sober living homes encourage residents to focus on building a life outside of their addiction.

    Residents of sober living homes must agree to pay rent, do chores, and – most importantly – maintain sobriety in order to remain at the residence. A zero-tolerance drug and alcohol policy protects everyone in the home. Support groups in each home are based upon house principles, and attendance is usually mandatory. Stay times are often flexible, ranging from a few months to multiple years, as long as the resident follows the rules and avoids relapse.

    You can find halfway houses in New York City by reviewing our database, or you can select the appropriate filter from our tool above. Alternatively, you can head to our guide on sober living homes and learn more about them, as well as search for a certified recovery residence in your area.

    IV. Substance Abuse in New York City

    The number of fentanyl-related overdose deaths in NYC has skyrocketed since 2000


    of all overdose deaths in NYC involving fentanyl, 2000-2014


    of all overdose deaths in NYC involving fentanyl, 2017

    New York City began tracking drug overdoses in earnest in 2000, and the data that the city has collected since then reveals an alarming trend. Within New York City’s five boroughs between 2000 and 2014, fentanyl was involved in 2% of all fatal drug overdoses; however, by 2017, that percentage had risen to 57%. Overall, the number of fentanyl-related overdose deaths increased from 0.4 of every 100,000 overdose deaths in 2014 to 12.1 of 100,000 overdose deaths in 2017, a shocking rise of 3,000% in only three years.

    Physicians occasionally prescribe fentanyl to patients who can no longer manage their pain with weaker opiates, such as morphine. However, it can be deadly in extremely small doses. Fentanyl slows breathing, frequently causing an overdose that, while indistinguishable from a heroin overdose, requires more Naloxone to reverse.


    of all cocaine-related overdose deaths in NYC involving fentanyl, 2015


    of all cocaine-related overdose deaths in NYC involving fentanyl, 2016

    While the rate of fentanyl prescriptions has remained stable in New York City, fentanyl-related overdoses have skyrocketed due to the illicit manufacture of the drug both in the United States and internationally. Because fentanyl is cheap, illegal drug manufacturers and dealers mix it into other drugs, especially heroin, cocaine, and methamphetamine, as well as counterfeit prescription drugs, such as Xanax. The New York City Department of Health and Mental Hygiene reported in 2017 that 37% of cocaine-related overdose deaths in 2016 also involved fentanyl, up from 11% only a year earlier in 2015. Fentanyl makes these drugs more deadly, and its presence is undetectable to the user. The only way to be sure you are not taking fentanyl is to avoid street drugs.

    Law enforcement in NYC is seeking to limit prescription opioid abuse


    of New York City residents abused prescription opioids, 2013-2014


    of New York City residents abused heroin, 2013-2014

    New York City residents have historically struggled with the abuse of prescription opioids. Commonly abused opioids include Oxycodone, Codeine, and Vicodin, but there are many other pharmaceutical opiates available. According to the 2013-2014 NYC Health and Nutrition Examination Survey, 8% of New York City residents ages 20 and older abused prescription opioids during that time period. In contrast, only 1.9% of the same demographic abused heroin in that time span.

    Since the Food and Drug Administration oversees the production of prescription opioids, patients may perceive these drugs as less risky than illicit drugs. Of course, typically patients are prescribed opioids for a legitimate reason but become addicted and unable to stop without intervention. Moreover, the Office of the Special Narcotics Prosecutor for the City of New York stated in its 2017 Annual Report that most new heroin users report being addicted to prescription opioids before they began using heroin, revealing that these legitimately prescribed medications can be a gateway to more deadly habits.

    In light of this grim fact, the city’s Special Prosecutor has aggressively prosecuted those who traffic in prescription opioids, including physicians who intentionally over-prescribe for personal profit. As a result of vigilant law enforcement, better medical standards, and increased public awareness of the dangers of prescription opioid abuse, New Yorkers filled 7.5% fewer prescriptions for oxycodone in 2017 than they did in 2016.

    NYC’s rate of fatal overdoses is lower than the national average, but some boroughs suffer more than others


    of New York County deaths caused by drugs and alcohol


    of US deaths caused by drugs and alcohol

    Although the percentage of drug and alcohol overdose deaths in New York County has grown alarmingly in the past several years, it still has a lower percentage than the national average. The percentage of New York County residents who died of a drug and/or alcohol-induced overdose between 2008 and 2017 was 10.24%, while the national average was 12.71%.

    New York’s City’s local government fights the effects of the opioid epidemic in part by promoting the use of Naloxone by laypersons. New York City advertises up-to-date Naloxone training and distribution resources on its government website, and this harm reduction-based Naloxone policy may well be what is keeping the county’s fatal overdose rate below the national average. If you are susceptible to opioid misuse or are likely to be around someone who is, consider downloading the “Stop OD NYC” app, which is dedicated to helping New Yorkers recognize and reverse overdoses.

    Drug and Alcohol-Induced Deaths Between 2008 and 2017
    0-1718+All Ages
    Drug-Induced Deaths in New York County68,8168,822
    Alcohol-Induced Deaths in New York County22,5102,512
    Total Deaths in County1,051109,676110,737
    Percentage of Drug & Alcohol-Induced Deaths in County.076%10.33%10.24%

    Source: CDC Wonder

    Regarding overdose deaths in New York City’s five boroughs, The Bronx suffered from the second-highest number of overdose deaths in 2017, despite having the second smallest population of the five boroughs.

    Overdose deaths in New York City boroughs, 2017
    YearBrooklynThe BronxQueensManhattanStaten Island

    Data gathered from CDC Wonder

    Key Indicators of Substance Abuse

    Addictions take a toll on society by all too often removing people from the workforce, stripping them of personal wealth, isolating them from their families and friends, and making them susceptible to depressive or anxious thinking and behavior. Looking at the social and economic health of a city can help us understand how addictions might be shaping people’s personal success and happiness. By studying mental health surveys, death records, and data on homelessness, we can identify vulnerable points in New York City culture.

    Mental Illness rates in New York City mirror those of the nation


    of New York City residents suffer from a mental illness


    of Americans suffer from a mental illness

    Mental health issues and substance use disorders frequently occur simultaneously, and a substance use disorder is itself considered a form of mental illness. Abusing a substance can exacerbate existing mental health issues or even trigger them in some cases. 20.7% of participants in the 2013-2014 NYC Health and Nutrition Survey self-reported having a mental illness in the past year. This statistic echoes the results of research by the National Institute of Mental Health (NIMH) that reveal nearly 20% of adults – one in five – in America suffer from mental illness in a given year.

    This local and national data suggests that in New York City, and probably in your own social circle, one in five people are struggling internally. Having a mental condition such as depression, anxiety, schizophrenia, or a personality disorder increases a person’s likelihood of developing a substance use disorder; in fact, the U.S. Department of Health and Human Services states that one in four adults with a mental health issue is also living with a substance abuse issue.

    Suicide rates in New York City are lower than state and national averages


    suicides in New York City per 100,000 adults, 2014


    suicides in New York State per 100,000 adults, 2014

    According to the New York State Office of Mental Health, New York City’s five boroughs collectively have a lower suicide rate than the state average, and the state of New York has a lower suicide rate than the national average. In 2014, the average suicide rate in New York City’s five boroughs was 6.9 deaths per 100,000 adults; the average in the state of New York was 8.6 deaths per 100,000 adults, and the national average was 13 deaths per 100,000 adults. Data from the New York State Office of Mental Health indicates that, throughout New York State, suicide rates are highest in rural areas.

    Despite its comparatively low suicide rates, New York City does have a suicide problem that is likely fueled in part by substance abuse. Substance abuse often increases impulsivity which, combined with an underlying, untreated mental illness, can reduce a person’s natural inhibitions about suicide. If you or someone you know wants to break free from addiction and the danger it poses to mental and physical health, many options are available, both on our list of local rehab centers and through other counseling venues. The National Suicide Prevention Lifeline is also available 24/7 as a confidential resource.

    Homelessness is decreasing in New York City in an unequally distributed pattern

    In compliance with the Department of Housing and Urban Development, New York City conducts a yearly count of its homeless population called the NYC Homeless Outreach Population Estimate (HOPE). New York City counts only its unsheltered homeless population, which numbered 3,588 individuals in January 2019.

    New York City’s overall homeless population decreased by 2% from 2018 to 2019. However, a closer look at the statistics reveals that there were significant inequalities among the city’s five boroughs and those individuals seeking shelter in the city’s subway system. Homelessness actually decreased between 20-30% in four boroughs and the subway system, but, in the Bronx, the rate only dropped by 3%. Such a stark difference is not surprising, considering that The Bronx struggles disproportionately from poverty, having a 10% higher poverty rate than the rest of the city.

    Homeless individuals are physically and economically vulnerable, and they often suffer from substance addiction. To meet the needs of the homeless, New York City has the HOME-STAT street outreach program that helps to bring New Yorkers off the street while providing compassion, support, and resources.

    V. Take Action

    New York City and its surrounding area have many resources available for those individuals fighting substance use disorders. Use our tool to discover a rehabilitation center near you that can help to determine your insurance coverage and treatment needs. Even if you are uninsured or you fear insurance may not cover all of your expenses, many low-cost centers exist that offer some or all of their services based on need rather than the ability to pay.