Another example of disjointed care and coverage: I'm thinking of client with major medical problems and major mental health problems. When this person was homeless and single, client qualified for 'charity care' at no cost, or very, very minimal cost (co-pays so low that neither medical or mental health providers paid attention to if the co-pays were made or not.) Said client got married to a person who worked at a major medical center whose employees are State employees. Spouse grosses less than $35,000 per year, and has custody of 3 younger siblings which spouse must provide for. To add client to spouse's State insurance would cost $450 per month. At that salary, they can not afford to add client to insurance and still pay for basic needs, and could not afford co-pays if they could afford the the insurance premium. Because of client's spouse's income, client no longer qualifies for 'charity care.'   Because client and spouse take financial obligations seriously, client has withdrawn from medical treatment for the broken back, seizure disorder, hypertension, and chronic pain from broken back, and has reduced needed care for PTSD because of the increase in co-pay in sliding scale fee once client married.