answer:you must be over 65, under 18, or have dependent children. The amount you pay is a spindown. You must spend down your money to the point of qualifying for a free card, which is good for one calendar month. If your card is free it means you are at or below the poverty level for your area. If you have a $100 spindown, it means you make $100 over the poverty level in your area. You do not get inferior medical help, the doctors are not told what insurance you have or don’t have, therefore it has no bearing on your coverage. what is covered depends on the doctors findings. i.e. if you have a broken leg, they will not pay to get you an arm x-ray etc