Stationed in the Boriken Neighborhood Health Center in East Harlem, Nurys Escano meets with patients who need to see a doctor but have no health insurance. She works for Healthfirst, an HMO; other representatives at the clinic work for MetroPlus, Neighborhood Health Providers, and WellCare.

Escano has heard every possible reason that patients remain uninsured: worries that children will be taken away, confusion about how much income they can earn, fears of deportation.

Such stories are common in low-income neighborhoods like upper Manhattan. Last year, 14.4 percent of New York City’s population was uninsured, according to the Census Bureau. Yet many of these people qualify for subsidized insurance. Unaware of their options, they never apply.

The Bloomberg administration targeted this group shortly after the mayor took office in 2002. “We’ve created numerous opportunities so that anyone who could be eligible can at least explore their health insurance options,” said Barbara Brancaccio of New York City’s Human Resources Administration. The city developed a new web-based tool allowing residents to shop for and compare insurance plans, for example.

Still, about 1.2 million New Yorkers remain uninsured. Nationally, the disparities are glaring: 28 percent of Latinos are uninsured compared to 17 percent of the total population, according to the Pew Research Center.

Boriken does its part to help: its doctors see anybody who enters, regardless of coverage, but people who are uninsured must sit down with Escano or another HMO representative to go over subsidized options, often applying for insurance on the spot. Escano first assesses whether patients qualify for Medicaid; most don’t because the required incomes levels are so low. Of those she helps apply for private insurance, eight of 10 are approved for subsidies or free care, she reported.

“If they become eligible, usually the insurance company will go back 30 days and pay for the clinic visit,” added Elizabeth Sanchez, the Center’s executive director. Those who make too much money to qualify but not enough to afford private insurance pay for their care on a sliding fee scale, as little as $30 or $60 a visit.

Patients often simply don’t know about their subsidized options, Sanchez said. “Newspapers and the political leaders put the information out there,” she explained, “but very few people in this community read or speak English.” Even when brochures and flyers are available in Spanish, “it’s not the day to day usage that the client may use.”

Sanchez also stressed the community’s workload. “The last thing on their minds is health care,” she said. Many residents are single mothers and “their first priority usually is taking care of their children and putting bread on the table.”

Andy Nieto, director of community health at New York-Presbyterian Hospital, also works with low income people who often qualify for subsidized care: upper Manhattan’s taxi drivers.

For the past five years, his hospital has sponsored a drivers’ health fair that provides free screenings for glaucoma, prostate cancer, hypertension, and diabetes.

Taxi driver Juan Payano visited this year’s health fair on a crystal clear fall day. A native of the Dominican Republic, he was uninsured, and had spent 13 hours in the emergency room earlier this year because he was feeling sick. The hospital ran tests but found a simple virus – a costly expense the hospital absorbed.

It’s difficult for fellow drivers to afford coverage, Payano said. “We are self-employed. It’s hard for us to buy insurance.” Besides, Payano added, arriving immigrants are often confused about insurance options. “You’re kind of lost. The doctors are expensive. It’s complicated,” he said.

Instead of trying to work through the system here, “sometimes when people go home, they check their teeth and their health because it’s less expensive.” But that doesn’t help if they get sick when they return.

Nieto added lack of time to Payano’s list. “These guys work six to seven days a week, so often these guys don’t have time to take care of their health care until it’s too late,” he said.

Nieto also runs a spring health fair for bodega owners, a group that faces similar barriers to health care. HMO’s offering subsidized care are invited to both events – Healthfirst showed up for the taxi drivers’ fair – to promote affordable insurance plans.

But even those who apply and get coverage may forget to re-certify each year. “Some patients are just irresponsible,” said Dr. Danielle Milano, who works at Boriken. She added that the HMOs’ mailed documents don’t always reach low-income patients, who move quite often.

Payano is a prime example. He previously applied for insurance but moved before finding out if he was approved. He was, but the documents were mailed to the wrong address. Too busy to follow up, he has had to re-apply and is awaiting a decision – but the stakes are now higher, because his wife and daughter finally joined him in New York last month.

Milano was sympathetic, acknowledging that poverty creates uncertainty. “Today they have a phone, tomorrow they don’t,” she said.