Before open enrollment for the Affordable Care Act marketplace began on Oct. 1, Keele looked online for insurance, finding nothing affordable.
"I can just take my check and pay for insurance, but where does that leave me then? Possibly homeless or without food in my home?" Keele said.
She may find a plan on the new marketplace, but doesn't know yet. She hasn't been able to sign on to the federal enrollment website to see how much a plan might cost and whether she is eligible for tax credits and subsidies.
For individuals and families without employer-based insurance who make less than four times the poverty level ($45,960 for an individual and $94,200 for a family of four), subsidies are available to reduce the cost of insurance.
In some states, including New Jersey and Delaware, Medicaid expansion will cover people earning up to 138 percent of the poverty level. In Pennsylvania, Gov. Corbett is negotiating with federal officials to expand the program on his terms, but so far, it will not cover more of Pennsylvania's lowest-income uninsured.
Keele has been working with a certified marketplace enrollment specialist, who has tried to give her a sense of what premiums, deductibles, and co-insurance could cost her.
For now, the enrollment specialist, Naima Grossmann, said she and Keele are filling out a paper application and will wait to hear back from the feds.
Grossmann works with Keele at Health Annex Family Practice and Counseling, at 6120B Woodland Ave. in Philadelphia.
Just having a plan with a low monthly premium isn't enough, Keele said. Because of her complex needs, she requires insurance with a low deductible and one that covers 80, 90, or even 100 percent of her medical bills.
And she doesn't want to have to leave her doctors, especially her primary-care doctor, who she has been seeing for 17 years.
"It would be dramatic to me as far as my health issues to try and find another doctor," Keele said. "They know me, they know what's going on."
For now, she said, she's accepting donations.
This story was done in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health-policy research and communication organization not affiliated with Kaiser Permanente.