When you go to the doctor, you assume insurance will pick up the bulk of the costs.

But, when the paychecks stop coming because of layoffs, so does the insurance.

These days, doctors and other health care professionals are seeing increasing numbers of people who are in that predicament.

“It's really frustrating. It’s awful. I see this on a daily basis,” said Dr. Adam Goldstein a U.N.C. professor of family medicine.

Goldstein has seen the number of uninsured rise proportion to the economy’s slide.

“This creates a duel problem for people because no longer is it just unemployment, but it's also lack of health care and lack of physicians. And this just compounds the problem for them,” he said.

Many are finding that the extension of health insurance benefits known as COBRA cost so much that it’s taking a large hunk of their unemployment benefits to stay insured. Because it’s so expensive, many elect to go without insurance altogether.

The lack of health insurance is causing folks to look for alternatives. That in turn is overloading hospital emergency rooms as well as community health care center like the one in Carrboro run by Piedmont Health Services.

“It puts an enormous stress on our ability to serve the people we want to serve,” explained Piedmont CEO Brian Toomey. “At times we can't serve everybody we want to because of  that situation”

Piedmont's working to try and find ways to make room for the additional patients. And its community health centers have a sliding payment scales to make care affordable for those without coverage.

“Last year about half our patients did not have insurance,” said Toomey.

If you find yourself without coverage, you have options.

 *  You can try a free clinic.
 *  You can seek out programs that offer reduced cost medications and prescriptions.
 *  You can explain to your doctor you're out of work and without insurance.

“I don't know any colleague who would refuse to see a patient just because they lost their job,” said Dr. Goldstein

And experts NBC-17 spoke with say they don't see any relief in store  regarding the numbers of uninsured in the coming months.

They say as the unemployment numbers continue to climb, so will those who can't afford COBRA continuing health coverage, or any other kind of insurance premium while they are out of work.