Insured but poorly protected: 25 million adults are un... (. The underinsured included those insure...)

Insured but poorly protected: 25 million adults are underinsured

Date:6/9/2008

. The underinsured included those insured all year who spent 10 percent or more of their income on out-of-pocket medical expenses or 5 percent of income if low-income (under 200% of federal poverty level), or who had per person deductibles equal to 5 percent or more of family annual income.

Underinsured Experiences Often Mirror Those of Uninsured

The study found that despite the fact that the underinsured have health insurance all year long, they are at high risk of access problems and financial stresswith experiences often similar to the uninsured. Both underinsured and uninsured adults were significantly more likely to go without needed health care and to struggle with medical bills than people with adequate health insurance.

Half of the underinsured (53%) and two thirds of the uninsured (68%) went without needed care because of cost, including not seeing a doctor when sick, not filling prescriptions, and not getting recommended diagnostic tests or treatments. By contrast, only 31 percent of the insured report going without such care.
The underinsured were almost as likely as the uninsured to face financial stress related to medical bills. Nearly half (45%) of the underinsured reported difficulty paying bills, being contacted by collection agencies for unpaid bills or changing their way of life to pay their medical bills as did half of the uninsured (51%). By contrast only 21 percent of the insured reported financial stress related to medical bills.

Insurance Characteristics

Underinsured adults were more likely than adults with more adequate insurance to have insurance plans with limits on the amount a plan would pay or on visits. And, underinsured adults were much more likely to have high deductiblesone quarter had annual deductibles of $1,000 or more.

Despite these limited benefits, the underinsured faced premium levels that were similar to those paid by adults with more adequa
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Contact: Mary Mahon
mm@cmwf.org
212-606-3853
Commonwealth Fund
Source:Eurekalert

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