When having insurance isn't enough
June 2, 2015 8:00 AM
In 2014, 31 million people ages 19 to 64 had such high out-of-pocket costs or deductibles that they were underinsured, according to the Commonwealth Fund Biennial Health Insurance Survey. Many underinsured individuals have large debts and/or skip medical care because they cant afford it. Here are key findings from the survey:
[Image: Fotolia]
[Image: Fotolia]
Overview
The survey defined underinsured as someone who was insured all year and:
Out-of-pocket costs, excluding premiums, over the prior 12 months are equal to 10% or more of household income; or
Out-of-pocket costs, excluding premiums, are equal to 5% or more of household income if income is under 200% of the federal poverty level ($22,980 for an individual and $47,100 for a family of four); or
Deductible is 5% or more of household income
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Out-of-pocket costs, excluding premiums, over the prior 12 months are equal to 10% or more of household income; or
Out-of-pocket costs, excluding premiums, are equal to 5% or more of household income if income is under 200% of the federal poverty level ($22,980 for an individual and $47,100 for a family of four); or
Deductible is 5% or more of household income
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Majority are covered by employer
59% of underinsured adults had employer coverage
[Image: Fotolia]
[Image: Fotolia]
Percent of uninsured in the largest states
Texas: 31%
Florida: 29%
New York: 22%
California: 19%
[Image: Fotolia]
Florida: 29%
New York: 22%
California: 19%
[Image: Fotolia]
Growing deductibles leads to underinsurance
Out-of-pocket costs were 10% or more of income (or 5% or more for low-income individuals) for 24 million people.
Deductible equaled 5% or more of income for 14 million people.
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Deductible equaled 5% or more of income for 14 million people.
[Image: Fotolia]
Financial constraints of being underinsured
Problems with medical bills or debt: 51%
Used all of savings: 47%
Unable to get needed care due to cost: 44%
[Image: Fotolia]
Used all of savings: 47%
Unable to get needed care due to cost: 44%
[Image: Fotolia]
Underinsured are skipping care
Did not fill a prescription: 26%
Had a medical issue but not go to a doctor: 25%
Skipped test, treatment or follow-up visit: 24%
[Image: Fotolia]
Had a medical issue but not go to a doctor: 25%
Skipped test, treatment or follow-up visit: 24%
[Image: Fotolia]
Adults with at least $4,000 of debt
50% were underinsured
41% had private insurance with high deductibles
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41% had private insurance with high deductibles
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Private insurance deductibles are increasing
No deductible: 25%
$1-$999: 37%
$1,000-$2,999: 27%
$3,000 or more: 11%
[Image: Fotolia]
$1-$999: 37%
$1,000-$2,999: 27%
$3,000 or more: 11%
[Image: Fotolia]
