Healthcare for Uninsured and Underinsured Where does someone go that has lost their job, and has no insurance? Resources may be limited. The Facts of Uninsured Patients It may be surprising to hear, but currently 33 million Americans still have no insurance. Nearly 9 million people gained insurance last year, a win for “Obamacare as the president’s signature health care law expanded Medicaid and opened health insurance exchanges. And yet, 33 million Americans, 10.4 percent of the U.S. population, still went without health insurance for the entirety of 2014. Millions more were uninsured for at least part of the year. Information released this month shows they were disproportionately poor, black and Hispanic; 4.5 million of them were children. It is not a surprise that some Americans still do not have health insurance. Despite aiming to insure everyone in the U.S., the Affordable Care Act left significant gaps in coverage, and decisions made by the law’s opponents have denied benefits to millions of people it was designed to help. But the new numbers reveal that most of the uninsured last year were people who should have been able to access insurance under the law. That presents a major challenge for President Obama in the final years of his term, but also an opportunity: Millions of Americans qualify for coverage but, for whatever combination of reasons, have not yet signed up. The White House has said it will focus this year’s enrollment push on the remaining uninsured. So it is worth taking a closer look at who those people were. Most of them, about 56 percent, fell into three major groups that were widely expected to have high insurance rates: immigrants, young adults and people in the so-called Medicaid gap. But that still left more than 14 million Americans who do not have insurance and do not fall into any of these categories. Related: Sporting Event Nurses Finding Health Care The average visit to a doctor when you are uninsured is $200. For a person that has lost a job, that can be a significant amount out of the family budget. Many people take regular medications that require a prescription, and without insurance, there may be no prescribing physician, not to mention the cost of the medication itself. It can be devastating for a family that has no health care coverage. Options for Uninsured Patients Many cities across the country now have free clinics, or clinics based on
income. This can literally be a lifesaver for someone without insurance coverage. The problem however with many of these clinics is, they help those that have very limited income, however what happens to those that still have some income. Perhaps one spouse is still working, but insurance coverage is not an option. If an income went from $75k to $12k in unemployment, that is a significant drop, and of course the house payment and all bills remained the same. How can a person in this category afford say $250 per month in prescriptions? There really is no simple answer. In many cases it is now middle America that suffers the most from the health care crisis. So what are the options? There are direct pay doctors. Most charge a monthly membership fee, which usually ranges from $20-$50. With that fee, you may have a co-pay for visits, but generally it's between $10-20. This entitles you to have a doctor, and helps from the high cost of visits with no insurance. Many of the direct pay doctors will work with the patient to prescribe the most cost effective medications, and they will often be familiar with the least expensive pharmacy to purchase it. Related: How to Properly Express a Complaint at Work There are also prescription savings apps now that help to locate the lowest price on prescription medications, this can offer substantial savings. Some pharmaceutical companies also offer patient assist programs that can help to get medications at low, or no cost, depending on patient's income. There are options for uninsured or underinsured patients, and as a nurse you should have some knowledge of this. A case manager or social worker can better explain their options, and guide them in the right direction. Always encourage patients to continue on their medications, and to seek out helpful resources if and when needed. Related: Exceptional Registered Nurse, Amanda Lee Hartshorn, RN, BSN, will be Spotlighted in the Worldwide Leaders in Healthcare Please follow us on Facebook, Linkedin, Pinterest and Twitter