Slideshow When having insurance isn't enough

Published
  • June 02 2015, 8:00am EDT
9 Images Total

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 can’t afford it. Here are key findings from the survey:

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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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Majority are covered by employer

• 59% of underinsured adults had employer coverage

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Percent of uninsured in the largest states

• Texas: 31%

• Florida: 29%

• New York: 22%

• California: 19%

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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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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%

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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%

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Adults with at least $4,000 of debt

• 50% were underinsured

• 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%

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