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Notes from the insurance underground: how the chronically ill cope

E D Kinney1, S K Steinmetz

  • 1Indiana University School of Law, Indianapolis.

Journal of Health Politics, Policy and Law
|January 1, 1994
PubMed
Summary

Individuals with multiple sclerosis (MS) face significant challenges obtaining and maintaining private health insurance, despite Medicare and employer plans. Many encounter high costs and coverage gaps, forcing difficult choices.

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Area of Science:

  • Health Services Research
  • Public Health
  • Insurance Studies

Background:

  • Access to adequate and affordable health insurance is crucial for individuals with chronic illnesses like multiple sclerosis (MS).
  • Previous research indicates challenges in health insurance access for vulnerable populations, but specific experiences of MS patients in obtaining private insurance remain under-explored.

Purpose of the Study:

  • To investigate the experiences of individuals with multiple sclerosis (MS) in Indiana regarding obtaining and retaining private health insurance.
  • To identify barriers and strategies employed by MS patients in navigating the health insurance landscape.

Main Methods:

  • A telephone survey was conducted with individuals diagnosed with multiple sclerosis (MS) residing in Indiana.
  • The survey collected data on health insurance acquisition, retention, associated challenges, and coping mechanisms.
Keywords:
Empirical ApproachHealth Care and Public HealthMedicaidNational Multiple Sclerosis Society

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Main Results:

  • While most respondents could secure insurance via Medicare or employer plans, significant barriers persisted, including pre-existing condition exclusions, policy cancellations, high premiums, and coinsurance.
  • Respondents utilized strategies like selective claims submission to maintain coverage, inadvertently reducing their overall health insurance benefits.

Conclusions:

  • The findings highlight the extraordinary measures individuals with chronic illnesses may need to take to secure and keep health insurance.
  • Insurer practices in pricing and benefit determination may exacerbate insurance inadequacy and unaffordability for the chronically ill, contributing to a broader health insurance crisis.