Introduction
The underinsured are those individuals that have access to health benefits that are not capable of taking care of all their medical expenses. Under normal circumstances these individuals do not realize that they are underinsured until they are hit by an illness that demands costly medical expenses that can not be met by their benefits.
Underinsurance is a situation that often develops from the following situations: a case where an individual is covered by an employer insurance plan as their personal benefits are insufficient; where individuals have purchased coverage plans that cover only specific medical needs; where individuals purchase policies that come along with substantial deductions or co-expenses; or in the case where individuals buy policies that cover them for only a given period of time. (Collins, Kriss, Doty & Rustgi, 2008)
Body
According to health records the number of underinsured people is on the rise covering people on the middle and lower income classes; within the age group 19 and 64; spending above 10% and 5% of their earnings on out of pocket medical expenses for the middle and low-class earners respectively; often low-income adults; the sick and aged who are not eligible for Medicare. It is also worth noting that the amount of premiums individuals pay is based on their demographic characteristic traits like age; gender and health status except only in 18 states. (Gabel & McDevitt, 2009)
Among the needs and health practices of the underinsured and the uninsured include: avoiding going to the doctor or signing for prescriptions for the fear of not affording the expenses; encounter by health related debts among other substantial financial problems and can only purchase time limited insurance plans. Another distinctive need of the underemployed and the unemployed is that they are individuals that need special medical attention like the aged and the sickly. (Doty, Collins, Rustgi & Kriss, 2008)
The organizations that will be directly affected by the uninsured and underinsured population include: the insurers who will be required by legislation to set insurance repayments on the minimum so as to cover all economic groups; the law enforcers who will have to enforce the new health regulations on the insurers; employers who will have to pay for policy coverage of employees by the law, and Medicaid institutions who will be required by law to take care of the disabled and poor; (Doty, Collins, Rustgi & Kriss , 2008)
Medi-cal as an organization is directly affected by the uninsured and underinsured; has the mission of providing deserving individuals and families that are short of resources and low-earners with healthcare. Medi-cal is funded by the central government and divisions of the California state, but is managed by the federal government. The community position of Medi-cal is serving citizens and resident foreigners who constitute low-earning adults and their families as well as individuals with definite disabilities. Medi-cal often covers medical expenses of aging and nursing homes and operates as a health care support program using the title XIX of the social security act. (Collins, Kriss, Doty & Rustgi, 2008)
Medi-cal made a partnership for long-term care with the help of the “Robert Wood Johnson Foundation” to protect the people of California from spending all their savings on long-term care. In July 2009 medi-cal as a measure to avoid over-dependence on its health plan; cancelled dental insurance for people above the age of 21. (Gabel & McDevitt, 2009)
Conclusion
Underinsurance as the inability of individuals to fund their medical expenses is a problem on the increase and is a situation that not only demands the intervention of government authorities; but also the involvement of other institutions and key players in the insurance and health provision sectors.
Reference list
Collins, S., Kriss, J., Doty, M. and Rustgi, S. (2008) Losing Ground: How the Loss of Adequate Health Insurance Is Burdening Working Families: Findings from the Commonwealth Fund Biennial Health Insurance Surveys, 2001–2007, The Commonwealth Fund.
Doty, M., Collins, S., Rustgi, D. and Kriss, J. (2008).Seeing Red: The Growing Burden of Medical Bills and Debt Faced by U.S. Families, The Commonwealth Fund.
Gabel, J. and McDevitt, R. (2009) “Trends in Underinsurance and the Affordability of Employer Coverage, 2004–2007″. Health Affairs.