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Cover America: Somewhere between insured and uninsured

Consumer Reports News: September 15, 2008 02:17 PM

When it comes to living insured vs. uninsured, the Cover America Tour has learned that it usually isn't a case of one or the other these days. A disturbingly large chunk of the people we have talked to and visited with are somewhere between insured and uninsured—a scary place where they pay budget-blasting premiums for health care coverage that really doesn't cover much of anything except for the most catastrophic illnesses or injuries.

Welcome the world of the underinsured.

Record numbers of Americans are paying dearly each month on health insurance premiums for what is politely called 'catastrophic coverage' that only provides protection in case of cancer or getting hit by a bus, the two grim examples everyone we've talked seems to use. But day-to-day coverage? Preventative care? 'Small' problems that can be toughed out? No way. The out-of-pocket costs are just too high.

Loosely defined as having 'insufficient coverage', being underinsured takes its toll in different and often unpredictable ways. If you ask Gina in St. Joseph, Missouri (above) it meant suffering through the pain of a miscarriage, dealing with it on her own instead of going to the doctor because the $5,000 deductible put that option beyond the reach of the family’s budget. Bobbie in Redding, CA knows the importance of follow-up visits after her diagnosis of skin cancer, but hitting her policy's big annual deductible when the premiums are already so high is out of the question? It just costs too much to go.

A recent Commonwealth Fund report numbers America's underinsured at about 25 million, stating that nearly half of those "reported difficulty paying bills, being contacted by collection agencies for unpaid bills, or changing their way of life to pay medical bills."

In Weiser, Idaho, Amanda's experience hit a few of those marks. When we visited her she was 5 months pregnant and insured—but not for long. Her current coverage comes with a tolerable $1000 deductible, but when she re-read the fine print on her policy she realized that maternity care came with a much higher price tag—a $5,000 deducible.

She and her husband are now stretching the budget even further to make "down payments" to her doctor for the bills they know will be coming after the baby's born in December. Furthermore, she's made the decision to cancel her policy after delivery and just insure the new baby to save money on premiums and help pay off the impending debt.

All of that money sunk into paying for coverage they can't afford to use. For those we talked to, it seems illogical and frustrating as they cut back in other areas or work extra hours just to pay for insurance that will help only if the worst happens.

For too many, it seems like the true definition of being underinsured is more like: 'having insurance… but not really.'

Meagen Bohne, campaign organizer

Visit Cover America Tour to see more videos of the people we're talking to across America and to share your own health care story, and read more from our survey of Americans who can't depend on their health insurance.

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