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Patient Advocate Foundation
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Home > Resources > PAF Publications > PAF Guides & Major Publications > National Underinsured Resource Directory Booklet > Health Insurance and the Underinsured

Health Insurance and the Underinsured

The numbers are in. An estimated 25 million Americans are reported to be underinsured. (CNN Money, 2009) Many people are finding that they are faced with obstacles associated with high medical costs despite having some sort of medical coverage. These people are underinsured.

Health insurance comes in many forms:
  • Employer sponsored plans
  • Individual/privately purchased plans
  • Health Savings Accounts/High-Deductible Health Plans
  • Risk pool or guaranteed issue plans
  • Catastrophic/Limited benefit plans
  • Military/TRICARE
  • Medicare Entitlements
  • Medicaid Entitlements

When a patient is diagnosed with an illness, he or she may quickly learn that their insurance coverage is inadequate and they are "underinsured." For this publication, underinsured is defined as having some insurance coverage but not enough, or when one is insured yet unable to afford the out-of-pocket responsibilities not covered by his or her insurer.

Insurance issues faced by consumers can go full circle, from benefit exclusions to running out of a specific benefit. We will be discussing issues commonly reported to Patient Advocate Foundation, including a brief definition of each
term in the back of the publication. Following the terms, recommendations will be made to help find a positive outcome on your issues.

In order to help you navigate the healthcare system, we will divide the issues into two groups: financial and access to care. While you may be impacted by both, we will try to give specific recommendations to help overcome each of these obstacles.