When it comes to health coverage, access to health care services is not always the same. For some, out-of-pocket costs may create barriers to access and hinder adherence to needed services and treatments.
Our last video explained how insurance covers your medicines, and this week, we discuss how insurance doesn’t treat all types of care the same way. Patients with commercial coverage pay, on average, around 20 percent of the total costs of their prescriptions while paying just 4 to 7 percent out of pocket of the total cost of their inpatient and outpatient hospital care.
These out-of-pocket costs can have a big impact on access to medicines. For example, when you go to the doctor or hospital you are only responsible for paying a limited amount of costs out of pocket – usually a fixed copay. And in the hospital, you likely won’t be refused care if you can’t pay right away. But when you go to the pharmacy to pick up a needed medicine, you may have to pay as much as 20 to 40 percent of the costs out of pocket and they aren’t always predictable. And if you can’t pay at the counter, you’ll have to leave without your medicine.
To learn more about health coverage disparities, watch the latest video and take time to review your coverage options and ask questions to make sure you have access to the medicines you and your family need. Check out our new Access Better Coverage (ABC) website, for the latest news and white board videos on coverage basics.
Allyson Funk Ally is a former senior director of public affairs at PhRMA focused on advocacy issues for the biopharmaceutical industry. Her expertise includes Medicare, Medicaid, 340B, health reform and more. Prior to PhRMA, her experience included leading health communications for a large membership organization, supporting public affairs clients and working for the governor of Louisiana.