We Make Insurance Simple & Easy
“When it comes to health insurance, it’s easy to know if you’re uninsured: you either have coverage, or you don’t. But being underinsured is more of a gray area. You have health insurance, but because of a high deductible or other out-of-pocket costs, it doesn’t cover as much as you might need. Your income may not be high enough to offset the coverage gaps.
Below, we break down what counts as being underinsured, the financial risks involved, and options if you find yourself in that position.”
In 2016, Richard Timmins went to a free informational seminar to learn more about Medicare coverage.
“I listened to the insurance agent, and basically, he really promoted Medicare Advantage,” Timmins says. The agent described less expensive and broader coverage offered by the plans, which are funded largely by the government but administered by private insurance companies.
It’s frustrating when your health insurance won’t cover your medication. Often, a drug appears on a formulary — the list of medications covered by an insurance plan — but then gets dropped. This can happen if a medication is seldom used, there is a generic available, or a more affordable option exists.Whatever the reason, you’re stuck with the full cost despite having coverage for prescribed medications.
Here’s what you can do if your prescription medication is not covered.
By the time Eric Tennant was diagnosed in 2023 with a rare cancer of the bile ducts, the disease had spread to his bones. He weighed 97 pounds and wasn’t expected to survive a year with stage 4 cancer.
Two years later, grueling rounds of chemotherapy have slowed the cancer’s progress, even as it has continued to spread. But chemotherapy has also ravaged Tennant’s body and his quality of life.
“When Alyne Diamond fell off a horse in August 2023 and broke her back, her employer-based health plan through UnitedHealthcare covered her emergency care in Aspen, Colorado. It also covered related pain management and physical therapy after she returned home to New York City. The bills totaled more than $100,000.”
