Coverage Classroom

Health Coverage Disparity

Insurance & Medicines

Health insurance is meant to protect you and your family from overwhelming health care costs. While many reforms in the Affordable Care Act aim to do just that, insurance doesn’t treat all types of health care the same way.

For some, out-of-pocket costs may create barriers to access and hinder adherence to needed services and treatments. 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. 

More Videos

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  • Improve Access to Out of Pocket Cost Information

  • Out of Pocket Costs in the Exchanges

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  • Exchange Plan Transparency

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  • 3 Tips for Choosing a Health Insurance Plan

    How to Shop for a Plan
  • What Are Health Insurance Exchanges?

    Different Levels of Coverage
  • health coverage hurdles

    How Insurers Limit the Use of Medicines

    Insurance Limitations
  • How Does Insurance Cover Your Medicines?

    An Overview of Coverage
  • Health Insurance Coverage 101

    Basics Explained