What does wellness look like? Is it a busy executive trying to lower his or her cholesterol and shed a few pounds? A working mom joining a gym to keep up with her active lifestyle? In our industry, wellness used to be viewed as a luxury item reserved for people with the time and money to spend on their health. In fact, it is true that wellness benefits and programs are often reserved for individuals with major medical coverage — full-time, salaried employees with a full range of benefits.
But what about the working uninsured, those who don't have access to comprehensive coverage through their employer or spouse? They are often hourly or part-time employees struggling to pay for the rising costs of gas and groceries — without the benefit of basic medical care. The working uninsured have more stress related to financial and family issues and have more risk of developing chronic health conditions. And yet this population is the least likely to have access to preventive measures that will keep them well, out of the hospital, and on the job.
The working uninsured also typically lack an ongoing relationship with a primary care doctor, resorting to urgent care clinics or emergency rooms, even for non-emergency care. This leads to an inconsistent approach to both medical care and documentation in medical records. And even if they want to take an active role in wellness, these individuals face financial hardships that can make buying healthy foods or joining fitness clubs and weight loss programs difficult at best.
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An important first step: Providing basic medical coverage
The first and easiest step in improving the health of the uninsured is finding a way to provide access to health benefits for basic medical care and wellness. Fortunately, the limited-benefit health plan industry has expanded access to health coverage for the working uninsured, primarily hourly or part-time employees. For many of these workers, a limited-benefit health plan is the only affordable option that provides them with coverage for their everyday medical needs. Of course, not all limited benefit plans are created equal. A plan with real value should include coverage for common health conditions, including prescription and outpatient benefits. Leading health insurance companies have also started providing plan options with basic wellness coverage for annual exams, laboratory testing or vaccinations.
Studies support the idea that something as simple as receiving an annual exam can be a powerful tool in prevention. According to the National Institute of Health, the working insured who receive preventive care through wellness exams were less likely to contract breast or prostate cancer or have cholesterol problems, by over 10 percent in each category.
Although not all limited-benefit plans offer traditional wellness programs and incentives, some do offer significant discounts on physical fitness centers, stress management programs and oral health products. Many will also offer access to health education and information such as online smoking cessation tools and weight loss programs.
Easy access to health advice and information
For many workers, a limited-benefit health plan is the first experience with the health insurance system that they've had as an adult. They may not know when it's appropriate to access care — and through what means. One very helpful tool for this population is access to a 24-Hour Nurseline. Instead of going straight to the emergency room, an individual can simply contact a nurse to find out if his or her health condition is truly an emergency, or whether a doctor visit is called for or if an over-the-counter remedy would be more important.
To address behavioral and mental health issues, a strong Employee Assistance Program is also important for this population. Whether over the phone or in-person, EAP consultations can provide support for depression, addiction and other series mental health issues. They can also simply provide a good means of support for workers facing family challenges, work stress and relationship issues.
A brighter future for the working uninsured
Limited-benefit health plans serve a significant demographic in the insurance market, and their members can greatly benefit from the knowledge and health care access a good plan can provide. These members — regardless of their economic status, work shift or skill set — simply need a set of tools to help them access the health care system and make lifestyle changes that can improve their future. Fortunately, limited-benefit health plans give us the opportunity to offer creative, affordable strategies to improve the health and wellness of the working uninsured.
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