The gulf between those able to access quality health care services and the underserved masses of the country is widening at an alarming rate. The economic downturn and financial constraints have significantly worsened the situation, causing more people to avoid seeking proper medical attention. The health care industry must shoulder some of the burden for creating an affordable solution to the rising expenses of primary health care.

Although there are an abundance of program providers in the market, consumers have a difficult time finding supplemental medical insurance plans or health care assistance programs that are backed by long-standing and trustworthy organizations. Many carry exclusions and severe limitations, denying coverage to those who need it most: individuals with low incomes or non-citizenship status.

While the Internet is a good place to begin research, a simple Google search will not be sufficient to identify the best programs, the most robust benefits, and, most importantly, a good track record. To choose the best-suited plan, people must have a clear idea about the type of insurance coverage that responds to their needs.

Here’s where a skilled broker or agent can help both individual consumers and small employers looking to provide a budget-friendly program to their part-time, seasonal, or otherwise formerly ineligible employees.

Health care assistance programs to the rescue

For the under-banked and under-employed, purchasing a traditional insurance program outside of employer sponsorship may be simply impossible from a financial perspective. To close this gap, many health insurance providers now offer affordable alternatives in the form of limited liability, short-term medical, and discounted medical programs.

The aim is to lower out-of-pocket expenses on routine and preventive care and to provide real relief in the event of a catastrophic event. Health care assistance programs are the best way to shield the pockets of the un- and under-insured against heavy medical expenses that can occur at any point in time.

Choosing a program

When considering a health care assistance program for their clients, agents should ask which health services will be most needed and how accessible those services are. Here are some key questions:

  • Do the employees need to be able to access services or get help in anther language? If so, look for programs that include bilingual health care support and advocacy.
  • Do the employees have transportation issues? Look for programs that include a telemedicine component that offers a great alternative when getting to an office is not possible.
  • How much can the employer or employees afford in terms of monthly payment?
  • Is a supplemental program needed to reduce the burden of deductibles or will the health care assistance program be used as a primary source for medical discounts and payments?

The best of the best

With so many things to consider, a skilled agent can significantly reduce the stress and headache of finding a program that is tailored to a client’s needs. The best programs offer a variety of insured and non-insurance options, such as:

  • Health care advocacy: assistance finding providers and understanding the discounts
  • Telehealth: saves consumer time and money, while still delivering quality care
  • Bill remediation program: this covers members across the entire continuum of care and collections

The best programs include deep discounts on routine medications like antibiotics or blood pressure medications and will still be able to offer discounts for more expensive brand name medicines. Most programs offer a free discount pharmacy card, which gives members instant savings on everything at the drug store – from prescription medications to bandages to cough medicine.

Member-based discount rates are often available for a varied range of other services, including hospitalization through either short-term medical insurance or guaranteed-issue limited indemnity medical insurance, discount dental plans, routine checkups, and pathological services. Additionally, for these programs to truly make a difference in the lives of working individuals, they should include a health care advocacy component. Health care advocacy rounds out a good program by providing members with:

  • Telephone access to advice and assistance in navigating the complex health care system
  • Insight on discounts available for covered services
  • Medical bill remediation services to ease the growing and unbalanced burden for the cost of care borne by low-income workers

A key component to these programs is an emphasis on preventative care, as well as health and wellness. With more and more expenses being passed on to the consumer, it is more important than ever to find programs that offer discounts on every possible required service. As the country struggles to improve the health of every individual, assistance programs, developed in close collaboration with individuals from the public and the private sectors, are beginning to emerge as an important option for many Americans.

Richard L. Lungen is the president of National Health Options. He can be reached at (914) 304 – 8127 or richardl@nationalhealthoptions.com.