Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Insurance Coverage”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 91 records · Page 5Linked to original sources

Employer-sponsored insurance coverage for alcoholism and drug-abuse treatments.

This article examines the growth in employer-sponsored health insurance coverage for alcoholism and drug-abuse treatments. Data are drawn from the Bureau of Labor Statistics' Employee Benefit Surveys of 1981, 1983 and 1985. The surveys provide information on approximately 20.5 million full-time permanent employees in 43,000 establishments each year. The data are nationally representative. In 1985, 68.5% of employees with medical insurance had coverage for alcoholism treatments and 61.6% had coverage for drug-abuse treatments. Alcoholism coverage increased 89% from 1981 to 1985. The increases were reflected across all regions, firm sizes and occupational groups. Self-insured firms, exempt from mandated coverage laws, had the greatest increase in coverage. HMOs appear to have reduced coverage since 1981. Finally, substance abuse coverages did not appear to be discretionary and, therefore, were unlikely to be eliminated if tax laws on fringe benefits were changed.

Alcoholism↗

Dental service use and dental insurance coverage--United States, Behavioral Risk Factor Surveillance System, 1995.

In the United States, 94% of adults have evidence of past or current tooth decay, and only one third of adults aged 35-44 years have all of their permanent teeth. Dental insurance is associated with increased use of dental services and improved oral health status. This report summarizes state-specific and aggregated state data on both private and public sources of dental insurance coverage and the use of dental services among adults in 25 states who participated in the oral health module of the 1995 Behavioral Risk Factor Surveillance System (BRFSS). The findings indicate that nearly half (44.3%) of adults in this survey reported having no dental insurance coverage.

Adult↗

Health insurance coverage in U.S. urban and rural areas.

This study examines the health insurance coverage of the nonelderly population in U.S. urban and rural areas in 1989, using data from the March 1990 Current Population Survey conducted by the Bureau of the Census. Access to coverage was assessed by classifying all persons by family employment status and income. Rural residents had less access to coverage than urban residents but were only slightly less likely to be insured. In comparison to urban residents, fewer rural residents obtained coverage through employment, and more purchased private coverage outside the work place. The differences in coverage by family employment status and income were generally much greater than the differences by place of residence.

Adult↗

Insurance coverage and usage of preventive health services.

The 1991 Florida Behavioral Risk Factor Survey which included 2,246 respondents to a random-digit-dial telephone survey, showed that 19.2% of Florida residents aged 18 and older reported they had no health insurance, and 24.7% reported they had no insurance covering outpatient services. Lack of insurance coverage was reported more frequently by younger adults (70% under age 40 vs 93% over age 60), by those with less than a high-school education (69% vs 85% for those with some college), by members of racial-ethnic minority groups (Hispanics 67.5%, Blacks 71.5%, whites 85%), and by residents of southeastern Florida. Persons without insurance coverage were less likely to report having had a check-up by a physician in the last year, more likely to report they needed to see a physician but could not because of cost (37% vs 9%), and less likely to have received a mammogram (33% vs 56%) or Pap smear (51.6% vs 67.8%) in the last year. These findings support the need for health-care reform to include assurance that health insurance covers preventive services.

Adolescent↗

Health insurance coverage and medical care utilization among working-age Americans with visual impairment.

As access and cost of medical care emerge as the fundamental issues in the discussion of reforming the nation's health care system, more attention needs to be devoted to the understanding of how visual impairment and functional disability in general affects an individual's access to health insurance as well as medical care utilization. Based on the 1984 Survey of Income and Program Participation (SIPP), we estimate that only 57.5% of 7.0 million working-age (15-64 years old) visually impaired Americans, compared with 79.0% of those not visually impaired, have private health insurance coverage. Moreover, an estimated 1.5 million visually impaired working-age Americans are not covered by any form of health insurance, public or private. This 20.7% uninsurance rate is significantly higher than the 14.1% reported among those who are not visually impaired (p < 0.001). Multivariate logistic regression also supports the inverse association between visual impairment and insurance coverage. On the other hand, multivariate logistic regression suggests a positive association between visual impairment and utilization of outpatient medical services. Although there is a trend toward higher utilization of inpatient services as well among the visually impaired, the finding is not statistically significant. These findings suggest that visual impairment poses a barrier to accessing health insurance, even when controlling for income, education, and employment status. On the other hand, regardless of the health insurance status, visually impaired Americans are likely to have utilized more physician services, but not the hospital services, than the non-visually impaired.

Adult↗

Health insurance coverage of immigrants living in the United States: differences by citizenship status and country of origin.

OBJECTIVES: This study examined health insurance coverage among immigrants who are not US citizens and among individuals from the 16 countries with the largest number of immigrants living in the United States. METHODS: We analyzed data from the 1998 Current Population Survey, using logistic regression to standardize rates of employer-sponsored coverage by country of origin. RESULTS: In 1997, 16.7 million immigrants were not US citizens. Among non-citizens, 43% of children and 12% of elders lacked health insurance, compared with 14% of non-immigrant children and 1% of non-immigrant elders. Approximately 50% of non-citizen full-time workers had employer-sponsored coverage, compared with 81% of non-immigrant full-time workers. Immigrants from Guatemala, Mexico, El Salvador, Haiti, Korea, and Vietnam were the most likely to be uninsured. Among immigrants who worked full-time, sociodemographic and employment characteristics accounted for most of the variation in employer health insurance. For Central American immigrants, legal status may play a role in high un-insurance rates. CONCLUSIONS: Immigrants who are not US citizens are much less likely to receive employer-sponsored health insurance or government coverage; 44% are uninsured. Ongoing debates on health insurance reform and efforts to improve coverage will need to focus attention on this group.

Adolescent↗

Consumers' knowledge about their health insurance coverage.

This paper describes how much families know about their health insurance coverage and investigates whether consumer education and simplified benefit structures would improve knowledge. Families' perceptions about their insurance benefits were measured in two household surveys administered in six sites. Knowledge was assessed by comparing families' responses with policy data collected from the carrier. The vast majority of families understand insurance policies that specify one or two parameters in their benefit provisions. However, more complex payment structures are not well understood. Increased exposure to information in the plans leads to increased knowledge which suggests that education programs could improve the general level of knowledge. We conclude that if market strategies for allocating medical resources are pursued, simplifying insurance benefit structures and educating consumers about their insurance benefits would aid consumers in making more informed economic choices about medical care.

Awareness↗

Going bare: trends in health insurance coverage, 1989 through 1996.

OBJECTIVES: This study analyzed trends in health insurance coverage in the United States from 1989 through 1996. METHODS: Data from annual cross-sectional surveys by the US Census Bureau were analyzed. RESULTS: Between 1989 and 1996, the number of uninsured persons increased by 8.3 million (90% confidence interval [CI] = 7.7, 8.9 million). In 1996, 41.7 million (90% CI = 40.9, 42.5 million) lacked insurance. From 1989 to 1993, the proportion with Medicaid increased by 3.6 percentage points (90% CI = 3.1, 4.0), while the proportion with private insurance declined by 4.2 percentage points (90% CI = 3.7, 4.7). From 1993 to 1996 private coverage rates stabilized but did not reverse earlier declines. Consequently, the number uninsured continued to increase. The greatest increase in the population of uninsured [corrected] was among young adults aged 18 to 39 years; rates among children also rose steeply after 1992. While Blacks had the largest percentage increase, Hispanics accounted for 36.4% (90% CI = 32.3%, 40.5%) of the increase in the number uninsured. From 1989 to 1993, the majority of the increase was among poor families. Since then, middle-income families have incurred the largest increase. Northcentral and northeastern states had the largest increases in percent uninsured. CONCLUSIONS: Despite economic prosperity, the numbers and rates of the uninsured continued to rise. Principally affected were children and young adults, poor and middle income families, blacks, and Hispanics.

Adolescent↗

Recent trends in employer-sponsored health insurance coverage: are bad jobs getting worse?

We examine whether the decline in the availability of employer-provided health insurance is a phenomenon common to all jobs or is concentrated only on certain jobs. We find that declines in own-employer insurance coverage over the 1988-1997 period are driven primarily by declines in take-up for long-term full-time workers and declines in eligibility for new and part-time workers. We also look at trends by workers' education level, and see how much of the decline in is offset by an increase in coverage through a spouse's policy.

Eligibility Determination↗

Expanding health insurance coverage for smoking cessation treatments: experience of the Pacific Business Group on Health.

The business case for health insurance coverage of smoking cessation treatments by employers is a strong one. Smoking is one of the nation's costliest health problems, in both human and financial terms. The science behind smoking cessation treatment and promotion of treatment is strong; the cost effectiveness of smoking cessation treatment is among the highest in all of medicine, the time required before a positive return on investment is reasonable for employers, and the short-term costs of treatments are well estimated and manageable for health plans and employers. Armed with this business case, the PBGH Negotiating Alliance has expanded health insurance to include pharmacotherapy, over the counter or by prescription, and behavioral interventions. Because PBGH has been a national leader, we hope that other employers, employer coalitions, and public purchasers will follow their lead. The potential health effect of even small reductions in smoking are striking, and unlike other chronic illnesses, nicotine addiction is curable, at both individual and societal levels. Thus, if employers make the investment in smoking cessation and other tobacco control today, they face the real possibility that the need for such outlays could decrease in the future.

California↗

Benign moral hazard and the cost-effectiveness analysis of insurance coverage.

When a medical intervention is found to be cost effective, what level of insurance coverage should apply to it? The optimal level of coverage may be less than or greater than full coverage of medical care costs; a finding of cost effectiveness for a service does not necessarily imply v full coverage or coverage at the same rate as other services. If there is some imperfection in the ability to translate higher insurance benefits into higher insurer revenues, the optimal level of coverage will be greater the higher the degree of moral hazard applying to the service.

Aged↗

Insurance coverage and ambulatory medical care of low-income children: United States, 1980.

In the household survey phase of the National Medical Care Utilization and Expenditure Survey of 1980, a survey was conducted of 17,123 persons who constituted a representative sample of the civilian population in the United States not residing in institutions. Through repeated interviews the survey obtained information on the health conditions of these people, the health care services they received in 1980, the costs of these services, and the sources of payment for services. This report, one of a series of reports on the survey findings, provides a profile of low-income children: Their health insurance coverage, health service use, and expenditures for physician visits. Children under 18 years of age in families below 150 percent of the 1980 Federal poverty level are considered low income. However, children who were ineligible to participate in the survey for part of the year are excluded, such as those who were born, who died, or who were institutionalized in 1980. A physician visit is defined as a face-to-face contact with a physician or a nonphysician working under the supervision of a physician. In addition, visits to nurse practitioners and physician assistants who were reported as "independent providers" are included. Otherwise, visits to independent providers (primarily chiropractors and optometrists), mental health visits, visits by physicians to hospital inpatients, and telephone contacts are excluded. Of the 63.9 million children under 18 years of age in the United States in 1980, about one-fourth (16.8 million) lived in low-income families, according to estimates from the National Medical Care Utilization and Expenditure Survey. Nearly one-half (46 percent) of the 16.8 million low-income children were covered by Medicaid for all or part of 1980: 31 percent were covered by Medicaid only for the full year, 3 percent were covered by Medicaid for part of 1980 and uninsured for the remainder of the year, and 12 percent were covered by both Medicaid and private insurance during the year. An additional 30 percent of the low-income children were privately insured for the full year, while 8 percent had private insurance coverage for part of the year and were uninsured otherwise. Sixteen percent of the children in low-income families, or 2.7 million children, were uninsured for all of 1980. When added to the 3 percent with part year Medicaid coverage and the 8 percent with private coverage part of the year, over one-fourth (28 percent) were uninsured for at least part of 1980.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

Health insurance coverage of the immigrant elderly.

In this paper, I examine and contrast factors that contribute to whether individuals are covered by public health insurance (Medicare, Parts A and B, with and without Medicaid benefits) or private insurance. The study, based on data from a sample of foreign- and native-born elderly, employs descriptive analysis and a multivariate investigation involving logistic regression models. The results show that the immigrant population is less likely than native-born elderly to be covered by public insurance or to have private insurance. Medicare coverage for the immigrant elderly is strongly influenced by their length of stay in the United States, employment status, and country of origin, while their having private insurance coverage is affected by race, income, and employment status. For native-born elderly, race, income, and employment status are contributing factors to the type of insurance coverage retained. Policy implications are discussed.

Black or African American↗

Correlates of health insurance coverage: evidence from the Midwest.

The Midwest is often overlooked in national studies of health insurance status. We analyzed the economic and social characteristics of uninsured and underinsured individuals and households in a Midwestern state using both bivariate and multivariate techniques. As in much of the country, economic factors, particularly income and employment, were most significant in accounting for insurance coverage. Unexpectedly, rural and urban residents were equally likely to lack insurance. Results indicate that in rural areas, underinsurance may be a greater problem than uninsurance, and that income-based health insurance is more effective than employer-provided plans in reaching all Americans.

Adolescent↗

Parental employment and health insurance coverage among school-aged children with special health care needs.

OBJECTIVES: This study examined parental employment and health insurance coverage among children with and without special health care needs. Special needs were defined as conditions likely to require a high amount of parental care, potentially affecting parental employment. METHODS: Data from the 1994 National Health Interview Survey were analyzed for 21,415 children aged 5 to 17 years, including 1604 children with special needs. Logistic regression was used to estimate the effect of special needs on the odds of full-time parental employment and on the odds of a child's being uninsured, having Medicaid, or having employer-sponsored insurance. RESULTS: Parents of children with special needs had less full-time employment. Their children had lower odds of having employer-sponsored insurance (adjusted odds ratio [OR] = 0.7) than other children. Children with special needs had greater odds of Medicaid coverage (adjusted OR = 2.3-5.1, depending on family income). Children with and without special needs were equally likely to be uninsured. CONCLUSIONS: Lower full-time employment among parents of children with special needs contributes to the children's being less likely to have employer-sponsored health insurance. Medicaid covers many children with special needs, but many others remain uninsured.

Adolescent↗

Health insurance coverage for smoking cessation services.

The health benefits from quitting smoking have been well documented; however, most health insurance plans in the United States, both public and private, have excluded coverage of smoking cessation services. Since 1988, numerous public health policy documents have called for health insurance coverage of smoking cessation services, although there is little agreement over what kinds of services or interventions are most appropriate for health insurance coverage. The purposes of this paper are to (1) describe current public policy for health insurance coverage of smoking cessation services; (2) review the current status of policy adoption by private health insurance carriers, health maintenance organizations, self-funded employers, as well as public insurance programs including Medicare and Medicaid; (3) analyze the major barriers faced by health insurers, health care providers and policy makers in offering coverage for smoking cessation services; and (4) outline the specific policy options that the federal government, state governments, employers and anti-smoking coalitions can take to increase insurance coverage for smoking cessation services. The paper concludes with recommendations for practitioners, researchers and policy makers.

Accounting↗

Long-term determinants of patterns of health insurance coverage in the Medicare population.

Using data from the 1990 Health Supplement to the Panel Study of Income Dynamics, we examine the determinants of patterns of insurance coverage among the elderly. Among those with supplemental insurance through an employment-based source, the primary determinant of having insurance is work history, specifically job tenure and occupation of household heads and their spouses. Among those who do not have employer-provided insurance, wealth is the most important economic factor in the purchase of private insurance. Blacks, persons with less education and women household heads are less likely to purchase supplemental insurance. We find little evidence that persons in prior poor health are more likely to purchase supplemental insurance, and the most important determinant of dental or drug coverage is having employer-based insurance. The current trend toward decreased generosity of post-retirement benefits implies that fewer older Americans will have insurance for these services.

Black or African American↗