A patient’s right to choose health care coverage

10.2.17

Currently over 660,000 people in the United States are living with end-stage renal disease (ESRD) or kidney failure. Without regular dialysis treatment, the disease would be fatal. A recent opinion editorial published by Dr. Wayne Winegarden in Forbes points out that health insurance companies continue to fail kidney patients in their greatest time of need.

ESRD treatment is costly and the National Kidney Foundation estimates that patients’ annual out-of-pocket health care costs are more than $7,000. Over 70 percent of dialysis patients are too sick to work full-time and cannot afford these out-of-pocket costs. In fact, the average annual income of ESRD patients is $20,000 – making financial assistance, such as charitable premium assistance, a crucial financial lifeline for patients battling this horrific disease.

Insurers incur high costs covering dialysis patients, as this critical and lifesaving treatment is costly, and kidney patients have a high rate of hospitalization. As a result, ESRD patients are eligible for Medicare even if they are under the age of 65. Private insurance providers, through a legal loophole, “steer” kidney patients off their private plans and onto Medicare by raising the cost of premiums and rejecting third-party payments from charities through programs that are able to help kidney patients afford their medical bills.

Every patient is different and private insurance coverage may be more suitable than Medicare for some. Why then are insurance companies rejecting payments from ESRD patients who receive charitable premium assistance to help cover the costs of their disease? In effect insurance companies leave the kidney patients with one coverage option: Medicare.

Premium assistance programs allow kidney patients the freedom to choose the type of health care coverage that is best for them. If insurance companies continue to reject payments from charities, additional patients will be forced onto government health care programs that don’t necessarily provide the best coverage for the patient.

Writes Dr. Winegarden: “The purpose of assistance programs is to empower patients, and give patients control over what type of coverage best fits their needs as they manage a very difficult disease. And, it is the patient, of course, who should be driving the coverage decisions.”

At the Chronic Disease Coalition we believe patients should have the right to choose which health care plan is most suitable for their needs. You can read more about insurance discrimination in Forbes’ full article and join us as we protect the patient’s right to choose.