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Supporting the Functionally Uninsured Employee

Wednesday, April 1, 2020
Supporting the Functionally Uninsured Employee

In the constant quest to reduce rising health care costs, companies are asking their employees to share in part of the financial risk with high deductible plans and other cost-sharing measures.  Many insured Americans struggle to pay for medical care even with access to insurance plans, especially when unexpected major medical claims occur.

They enter the world of the functionally uninsured – employees who can’t afford the upfront costs associated with high deductible plans, and that includes the ever-increasing fees that come out of their salaries.

As an Employer – how can you make sure the health of your employees is protected, along with your bottom line?

The obvious is keeping your employees healthier with a variety of wellness initiatives, but that’s a long-term strategy and won’t help your employees right now. So what else?


Consider offering diagnostic solutions that don’t involve visits to costly doctors’ offices, ERs, and urgent care centers. Telemedicine became the new normal during the COVID-19 pandemic, not as a cost-saving measure, but to ensure the safety of communities and health care providers.   The added benefit was the often “no copay” policy many carriers have when using telemed doctor services.  Anything that employees don’t have to pay for will be quickly adopted – especially if they are in the functionally uninsured bracket.


The most important thing you can do for your employees is to educate them on how to best manage their health care journey – from choosing the best and most cost-effective providers to managing their prescription costs. Make sure they understand “In-Network” and “Out-of-Network” and what happens when they travel, or if they see a specialist.  Some of these things may seem obvious to those who work in insurance, but not everyone does!

This goes beyond having some documents on your intranet or hanging a poster in the cafeteria. HR departments will want to actively engage with employees on an ongoing basis.  Consider bringing in your benefits broker to do some educational coaching, training, or having an information booth in your lunchroom every other month.  Encourage employees to ask before they book an appointment with a specialist to ensure they don’t incur unexpected fees.  Be creative: the goal is to make education easily accessible and in front of their minds!

Managing Data

If you’ve ever had to navigate the health care system, you know it can be daunting.  What will insurance cover or not cover, and then there are the surprise bills that show up despite getting every approval beforehand.  Managing the amount of data and paperwork can quickly become overwhelming.

Many of our clients have decided to invest in the HealthJoy app to enhance the employee experience – allowing employees to manage their health care data, including providers, medical records, and testing all in one mobile application.  Health data management technology should reduce some of the frustration your employees will have when multiple providers are involved, especially after a major medical incident.

Face to Face Support

We can’t stress the importance of having a dedicated person your employees can reach out to when they are in crisis, have questions, or if they feel overwhelmed.  Just knowing someone is there to help, is a stress reducer and a massive relief for many employees.

Financial Support

In the end, it all comes down to money for most functionally uninsured employees.  Supporting your employees with HSA funding and emergency funds, if needed, not only helps financially but helps with their peace of mind.  What that exactly looks like can be different for every company. For instance, it could be on a 1:1 basis. The key is to be aware of your employees’ situations and watch for cues that things just aren’t “okay.”

Only time will tell what the future holds for health care in the U.S. as so much is dependent on federal legislation and market trends.  What you should focus on is the now, and ensuring your employees stay healthy by supporting them in every possible.  If you are interested in any of these concepts or wish to learn more, contact one of our Horton team representatives.

Material posted on this website is for informational purposes only and does not constitute a legal opinion or medical advice. Contact your legal representative or medical professional for information specific to your legal or medical needs.