13 msfocusmagazine.org healthcare coverage. Part-time employees are not typically eligible for benefits, and very small businesses are not required to provide insurance, even for full-time employees. In other cases, the quality or coverage of employer-provided healthcare may not meet your needs. Fallingthroughthecracks–Millionsofpeople earn too much to qualify for Medicaid, but not enough to afford to purchase coverage through the Marketplace. The consequences of not having medical insurance can be dire, especially for someone withMS.Alackofinsurancemeanspreventable conditions, minor injuries, and chronic diseases go undetected or untreated, leading toworsening health and quality- of-life. People often postpone or forego needed prescriptions because of high costs. This is sometimes called a “medication vacation” and can lead to more disease activityand progression. They are also likely to receive fewerdiagnosticandtherapeutic serviceswhen hospitalized, and frequently must pay higher rates for the services they do receive, which can lead to serious financial trouble because of medical debts. Underinsurance and MS In short, underinsurance is when someone has medical insurance, but has trouble covering the costs of care, medications, orboth. This is often the result of insurance plans that only offer minimum coverage and carry high deductibles. For those with Medicare drug coverage, they may experience the coverage gap referred to as the “donut hole,” when the plan places a temporary limit on what will be paid for drugs. When someone is underinsured, and faces a chronic illness like MS, they are frequently forced to spend a high portion of their earnings on medical care. Studies have shown that nearly half of those who are underinsured have exhausted their savings to pay their medical bills. People in that situation typically have lower credit ratings and are likely to file for bankruptcy because of their medical bills – even though they had insurance when their illness began. And, just like the uninsured, people who are underinsured are very likely to put off care because of high out-of-pocket costs; skip recommended treatments and tests; and frequently won’t fill prescriptions or will skip medication doses. A study found that the underinsured tend to be older, sicker, and use the healthcare system more often. They were also more likely to have a chronic health condition. Help is available Given that MS is an unpredictable chronic illness that can result in giving up employment, and comes with high medical expenses, it is frequently true that people with MS are either uninsured or underinsured. Thankfully, there are assistance programs that can aid people who are struggling to bridge the gap between inadequate medical coverage and their bills. Take the time to review these resources, and learn what is available to you if you are facing uninsurance or underinsurance. Underinsurance is when someone has medical insurance, but has trouble covering the costs of care, medications, or both.