Understanding the Healthcare Coverage Gap

You might be surprised who doesn’t have health insurance.

At a recent Charis Board of Directors meeting, two of the board members — who are licensed medical professionals — acknowledged that they are currently or were previously in a non-coverage situation.

Many of the uninsured patients we serve work full time or are self-employed. Sometimes it’s a temporary gap in coverage, other times they aren’t eligible for employer plans or they simply can’t afford the premiums.

Some scenarios when a worker may not have health insurance coverage include:

Employer group insurance plans often have a waiting period up to 90 days before a new employee’s coverage begins. Employer insurance plans may also have a pre-existing condition exclusion period of 12 months or more. Individual and employer HMO plans may have an affiliation period before being able to use HMO benefits. Interim coverage during a waiting period may be available, but it can be expensive.

Most working people earn too much to qualify for a healthcare exchange subsidy, and the individual plans on the exchange can be expensive and have high deductibles. For low-wage employees, basics like food and rent take up most of their income and they can’t afford the premiums. Small business owners may make the difficult decision to invest in their business and employees first and go without health insurance themselves.

Workers may not be eligible for an employer group insurance plan because their job is not considered full-time. Many people work multiple part-time jobs, but they’re not eligible for insurance with any of their employers.

When employer insurance plans are available, the employee share of the premiums may not be affordable for low-wage employees.

Nashville’s explosive growth brings new people to our city every day who are in between jobs or starting a new job and don’t have health insurance coverage.

“The health insurance coverage gap is real. It impacts many people that you’d never imagine don’t have healthcare coverage because they don’t talk about it,” said Lea Rowe, Executive Director. “Charis is here to serve the coverage gap in our community with compassion and dignity.”

Charis Health Center a nonprofit faith-based primary care clinic with no political affiliation. Charis provides routine examinations, assessments and basic laboratory testing for the medically uninsured. There is a $25 copay for an office visit. A well-woman exam, including a free mammogram referral, is $40.

Prescription assistance and prescription discount information is available for patients. If a referral to a specialist is necessary, Charis has a network of providers who will treat referred patients for a discounted rate.

“Charis Health Center is more than a walk-in clinic,” stated Lea Rowe, “Charis provides ongoing medical management that is holistic in nature. Because emotional and spiritual wellbeing play a vital role in overall health, Charis is a place where patients can share freely without judgment, pray with their healthcare providers or receive referrals for additional counseling.”

“We work with our patients to understand their needs and bridge the coverage gap. Hopefully they will gain access to health insurance. In the meantime, we’re here to serve them,” Rowe said.


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