Availability and Sources of Health and Other Types of Insurance in MS

Background: Unemployment for people with MS can lead to significant distress regarding their health, financial security, and future. Among working-age adults, access to personal insurance, including health (HI), short- and long-term disability income (STD, LTD), long-term care (LTC), and life insurance (LI), is largely employer-based or purchased out of pocket from earnings. Maintaining employment can cause concern or stress regarding the cost and coverage of their insurance plans.

Objectives: To determine insurance coverage, including source, for people with MS.

Methods: US residents, diagnosed with MS, ages 18-65, were surveyed through the North American Research Committee on MS (NARCOMS), iConquerMS, and the NMSS regarding the current types and sources of insurances, employment status, and concern about maintaining insurance with regard to employment status. Results are presented as percent or Mean.

Results: 2507 respondents met the eligibility criteria and completed survey information regarding types of current insurance and demographic information: 82.9% female, 53.5 years old, 3.8% Hispanic/Latino, 91.2% Caucasian, 3.8% African American, 65.4% currently married, with a mean disease duration 16.4 years, 42.5% were employed full- or part-time, and 29.3% were not employed or retired due to disability. Respondents reported that 96.3% have HI, 58.8% LI, 35.9% LTD, 18.1% STD, and 9.7% LTC. 77% hold private policies, with 82.2% of those employer/union based (62.9% self, 36% spouse) and 7.9% purchased HI via the Exchange.  Respondents were asked whether they had concern over maintaining their (or their spouse’s) employment status in order to maintain each type of insurance. Some respondents indicated no concern for HI (43.7%), STD (55.6%), LTD (57.2%), and LTC (66.8%), while others indicated a lot or a little concern for HI (56.3%), STD (44.4%), LTD (42.8%), and LTC (33.1%).

Conclusions: Nearly all of respondents currently have HI, most of which was obtained through an employer or Union source. Over half (56.3%) of these respondents indicated that they were concerned about maintaining employment (themselves or a spouse) in order to remain eligible for HI. Insurance rates for the other types of insurances were lower than HI, varied greatly by type, but between 33-44% of those expressed concern about maintaining employment to keep coverage. The concern of maintaining employment in order to ensure continuing coverage of all insurance types may impact employment decisions and lead to stress within families of people with MS.