HEALTH-INSURANCE COVERAGE FOR ADULTS WITH DIABETES IN THE US POPULATION

OBJECTIVE - To compare the extent and types of health insurance covera ge for adults with diabetes to coverage for those without diabetes in the U.S. population. RESEARCH DESIGN AND METHODS - Nationally represen tative samples of 2,405 adults with diabetes and 20,131 adults who wer e not known to have diabetes in the U.S. completed a questionnaire on current health insurance, including coverage through Medicare, private insurance, the military, and Medicaid and other public programs. RESU LTS - Among all adults with diabetes, 92.0% have some form of health i nsurance, including 86.5% of those 18-64 years of age and 98.8% of tho se greater than or equal to 65 years of age. Approximately 41% are cov ered by more than one health insurance mechanism, but almost 600,000 p eople with diabetes do not have any form of health-care coverage. Litt le difference was found by type of diabetes in the proportion who have health insurance. Only small differences exist between people with di abetes and those without diabetes in the percentages covered and the t ypes of health-care coverage. Government-funded programs are responsib le for health-care coverage of 57.4% of adults with diabetes, includin g 26.4% of those 18-64 years of age and 96.0% of those greater than or equal to 65 years of age. Private health insurance is held by 69.3% o f diabetic people. Lack of private insurance appears to be attributabl e primarily to lower income. CONCLUSIONS - Almost all patients with di abetes who are greater than or equal to 65 years of age have health-ca re coverage, but 13.5% of those 18-64 years of age have no health insu rance. Few differences exist in coverage between individuals with and without diabetes. However, the absence of insurance should have a subs tantially greater impact on the ability of patients with diabetes to o btain services necessary for care of their disease, compared with thos e without diabetes. Government-funded insurance mechanisms cover a lar ge proportion of diabetic patients, which indicates a significant soci etal burden associated with diabetes. Any changes in government reimbu rsement and coverage policies could have a major impact on health care for patients with diabetes.