Living with Chronic Pain
Insurance
Health Insurance is designed to help pay for medical expenses, something extremely important for individuals living with chronic pain. There are two types of insurance plans: private health insurance and public/government health insurance.
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Private health insurance can be subdivided based on the way plans are administered or how they connect with healthcare providers. Managed care plans are insurance plans in which the insurance company has a contract with a network of providers to provide low cost medical care. Health maintenance organizations (HMO) provide service directly to the individual, through a primary care physician that will coordinate all necessary care. Preferred provider organizations (PPOs) will allow individuals to go to any doctor they want but also has a network of providers they prefer. Point of service (POS) plans are a combination of HMO and PPO.
Public or government based health insurance are insurance plans in which the government subsidizes the plan, such as Medicare and Medicaid. Medicare is a federal insurance program that covers the elderly and certain disabled individuals. Medicaid is federally handled, but state overseen insurance for individuals and families with few resources.
Individuals who live with chronic pain can have specific issues with insurance because of their chronic pain. This can include denials of services, including payments for doctors visits or prescriptions, needing pre-authorizations for prescriptions or treatments, and difficulties accessing the newest treatments.
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