How to Help Employees Afford the Medical Care They Need

The rising cost of health care and prescription drugs is making it increasingly difficult for employees to afford medical care — a problem that has been exacerbated by delays in care since the start of the COVID-19 pandemic.

To make matters worse, a Gallup report reveals that many people are attempting to save costs by avoiding care altogether, even when they have a known medical issue in need of treatment. Down the road, this avoidance can lead to higher costs for your employees and your health plan — not to mention serious or even deadly outcomes that could have been prevented.

Let’s examine how your benefit offerings can help employees access the care they need at a price they can afford.

The high cost of medical care

The pandemic caused many people to delay medical visits, leading to worsening conditions and higher expenses. Meanwhile, prescription medication costs continue to grow even faster than inflation, according to AARP.

The details are startling:

Half of adults said they delayed or avoided health or dental care over the past year due to cost, according to the Kaiser Family Foundation (KFF). And 30% said they did not adhere to prescription medications because of the price.
Gallup reports that almost one-third of Americans have avoided medical treatment for a known health issue because of financial reasons.
KFF also reports that almost half of adults have trouble paying for out-of-pocket health care expenses, and 25% struggle to pay their deductible.
The New York Times reports that medical bills make up the biggest source of debt for Americans, with nearly 20% of adults facing collections for their medical debt.

Few employees will remain untouched by this issue. The struggle to afford medical care cuts across all demographics, including income. The Gallup report revealed that 20% of Americans making more than $120,000 a year said they have skipped care because of cost.

How your employee benefits can help

Affordable, accessible health care is the best way for your employees to maintain good health. Insights from the Society for Human Resource Management (SHRM) show that many employers are attempting to defray employee health care costs.

Even though per-employee health care expenses are expected to rise 5.6% in 2023, many employers are not shifting those costs to employees. That said, keeping the same level of cost for an employee’s deductible may not move the needle on them seeking the care they need.

Your employee benefits, however, can play a larger role — but only if employees understand and use them. A Policygenius survey revealed that more than 25% of employees skipped medical care because they didn’t understand their employee benefits.

Communicating your offerings can make a difference in helping employees access and afford necessary care. Benefits to highlight include:

Preventive care
Prescription drug coverage
Telehealth services
Your employee assistance program (EAP)
Financial education and partnerships

Preventive care

The Affordable Care Act requires most health plans to cover preventive care without cost-sharing like deductibles, copayments or coinsurance. Some employees still don’t know this and unnecessarily avoid care. By promoting prevention to your employees, you can play a part in keeping them healthier and catching medical conditions earlier. According to the Centers for Medicare and Medicaid Services, preventive care services typically include:

Blood pressure, diabetes and cholesterol tests
Cancer screenings
Pregnancy care and well child visits
Flu, pneumonia and routine vaccines
Counseling on smoking cessation, nutrition, depression and more

Prescription drug coverage

Prescription medication costs continue to increase, but there are strategies that can save money for your employees and your plan. Encourage your employees to:

Ask their physician for generic drugs instead of brand-name drugs (Generics can be just as effective for a lower price.)
Subscribe to a mail-order program or get a 90-day supply for ongoing medications
Participate in manufacturer assistance programs for certain prescription drugs
Use coupons and discounts through services like GoodRx and SingleCare

Telehealth services

Virtual care visits have become a routine part of care for millions of Americans. Use this new familiarity with telehealth to encourage employees to start or continue seeking virtual care. You can even promote telehealth as a way to avoid missing work. A common reason for delaying medical treatment is that employees can’t afford to miss work or don’t have paid time off.

Telehealth is easy and convenient and often comes at a lower price than an in-person visit. Many telehealth options are available for a $25 payment per visit.

Telehealth can be used for:

Routine health care
Questions on medication usage
Eye and skin exams
Mental health counseling

EAPs

Despite being free to employees, EAPs remain an underutilized benefit. With the rate of mental health conditions skyrocketing in recent years, this could be another high-quality, affordable solution. Many EAPs offer free consultations with licensed professionals for mental health needs. EAPs can:

Help employees understand and identify mental health conditions
Provide preliminary care and connect employees with potential counselors or mental health providers
Encourage people who may otherwise be hesitant (due to a perceived stigma or other reasons) to seek help

Financial education and partnerships

Your EAP may also offer financial tools and resources. In addition, local credit unions, banks and other financial institutions sometimes offer free education on debt, budgeting and other topics that may be relevant to employees struggling to pay for medical care.

You may also be able to connect employees with financial professionals from your retirement plan provider for one-on-one support to address their specific needs. Making this service available during work hours removes another barrier for employees.

Financial education is often available online, allowing your employees to access resources on their own time. Common online delivery methods include:

E-learning courses
Webcasts
Budgeting calculators
Apps
Zoom meetings (either group or one-on-one)

Getting started

You can get started by surveying your employees to learn their most pressing issues and barriers to care.

To further explore benefits that can help your employees get the medical care they need, talk with your benefits adviser. They can help you assess health care plans that fit the budget of both your business and your employees. An adviser can also help you identify potential prescription drug, telehealth, EAP and financial education solutions.

This content is for informational purposes only and not for the purpose of providing professional, financial, medical or legal advice. You should contact your licensed professional to obtain advice with respect to any particular issue or problem.

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