Care Beyond the Coverage


Definition - What does Care Beyond the Coverage mean?

Care beyond the coverage refers to those health care services and initiatives that are not traditionally included in a health insurance plan. These care initiatives include services offered by health care providers, government agencies and community organizations. A particular focus of care beyond coverage programs is often access to health care by disadvantaged populations. Other areas of focus include global examinations of barriers to service and the impact of managed care and other marketplace changes on the quality of health care.

WorkplaceTesting explains Care Beyond the Coverage

The ability to pay for adequate health care is just one piece of a larger health care supply puzzle. This payment piece is often addressed through health insurance. This is the "coverage" referenced in the phrase "care beyond the coverage." But beyond payment there may be other barriers that prevent an individual or population from obtaining health services.

When examining care beyond the coverage researchers and administrators often find other barriers to access. These barriers may include cultural, legal, or logistical limitations on access. For instance, while the 2010 Affordable Care Act opened new avenues of treatment for those with mental health conditions, many cannot find suitable service providers in their geographic area. This lack of qualified health care providers is often more pronounced in minority communities.

Unequal access to care extends beyond just those seeking mental health care. This type of issue is one that policies aimed at providing care beyond the coverage are intended to address. Other issues that are addressed by care beyond the coverage include access to often non-covered services such as dental care. The cost of co-pays and deductibles, such as the high individual deductibles included in most ACA plans before the policy will pay any benefits, are also a barrier to care and effectively render policies worthless to low income individuals in many cases. Finally, care beyond the coverage initiatives may look to environmental and social factors beyond medical services and their impact on the health of a population.

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