In short, uninsured adults receive health care services that are less adequate and appropriate than those of patients with public or private health insurance, and have worse clinical outcomes and poorer overall health than adults with private health insurance. The premiums you pay for term life insurance are lower at a younger age compared to the premiums you pay for permanent insurance, but the term rates increase as you age. Coverage can be “leveled” by providing the same benefit until the policy expires or you can have “decreasing” coverage during the term with premiums that remain the same.

If you don’t pay the premium for your term life insurance, it usually expires without cash value, compared to a permanent type of policy with a cash value component. Currently, term life insurance rates are highly competitive and among the lowest historically experienced. All permanent or lifetime policies generally offer the benefit of lifetime coverage, but may charge higher premiums than term life products.

Permanent living, often called whole life insurance or cash value life insurance, provides coverage for the insured’s life, as long as the premium payments are up to date. Unlike long-term life, these policies can generate cash value, which an insured or his heirs have access to under certain conditions. Whole life products include several subcategories including traditional real life, universal life, variable life, and universally variable life.

Typically, you’ll need to undergo a medical exam when you apply for life insurance and answer a questionnaire about your hobbies and habits, including whether you’ve ever been a smoker or used illegal drugs. The most basic and cheapest is term life insurance, which pays a specific amount if you die within the time frame of the policy. Other types of policies include “permanent” life insurance, which does not expire as long as you pay your premiums. Universal Life Insurance is the most flexible of all the different types of policies because it handles the elements of the policy separately; Universal Life allows you to change or skip premium payments or change the death benefit more easily than any other policy. It works by treating the three elements of the policy (premium, death benefit and present value) separately.

For both low-income and higher-income adults, the perceived negative health effect of not having insurance was greater than that of having racial or ethnic minority status. Overall, the extent to which not having insurance adversely affected subjective health (a 4-point decrease on a 100-point scale) was greater than that of having disease, cancer, or gallbladder disease, and slightly less than that of arteriosclerosis (Franks et al., 1993b). Many consumers are contacted by life insurance agents single premium life insurance or life insurance representatives and are asked to consider cancelling their current life insurance policy to purchase a replacement policy. In most cases, the present value of current life insurance is used to purchase more insurance or a new policy. While the decision to replace an existing life insurance policy may be a good one, sometimes it’s not in your best interest. Replacing or changing your insurance policy at this time may affect the expected results of your overall financial plan.

Uninsured adults are much less likely to have a regular source of care and are more likely to identify an emergency department as their regular source of care than adults with any kind of coverage (Weinick et al., 1997; Cunningham and Whitmore, 1998; Zuvekas and Weinick, 1999; Haley and Zuckerman, 2000). Loss of coverage also disrupts patterns of health care use and results in delays in seeking needed care (Burstin et al., 1998; Kasper et al., 2000; Hoffman et al., 2001). For uninsured adults under the age of 65, 19 percent with heart disease and 14 percent with hypertension lack a usual source of care, compared to 8 and 4 percent of their insured counterparts, respectively (Fish-Parcham, 2001). For uninsured patients without a regular source of care or those who identify an emergency department as their usual source, getting care consistent with recognized standards for effective disease management is a daunting challenge. In studies evaluating results for adults with cancer (stage of the disease at diagnosis and mortality), Medicaid enrollees often do no better and sometimes worse than uninsured patients. This similarity in experience between patients enrolled in Medicaid and those without coverage may reflect the fact that uninsured individuals in poor health, once they seek care, may enroll in Medicaid as a result of their frequent interactions with the health care system (Davidoff et al., 2001; see Box 2.1).

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