to care is a major barrier affecting self-care management. Treatment of symptoms might require consultation with a healthcare provider. Access to the health-care system is largely influenced by providers. Many people with a chronic illness do not have access to providers within the health-care system for several reasons. Three major barriers to care include: insurance coverage, poor access to services, and being unable to afford costs. Without access to trained health care providers, outcomes are typically worse. Financial constraints Financial barriers impact self-care management. The majority of insurance coverage is provided by employers. Loss of employment is frequently accompanied by loss of health insurance and inability to afford health care. In patients with diabetes and chronic heart disease, financial barriers are associated with poor access to care, poor quality of care, and vascular disease. As a result, these patients have reduced rates of medical assessments, measurements of Hemoglobin A1C (a marker that assesses blood glucose levels over the last 3 months), cholesterol measurements, eye and foot examinations, diabetes education, and aspirin use. Research has found that people in higher social classes are better at self-care management of chronic conditions. In addition, people with lower levels of education often lack resources to effectively engage in self-management behaviors. Age Elderly patients are more likely to rate their symptoms differently and delay seeking care longer when they have symptoms. An elderly person with heart failure will experience the symptom of shortness of breath differently than someone with heart failure who is younger. Providers should be aware of the potential delay in provider-seeking behavior in elderly patients which could worsen their overall condition. Prior experience Prior experience contributes to the development of skills in self-care management. Experience helps the patient develop cues and patterns that they can remember and follow, leading to reasonable goals and actions in repeat situations. A patient who has skills in self-management knows what to do during repeated symptomatic events. This could lead to them recognizing their symptoms earlier, and seeking a provider sooner. Health care literacy Health care literacy is another factor affecting self-care management. Health care literacy is the amount of basic health information people can understand. Health care literacy is the major variable contributing to differences in patient ratings of self-management support. Successful self-care involves understanding the meaning of changes in one's body. Individuals who can identify changes in their bodies are then able to come up