Report: Many Connecticut Consumers Don't Understand Their Health Insurance Policies

By Rosner, Cara | New Haven Register (New Haven, CT), June 26, 2017 | Go to article overview

Report: Many Connecticut Consumers Don't Understand Their Health Insurance Policies


Rosner, Cara, New Haven Register (New Haven, CT)


Many consumers who obtain insurance through Connecticut's health care exchange don't understand the plans they buy -- and can struggle to access care as a result, according to a new report.

Insurance plans typically use complicated language that is difficult to understand, according to the Health Disparities Institute, UConn Health. As a result, some patients have trouble accessing care, experience delays in care, encounter administrative hassles and face other hurdles, the study found.

The institute conducted a statewide poll last year among 516 adults who enrolled in qualified health plans through Access Health CT (AHCT), the state health insurance exchange created under the Affordable Care Act. Many struggled to understand basic insurance terms like "premium," "deductible" and "co-pay."

More needs to be done to educate all health insurance consumers, regardless of where they buy their policies, said Lisa Freeman, executive director of the nonprofit Connecticut Center for Patient Safety.

"If people are going to access something, they have to understand what they're accessing," she said, and that goes beyond merely jargon. "It's so much more than just words on a page; you have to understand the relationship between the different pieces. It's really hard to put your arms around it, particularly if you're somebody who's new to health insurance."

Insurers acknowledge that health plans are complex and are taking steps to make plans easier to understand.

The study found that people with more education had an easier time than less-educated respondents, according to researchers. But among people with the same education level, the study uncovered "significant differences" by race, ethnicity and language preference. Black and Hispanic consumers had more trouble understanding their plans than whites, according to the institute.

Researchers said the Connecticut findings likely mirror national trends. The study marks the first time health insurance literacy has been examined among Connecticut consumers enrolled in private insurance plans, according to Health Disparities Institute Director Dr. Judith Fifield.

Among the findings: 20 percent of respondents did not understand the use of the word "premium" as it pertains to insurance; 66 percent didn't understand the word "formulary"; only 33 percent could calculate their out-of-pocket cost of a hospital bill when their plans included a deductible and a co-pay; and 40 percent realized in-network hospitals may have out-of-network doctors.

Access Health staff makes a concerted effort to help consumers understand health plans, but it can be challenging, said Andrea Ravitz, director of marketing and sales for the exchange. Staff strives to break plan complexities down to a fifth- to eighth-grade reading level, she said, and is trained to ask consumers whether they understand what has been explained to them. …

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