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Making Insurance Plans Easier to Understand

August 17, 2011 at 12:10 PM ET by Don Berwick
Summary: 
Because of the Affordable Care Act, every American consumer will receive an important new tool to understand their coverage. Under proposed rules announced today, health insurers and employers must provide you with clear and consistent information about your health plan.

Ed. Note: Cross-posted from HealthCare Notes

Having affordable, quality health insurance is incredibly important. But how can you pick the plan that is best for you and your family if insurance plans are written in words you cannot understand or in type so small you can barely read it? And how can you take advantage of the health benefits you have if you don’t know what your plan covers?

You’re not alone in your confusion. Too many Americans don’t have access to information in plain language to help them understand the health coverage they have.

Now, thanks to the Affordable Care Act, every American consumer will receive an important new tool to understand their coverage. Under proposed rules announced today, health insurers and employers who offer coverage to their workers must provide you with clear and consistent information about your health plan.

Specifically, you will have access to two important insurance forms:

  • An easy to understand Summary of Benefits and Coverage
  • A uniform Glossary of terms commonly used in health insurance coverage

This will include basic information that every person should have, including:

  • What is your annual premium?
  • What is your annual deductible?
  • What services are NOT covered by my policy?
  • What will my costs be if I go to a provider in my network versus one that is not in my network? 

Below is an example of a page from the proposed new form:

These common sense rules benefit from a public process led by the National Association of Insurance Commissioners (NAIC) and a working group composed of consumer advocates, employers, insurers, and other people involved in your insurance and care. As with all changes to health care, we are giving the public a chance to review this proposal and send us their comments before we make the rules final.

But starting in March 2012, if you are one of the 180 million Americans with private health insurance, help is on the way to make sure you understand your health insurance.

And this means you and your family will have an easier time accessing the health benefits you currently have--and you will be able to make a more informed decision about purchasing the coverage you need.

For more information about this announcement, please visit our factsheet on health insurance coverage.