Health plan options can be confusing

by Lesley Politi on November 12, 2008

Health plan options can be confusing

Insurers put focus on ‘health literacy’


NEW YORK — Millions of people are receiving letters in the mail this month notifying them of the open enrollment period for their health-care plans — the period when they can change their coverage for next year if they act by a certain deadline. And that deadline might be one of the few things in the letter that is easy to understand.

The issue of “health literacy” has been getting some attention in the insurance and health-care fields but has largely flown under the radar outside those specialized groups. Yet without a clear understanding of the terms that are used, consumers are in many cases left guessing about what types of coverage or features they have available, and which plans might be the best choices for them.

So far, the effort to improve the way health information is presented has focused mostly on actual health-care delivery, for instance making sure that people with a chronic condition understand what they need to do to manage it. But recognition of the need to better educate consumers is spreading to the health insurance and benefits arena, as well, said Susan Pisano, a vice president with America’s Health Insurance Plans, an industry group.

“It is a movement that is more or less in its infancy,” she said. “It’s gaining momentum and there is a serious commitment on the part of hospitals, insurers and others, to make information clearer and easier to act on.”

If you’ve received information about open enrollment that isn’t clear or doesn’t answer all of your questions, there are a number of sources you can turn to for help. One place to start would be your health insurance company’s Web site, where you can often find guides aimed at helping plan members navigate the jargon in order to make better decisions.

For broader information, you can look to a number of resources online. America’s Health Insurance Plans and the federal government’s Agency for Healthcare Research and Quality put together a consumer guide to health insurance that details the different types of insurance available and how they work. “Questions and Answers about Health Insurance” is a 36-page guide that can be accessed on the group’s Web site, Found by clicking on “Consumer Information,” the guide contains details about how plans work and a glossary of insurance and health-care terms.

A similar effort prepared from the consumer perspective, “The Managed Care Answer Guide,” can be found on the Web site of the Patient Advocate Foundation,, by clicking “PAF Publications.”

Seniors need to understand

Judith Stein, executive director of the nonprofit Center for Medicare Advocacy, said seniors using the government program need to make sure they understand their choices, especially for Medicare’s Part D prescription drug program and for Medicare Advantage plans, which are run by private insurance companies as part of Medicare.

“People need to make a choice every year because the plan they’re on this year may well not be best for next year,” Stein said. Moreover, different plans can cover different treatments and drugs, and need to be examined before they are picked. “You cannot just choose on the basis of premium,” she said.


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