Finally There’s a Way to Understand the Language of Health Insurance

On October 24, Health Literacy Missouri (HLM), in concert with Health Literacy Kansas and the Health Care Foundation of Greater Kansas City, staged its first annual Summit in Kansas City. At that conference, as at similar conferences this year across the nation, health insurance literacy was on the agenda.

The first enrollment period for health insurance marketplaces uncovered a secret that most of us have been able to keep for a long time.

The secret? Most of us don’t know a hill of beans about buying and using health insurance. Sure, those of us with employer-provided coverage enroll or renew our health insurance at least once a year. But our employers have already limited our choices and the exercise usually comes down to checking a box or two and signing our names. If we have questions, our HR folks helped us get answers and they shepherded us through the process. Our share of premiums are almost always deducted from our pay, further simplifying the process of maintaining coverage.

The task that faced folks seeking health insurance through the Marketplace was nowhere as easy, especially for those that didn’t speak health insurance-ese. Yes, there were navigators and certified application counselors (CACs) available to help the people whose choices were pretty straightforward. But for thousands of others, like folks who lacked basic knowledge about insurance and people dealing with tax and legal issues that complicated the selection process, getting health insurance was uphill all the way.

Navigators and CACs were understandably prohibited from giving legal and tax advice. Nor did they have training and tools to serve people who had to learn health insurance basics from the ground up.

This year’s enrollment process should be better in that regard. CMS has developed eye-catching material to educate consumers and community partners about health insurance. The readability level strikes me as a bit high for many users; but the From Coverage to Care booklet

  • offers an overview of health insurance concepts and terms, it
  • contrasts emergency room care to having an ongoing primary care “home,” and
  • coaches readers on how to choose providers and prepare for doctor visits.

It even shows how to read an Explanation of Benefits statement, a skill that I had to teach myself, and that I finally mastered only a couple of years ago.

Representative Maxine Waters once remarked that she never fully appreciated the public accommodations that the disabilities community argued for until she broke her leg. Because of curb cuts, designated parking for the handicapped and wheelchair access at airports, she was able to maintain her busy schedule despite having a leg in a cast. Through its efforts to make buying health insurance through online Marketplaces easier, CMS has made it possible for everyone to get a little smarter about buying and using health coverage.

Health Reform

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