It's almost a cliche to say people generally find health insurance confusing, until, that is, a new survey reinforces that.
About half of people who took a Kaiser Family Foundation quiz about health insurance flunked, getting six or fewer questions out of 10 correct. Only 4% got a perfect score, and 12% got nine questions right.
However, the scores were still higher than expected, said Liz Hamel, Kaiser's director of survey research. Most of the 1,292 U.S. adult respondents were familiar with the basics around premiums and deductibles.
People ran into problems when it came to calculating out-of-pocket costs, however. For example, one question asked how much someone would have to pay for a four-day hospital stay that cost $6,000, and the health plan had a $250 per day copayment and a $1,000 deductible. Only half of respondents got the correct answer, $2,000. Only 16% of people correctly answered another question about charges for an out-of-network lab test.
Cost-sharing provisions are becoming more important as more employers and individual shoppers move toward high-deductible health plans, which lead to lower monthly payments but put more of the payment onus on policyholders.
“It could mean people getting these high-deductible health plans may not realize what's going to come out of the pocket until they use services,” Hamel said.
Respondents similarly struggled to define a formulary, which is a list of prescription drugs a health plan will cover, as well as the concept that some doctors can charge out-of-network fees even if people receive care at an in-network hospital. People were more likely to have low scores if they were uninsured, had a high school education or less, or were younger.
For some people who are getting health coverage for the first time under the Affordable Care Act's upcoming open-enrollment period, which starts Nov. 15, providers and health insurers may need to provide additional education, Hamel said
“If there's anything they can do to talk to patients more or educate their insured folks more about some of those terms and concepts, they may end up with fewer situations where people are surprised about their out-of-pocket costs,” she said.
Follow Bob Herman on Twitter: @MHbherman
