The Affordable Care Act: Knowledge is Power

Confused consumerGreat news for anyone who has ever struggled to understand exactly what their health insurance covers, what conditions apply, and how much they will owe for medical care! (And isn’t that everyone?)

Health insurance is notoriously difficult to comprehend. Luckily, one of the many positive benefits of the Affordable Care Act is the requirement that insurers disclose certain facts in easily comprehensible language. Consumers overwhelmingly like this component of the law. In fact, this provision is the most popular piece of the entire ACA.

Starting in September of this year, insurance companies will be required to provide easily understandable summaries of the coverage they issue and the terms they use, making shopping for and using your insurance much easier. They will also have to use uniform language in describing their plans, making it easier for consumers to compare the benefits offered by each plan. “All consumers, for the first time, will really be able to clearly comprehend the sometimes confusing language insurance plans often use in marketing,” said HHS Secretary Kathleen Sebelius. “This will give them a new edge in deciding which plan will best suit their needs and those of their families or employees.” Of course, the “edge” is that it actually levels the playing field between consumers and insurers by putting everyone on the same page. 

This aspect of the ACA ensures that consumers will be able to better understand their coverage and compare plans. Insurers will have to issue a six-page document that discloses what benefits are actually provided by the insurance; additionally, the document will provide examples of common medical situations (childbirth, chronic disease management, outpatient surgery, etc.) and explain how much coverage the insurance provides in each example. Insurers will also provide a dictionary of common insurance lingo, such as “deductible” and “co-insurance.” Worried you’ll miss something in the fine print? No more tiny restrictions and warnings at the bottom of the last page—the law literally bans fine print by mandating all writing must be in at least 12-point font! 

While information about insurance coverage was difficult to find in the past, the new law will mandate that it is available before purchase to allow comparisons when the coverage is up for renewal, if the policy changes, or any other time the consumer wants. In addition, the glossary will be publicly displayed on www.HealthCare.gov, www.cciio.cms.gov, and www.dol.gov/ebsa/healthreform.

This piece of the ACA will increase consumer knowledge and allow consumers to efficiently and effectively compare coverage from different insurers. Providing the facts about insurance policies will let consumers avoid surprises in coverage gaps and pick coverage that works best for them.  

 

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