Many Americans Don’t Ask Basic Questions Before Choosing a Plan

Three out of four Americans say they understand health insurance. But 42% say they are somewhat likely or not at all likely to review plan details before signing up for coverage, according to a survey by the American Institutes for Research (AIR).  “Because many people believe they know more than they actually do about health insurance,…they may face the shock of high out-of-pocket expenses they didn’t expect,” said Kathryn A. Paez, Ph.D., R.N., an AIR principal researcher, and coauthor of the study. The survey reveals the following:

  • About half can identify general characteristics of an HMO, and 23% can identify the characteristics of a PPO.
  • While most can identify common insurance terms, such as “appeal” (80%) and “premium” (81%), far fewer can identify more complicated concepts, such as “step therapy” (37%) or “medically necessary” (60%).
  • Only 20% can calculate how much they would owe for a routine doctor’s visit.
  • Seventy-nine percent are at least moderately likely to check which hospitals and physicians are covered by various plans.
  • Those aged 22 to 34 answered 55% of the knowledge and skills items on the survey correctly, compared to 63% of 55- to 64-year olds.
  • People who have not seen a doctor in the past year answered 49% of the knowledge and skills questions correctly compared to 64% of those who see a doctor several times a year.

Last Updated 10/20/2021

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