Health Insurance Literacy

Health insurance is not only one of the costliest products a consumer will purchase, with an average health insurance marketplace price tag of $386 per month for an individual, it is also one of the most complex products to understand. Many people think they have the skills and knowledge to select and utilize their health insurance, but the evidence shows otherwise. Some examples:

  • A 2014 Kaiser Family Foundation report found that 37% of enrollees did not know the amount of their deductible, and 46% thought they were getting a subsidy though it was actually 85%.
  • Three out of 4 people in a 2013 survey by the American Institutes of Research stated confidence in their knowledge of health insurance, but only 20% could calculate the out-of-pocket cost for a visit with an in-network doctor.
  • A 2014 report from the Urban Institute noted that nearly 50% of adults reporting limited literacy and low numeracy skills, with income below 400% of the Federal Poverty Level (FPL), had difficulty locating information to help them support their insurance plan choices.

This lack of literacy can prove detrimental to the consumer if they select a plan that doesn’t provided needed benefits or puts them at financial risk. The concept of “health insurance literacy” is fairly new, and while there is no official definition it has been described as “the degree to which individuals have the knowledge, ability, and confidence to find and evaluate information about health plans, select the best plan for their financial and health circumstances, and use the plan once enrolled.” Another key issue not addressed in this definition is the ability of the consumer to retain insurance coverage over time.

In 2014, the American Institutes of Research reported on their work to develop a measure of health insurance literacy. They created a conceptual model containing four domains: Knowledge, Information Seeking, Document Literacy, and Cognitive Skills. Each domain presents a number of facets that might prove difficult for a consumer to understand, but could also be used as a tool for those developing information for consumers, or those assisting consumers navigate the health insurance landscape.

Resources for those assisting consumers/patients

Resources for consumers/patients

  • Get free help applying, selecting a plan and enrolling in your area at https://localhelp.healthcare.gov/#intro.
  • FairHealth.org. Numerous healthcare decision-support tools to help individuals understand healthcare costs.
  • HealthCare.gov. Resources for selecting or changing a plan, plan categories, determining the total cost of care, and understanding the different kinds of plans.
  • MedlinePlus: Health Insurance. Resources to assist consumers understand and select insurance, includes patient handouts. Many in Spanish.

If you know of a great resource, let me know and I will add it! Please feel free to share or reuse this post.

Dana Abbey, MLS[i] dana.abbey@ucdenver.edu

[i] Funded in whole or in part with Federal funds from the Department of Health and Human Services, National Institutes of Health, National Library of Medicine, under cooperative agreement number UG4LM012344 with the University of Utah Spencer S. Eccles Health Sciences Library.
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