Coming Soon: New Tool to Make Understanding Insurance Plans Easier


Given the choice, would you rather prepare your taxes, exercise at the gym, or try and figure out your health insurance policy? If you chose one of the first two options you’re not alone! A 2008 survey found that most Americans agree with you. The good news, however, is that coming soon a new tool will make it easier for 150 million Americans with private health insurance to understand their coverage and compare health plans.

This new resource, called the Summary of Benefits and Coverage (SBC), will provide consumers with a uniform description of their health plan choices in concise, understandable language. And because all insurance companies will have to use the same format and terms in the SBC they provide to consumers, Americans will be able to decide which insurance coverage to choose by making apples-to-apples comparisons of their options.

The SBC will also include a new feature, called “Coverage Examples,” that will show how the health plan’s coverage works for two common medical scenarios – having a baby and managing type 2 diabetes. These examples, which are modeled on the Nutrition Facts label required on packaged foods, will help consumers understand and compare what different insurance plans will pay and what their own share of the costs would be for these common medical situations. A sample SBC, including Coverage Examples, is available on the HHS website.

Why is this important? The information that consumers currently receive about their health insurance is often complex and highly technical, and as a result, patients too often don’t understand what their health plan does and does not cover until confronted with a serious medical condition and high bills for treatment. . In a 2009 survey of heart disease and stroke patients conducted for the American Heart Association, 42 percent of patients said it was “very difficult” or “somewhat difficult” to figure out what cardiovascular treatments and care were covered by their insurance.

The SBC is coming this fall for most Americans with private insurance—insurance companies and employers providing insurance coverage to their workers will have to begin providing the SBC at the beginning of open enrollment periods which occur after September 23rd of this year. Unfortunately, however, some special interests in Washington are pushing Congress and the Obama Administration to delay the availability of the SBC.

If you think Americans have waited long enough for simple, straightforward information about their insurance coverage, take action now and ask the White House not to delay this important new rule for consumers and patients.

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