The Science Of Choosing A Health Plan Survey: Many Americans Give Themselves Poor Grades On Understanding Health Benefits

BLOOMFIELD, Conn. — An estimated 162 million Americans have health insurance coverage through their employers, and during the fall, many of them will select the health care plan they and their family will use for the coming year during the employer’s open enrollment.
Unfortunately, many Americans do not have a strong understanding of their health benefits or the programs that can help them save on health care costs. According to a new survey by CIGNA HealthCare, 43{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of Americans give themselves a grade of ‘C’ or lower when it comes to understanding their health benefits.

“A health care benefits plan is something that many people don’t really think about until they have to use it,” said Andrea Gelzer M.D., vice president of health policy at CIGNA. “But at a time when costs are increasing, it’s more important than ever for consumers to know the details of their plan ahead of time, know how to use it, and know how to get the best value out of their health plan.”

As expected, affordability and accessibility continue to be major concerns for most Americans when considering which health plan to select for their family, with 83{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of Americans saying that a plan’s affordability is a very important consideration. More than three-quarters cited the services the plan covers and prescription drug coverage as important factors in making their selection. Sixty-one percent also said it was very important to them that their doctor be part of the network.

In researching health plan offerings, most people know to ask about cost, and whether they can continue to see their favorite doctors. But very few know to ask about other services that may vary significantly from plan to plan. These services can have a real impact on a family’s out-of-pocket health care expenses. In fact, when described to them in a recent survey, most say such offerings would be an important consideration in their selection of a health plan.

• 24-hour phone access to nurses — to provide information to people with questions about everything from a child’s persistent cough to a spouse’s mild chest pains; 70{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} say the service would be important, but 53{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} either do not have or aren’t sure if this resource is available to them;

• Nurse case managers — available to help consumers find rehabilitative services, assist with post-operative care, help with claims filings, assist in finding additional financial resources, or provide day-to-day assistance for people dealing with major illness; 71{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} percent say such assistance would be important, but 70{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} don’t have or aren’t sure if this resource is available;

• Wide range of health services — checking to see if services such as mental health, substance abuse benefits, dental, and vision coverage are available in one place from their health plan; 94{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} say it would be important, but 22{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} don’t have or aren’t sure if this resource is available to them;

• Discounts on health, fitness, and wellness services — such as smoking cessation, weight loss, health clubs, laser eye surgery, cosmetic dentistry, and massage therapy; 67{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} say these discounts would be important, but 65{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} don’t have or aren’t sure if the discounts are available;

• Disease management programs — to help people better manage chronic conditions ranging from heart disease to asthma or lower back pain; 79{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} say such services would be important, but 57{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} don’t have or aren’t sure if these programs are available.

• Personalized online health resources — to help people know more about particular health issues or better handle claims and benefits management; 61{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} say Web services would be important, but 44{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} don’t have or aren’t sure if this resource is available.

“What the survey tells us is clear — many still think their health plans only process bills and pay claims,” said Gelzer. “But many health plans also offer resources to help consumers make more informed health care decisions. If more people knew about the resources available to them that would help them save money, they would be more inclined to use them.”

The survey also revealed that consumers are beginning to take action to help rein in their health care costs, with more than four in 10 Americans saying they would use more generic drugs as a way to keep costs down. Generic drugs present money-saving alternatives for many consumers. Thirty-seven percent also indicated that they would take better care of themselves so they wouldn’t have to go to the doctor.

The survey was conducted by KRC Research and fielded from August 24-27. It includes responses from a random sample of 750 people enrolled in employer-based health plans around the country, and has a margin of error of 3.6 percentage points.

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