Customers Often Struggle To Understand Key Health Insurance Terms, Concepts

Do You Speak Health Insurance? It’s Not Easy

NPR, 12/30/2015

Solicit opinions about health insurance and you’re almost guaranteed to find consensus: It’s mystifying and irritating.

“It just seems like a lot of the buzzwords are intended to just complicate the whole thing and make it more expensive,” says David Turgeon, 46, who’s sitting in a Minneapolis mall eating lunch.

Enrollment season rolls on, and people shopping on HealthCare.gov and the other marketplaces have until Jan. 31 to decide on a plan.

But even people trying to pick from their employers’ options can find the process complicated and difficult to understand. The jargon can be overwhelming, and it can lead people to make costly mistakes or to avoid care altogether.

Ronen Ben-Simon, 28, also eating lunch in Minneapolis, says some basic health insurance terms are lost on him — even though he’s a nurse. “I don’t even know what coinsurance is, to be honest,” he says.

Coinsurance, if your plan has it, kicks in after you’ve met your deductible and requires you to pay a set percentage of medical bills.

Over in St. Paul, Minn., Seanne Thomas, a 50-year-old real estate broker, says she has gotten good at figuring out how health insurance policies work. She’s had to, because her family members are covered under three different plans. “So I had to compare copays, I had to compare out-of-pocket, you know, deductible and maximum coverage.”

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