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Patients Struggle to Learn Health Insurance Lingo


“I still don’t understand what the costs or coverage are,” said Hoerntlein, who lives near Yosemite and is a licensed real estate agent.

When his wife had some warts burned off, he got a bill for about $300. Hoerntlein said he was told that he had vision coverage but later told he didn’t. The booklet explaining his new health coverage arrived months after signing up for the policy.

To address these problems, efforts are underway across the nation by the government agencies, universities and health plans to help people understand the language of health insurance, what services are covered and how to make the best use of policies.  The University of Maryland and the nonprofit Insure the Uninsured Project in California are among those who have offered workshops or are planning to.

Health insurance exchanges are publishing glossaries of insurance terms. Insurers are holding webinars, sending out welcome kits and trying to make everything “clear, simple and easy to use,” said Susan Pisano, spokeswoman for America’s Health Insurance Plans. Pisano added that patients will take better care of themselves if they understand their benefits.

Deb Emerson, the Oroville woman who chose a policy through Covered California, said she has spent the last several months reading and asking questions about what is included in her plan and what her financial responsibilities are. She still isn’t clear why she paid about $70 to see a doctor before getting insurance – and $60 afterward. 

Come next month, Emerson expects to become eligible for Medicare and will have to start all over again.

“I am worried it might be more confusing,” she said. 


Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.

Sat, Jun 14 2014

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