Kansas City, Mo., - Health insurance--critical to the peace of mind of most Americans--has become increasingly complex and expensive, according to The National Association of Insurance Commissioners (NAIC). A maze of options and cost considerations--from health maintenance organizations to health savings accounts--now confront consumers.To help individuals clear up the confusion and gain a better understanding of the costs of their coverage, the NAIC has assembled useful information about health insurance--all organized by life stage needs--on its new consumer education Web site called Insure U at http://www.insureuonline.org/.

"The better consumers understand their health insurance options, as well as their share of the costs for premiums, co-pays and deductibles, the better they'll be able to plan for health related expenses," says Alessandro A. Iuppa, NAIC president and superintendent of the Maine Bureau of Insurance. "We've created Insure U to help educate consumers about insurance."

Recent research conducted by the NAIC indicates that cost and confusion regarding health insurance are significant issues for consumers across all life stages, even for those with access to health insurance through their employers or government programs like Medicare. According to the NAIC survey:

  • Only 36% of young singles said they knew the difference between an HMO and PPO. In addition, a high number--18%--said they had declined health insurance offered by their employers as a way to save money on the portion of premiums they are asked to contribute.
  • More than half of respondents from established families said they did not understand the terms under which they can elect to continue their health coverage from their old employer if their employment ends, as provided under COBRA (the Consolidated Omnibus Budget Reconciliation Act). Specifically, they did not understand they had to pay the full cost of their premiums, or that their coverage would end after 18 months.
  • Only 12% of older Americans thought they were very likely to need long-term care, even though some data indicate that 60 percent are likely to need long-term care at some point. In addition, those seniors surveyed underestimated the cost of long-term care by 100 percent--saying that expense would come to around $35,000 a year when the national average is closer to $70,000 per year.
  • Of those who have purchased medical discount cards (which typically provide a discount off fees charged by participating doctors), 18% said their experience had been very or somewhat negative.

The NAIC's consumer site explains the different types of health insurance and gives focused tips to consumers based on their likely needs in different life stages. For example:

  • Young singles who may not yet have a full-time job that offers health benefits should be aware that in a growing number of states, single adult dependents may be able to continue to get health coverage for an extended period (ranging from 25 to 30 years old) under their parents' health insurance policies even if they are no longer full time students. They should check with their state insurance department. In addition, some colleges also offer graduates interim coverage for a limited time. Another option: young people who can't afford the health insurance offered by their employers should consider a lower cost, high-deductible medical plan to cover catastrophic medical costs.
  • Young couples expecting a child should make sure they register their newborn with their health insurance provider within the deadline required. They should also review their health plan to see whether prenatal and neo-natal screening and tests, prenatal vitamins, delivery costs (Cesarean and traditional) and what level of pediatric care are covered.
  • Established families with children should consider flexible spending accounts if available to help pay for common childhood medical problems such as allergy tests, braces and replacements for lost eyeglasses, retainers and the like, which are often not covered by basic health insurance. All workers who lose or change jobs should know their rights to continue their health coverage under COBRA for up to 18 months.

Empty nesters/seniors who are under 65 and no longer employed, but whose COBRA benefits have run out, should research high deductible medical plans. At this life stage, consumers may want to evaluate whether they still need disability insurance. Many will want to decide whether long-term care insurance makes sense for them (e.g., will they be able to afford the premiums into old age, when most need to use such coverage).
"The more than 45 million consumers without any health coverage are particularly vulnerable to being targeted by fake companies selling discount health cards or bogus health insurance," notes Catherine J. Weatherford, NAIC executive vice president and CEO. "All consumers should be aware that discount health cards are not insurance plans, and therefore aren't regulated by the state insurance department in some states. Before purchasing any kind of health insurance, all consumers should protect themselves against scams by taking a few minutes to stop, call their state insurance department and confirm that the company offering the policy is legitimate and authorized to sell insurance in their state."

Source: National Association of Insurance Commissioners

Register or login for access to this item and much more

All Digital Insurance content is archived after seven days.

Community members receive:
  • All recent and archived articles
  • Conference offers and updates
  • A full menu of enewsletter options
  • Web seminars, white papers, ebooks

Don't have an account? Register for Free Unlimited Access