Understanding Health Insurance Terms: Clear Communication and Your Health

One out of four Americans struggle to understand health insurance basics like copays and deductibles. Even if you’re not among them, confusing health care and insurance information may make it hard to get the care you need.
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Only 1 in 10 Americans fully understand health care terms.

Let’s say your doctor is recommending an MRI to find out what’s causing your back pain. You have to find a place to get an MRI. And you want to know how much it’s going to cost. How do you figure it out?

You need information:

  • Which providers are covered by your plan? 
  • Do I need a referral from my PCP to get an MRI?
  • Can you compare costs between providers?
  • Do you have a copay or coinsurance for an MRI?
  • Does it count toward your deductible?
  • How much of your deductible has been met for the year? 

If you aren’t sure you can answer those questions or find the answers, you’re not alone. Close to 85 percent of American adults would have a hard time with these questions.

What’s health literacy?

Health literacy is the ability to find and understand the information you need to make health decisions. Nine out of ten Americans don’t fully understand and know how to use health care information.  Even people who have excellent literacy skills often lack health literacy.

That means that many of us find it hard to: 

  • Know what health insurance covers and how much care and services cost.
  • Get the right care.
  • Understand or remember what our doctor tells us.
  • Know how to take medications correctly.
  • Know how to care for our health.

Why’s low health literacy a problem?

This confusion means that people:

  • May take too much, too little or none of their medications. 
  • Don’t know where to get care.
  • Pay for costly emergency room visits instead of less expensive urgent cares or walk-in clinics.
  • Don’t get screenings, immunizations and treatment when they need them.
  • Don’t understand nutrition labels, know how to check blood sugar levels, understand how diet and exercise affect overall health.

HAP’s committed to clarity

We’ve made a commitment to helping our members understand their health and their health care plan. It’s our goal to help you get the care you need by making it easy to understand how to do that. We check everything we send out or put on our website for the four Cs:

  • Clear
  • Concise
  • Complete
  • Correct

We also follow plain language and readability standards designed to make all our information easy to understand.

Plain language

Health care can be full of jargon and acronyms. We use words people know - terms like heart disease instead of cardiovascular disease. We spell out acronyms. Instead of sending you an EOB, we send you an Explanation of Benefits. If we have to use a word you may not know, we explain what it means.

Readability

Information should be easy to find and read. Instead of walls of text, we present information in small chunks with clear headers. We keep sentences short. And we use short, commonly understood words to explain health care benefits, HAP programs and health conditions. We strive for all our content to be under an 8th grade reading level. In fact, this post is written at a 6th grade reading level!

How can you learn more?

Do you know the difference between a copay and coinsurance? If you don’t, you’re not alone. Most people don’t know what they pay for when they use their health plan. Never fear, we have web pages, videos and flyers to help you understand health plan terms like deductible, prior authorization and health reimbursement account.

To learn more, you can:

  • Check out HAP videos on everything from Understanding Cost Sharing to The Basics of Medicare.
  • Check out other HAP Balanced Living blog articles on health and health plan topics.
  • Go to hap.org and use the search feature to find information.
  • Ask HAP Customer Service questions by calling the phone number on your member ID card.

Categories: Get To Know Your Plan

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