Health Insurance and You!

People often complain that health insurance and the insurance shopping process is complicated and can be hard to understand. Important information is sometimes buried in fine print or lengthy booklets, and you may have to call the insurer to make sure you’re filling out the forms properly (and, as we recently blogged, that can be a challenge in itself).

To ease the process, the U.S. Department of Health and Human Services (HHS) announced earlier this summer that it was planning a standardized, simplified set of health insurance forms that insurers would be required to use. We tweeted about the planning in May, highlighting some proposed designs and explaining that the new forms would be modeled on food nutrition labels. More recently, a blog entry by the Robert Wood Johnson Foundation linked to two revised designs and described some of the recommended changes to those revisions.

Now, the new forms have been finalized and revealed. In an article for the Washington Times, Paige Winfield Cunningham describes the forms and links to samples (PDF).

Highlights of the new form include:

• A page limit of four double-sided pages
• A chart, in question-and-answer format, that describes premiums, deductibles, out-of-pocket costs, and other aspects of the plan, and explains why they matter
• A chart comparing the cost for common health services like primary care visits or diagnostic tests, for in-network and out-of-network providers
• Definitions of co-payments, coinsurance, and deductibles
• An itemized list of costs and who pays them for three sample scenarios: having a baby, treating breast cancer, and managing diabetes

The shortened, simplified forms will supplement the longer descriptions of plans, not replace them. They were created by the National Association of Insurance Commissioners, a nationwide group that assists state insurance regulators.