More than half of Americans said they are worried about getting surprise medical bills they cannot afford, and consumer advocates said one way to avoid them is to improve your health literacy. The task can feel daunting for many people overwhelmed by confusing insurance terminology, but Dr. Lauren Wilson, president of the American Academy of Pediatrics in Montana, said knowledge is power when it comes to healthcare.
She has witnessed many families in emergency rooms forced to balance their medical needs with their checkbooks. “And sometimes, in those moments is not the time when you can really address what might be an inadequate insurance plan, which is why it’s important to put the time in when you select your plan and make sure that it’s something that will work for you,” Wilson said.
60% percent of Americans said they have avoided or delayed medical care because of potential out-of-pocket costs, but Wilson said learning the ins and outs of individual plans can ensure that all families get the care they need. Open enrollment for health insurance plans through the federal marketplace begins November 1.
The health advocacy group Consumers for Quality Care is urging people looking for new coverage, or to change their existing insurance plan, to do their homework. Board member Mary Smith advises not to be lured only by low prices. She said the insurance plans with the lowest premiums often include high deductibles, co-insurance, and co-pays. “There are also sometimes short-term, limited-duration insurance plans,” Smith said. “They often exclude coverage on pre-existing conditions – including conditions an individual did not know they had or were not aware required medical intervention.”
Smith said people with prescriptions for an ongoing medical condition should also avoid what are known as co-pay accumulator programs, which can prevent using a drug manufacturer’s coupons as part of a patient’s maximum out-of-pocket costs. On ‘healthcare.gov’ or ‘CoverMT.org,’ you can also find out if you qualify for a federal subsidy to help with monthly premium costs. Congress renewed funding for the subsidies through 2025.
(Photo licensed via Envato Elements)