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Shopping for Health Care Just Got a Lot Easier!

By Ron Pollack,

09.19.2012

Originally posted on Huffington Post.

OK, I’m not prepared to say that shopping for health insurance is ever going to be as easy as shopping for a can of soup, but on September 23 it’s going to get a lot closer.

I think you’ll agree that health insurance is one of the most important and expensive products we buy. And for those consumers who don’t have law degrees, comparison shopping for this essential item can be one of the biggest challenges.

Why? Well, for one thing, when we’re shopping for this product, we’re trying to compare health insurance options by using brochures and promotional materials that are different for every plan.

Or we’re searching the web for information and coming away unsatisfied: Was I looking at the right criteria to choose a good plan? Did Google really know the best way to define those terms I didn’t know? Do I understand what those terms mean in the context of this plan? It’s difficult to find the information you need.

Then, when we finally have our policy in hand, we see so much legalese that most of us have trouble deciphering exactly what’s covered, when it’s covered, and what our share of the costs are. Unfortunately, by that time we’re whiping through the pages scrambling to find out why we’ve had a claim denied.

Wouldn’t it be nice, if we had information like that on a can soup?  Benefits, costs and coverage limitations listed like calories, cholesterol content, and carbohydrates? A simple summary that lets us look at the next brand and compare?

Is it possible for insurance companies to give us something that takes this important and complex product and lets us understand what we really have?

Yes it is! The Affordable Care Act gives us a new comparison “label” for insurance policies called the Summary of Benefits and Coverage, and it will be available for all health insurance policies in a matter of days.

Here’s the kind of information you’ll find in the Summary of Benefits and Coverage: how much you’ll have to pay for services before your plan starts paying and whether that amount is different depending on the service, limitations on how much you will pay and how much the plan will pay, your coverage for essential health services and the difference in cost if you use a participating provider or a non-participating provider, which services are excluded, what key terms mean and why they matter. You’ll also find real life examples of approximately how much you’ll pay in common medical scenarios, such as managing Type 2 diabetes.

Now I don’t want to oversimplify the shopping process. You won’t wake up the morning of September 23 and know everything about every insurance plan. You’ll still have important questions. But, you’ll be a much more informed shopper and a smarter health care consumer.

If you’d like more information about how the Summary of Benefits and Coverage can aid your search for health coverage, I invite you to check out Families USA’s report, “Decoding Your Health Insurance: The New Summary of Benefits and Coverage.