Oct. 04--Few things are more difficult, complex and downright confusing than trying to pick the best health insurance plan for yourself and your family.
But the task may now be easier for those who get coverage through an employer or buy it on the individual market.
Last week, the national health reform law began requiring insurers to give consumers a summary of benefits and coverage that should make it easier to do apples-to-apples comparisons of plans.
Such forms must follow a similar format and use plain English, rather than industry jargon.
Consumer advocates who sought the change say the forms are similar to the standardized nutrition labels on food items.
"When insurance is described using the same format for each plan, it makes it so much easier for consumers to compare," said Lynn Quincy, senior health policy analyst for Consumers Union, a division of Consumer Reports.
The fact sheets will clearly detail deductibles, out-of-pocket limits, co-payments for services, what is covered and what is not, and whether referrals are needed to see a specialist. The information will be in the same place on the forms from each insurer.
The documents will also include a couple of hypothetical examples showing how much consumers might pay for having a baby or managing type 2 diabetes under each plan.
Consumer advocates say the summaries, which are not required for Medicare plans, will help consumers avoid buying insurance plans
that don't fit their needs or being surprised by unexpected gaps in coverage.
The requirement kicks in just as the annual enrollment period opens at many companies, a time when employees select their plan for 2013.
Those who do not receive such summaries should request them from insurers or their company benefits manager, Quincy said.
Some insurers have criticized the summaries as a new administrative burden that will drive up the cost of coverage. But consumer advocates counter that the summaries should help people make better informed decisions.
"Our previous consumer testing showed that people dread purchasing insurance largely because they don't understand it," Quincy said.
Sandy Kleffman covers health. Contact her at 510-293-2478. Follow her at Twitter.com/skleffman.
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