Health Insurance Confusion Grows

November 3, 2019

Survey finds that one in four Americans have avoided care because they were unsure what their plan covered.

Americans' lack of healthcare literacy may be leading them to avoid medical care.

More than one in four people (27.2%) have avoided care or treatment because they were unsure of what their health insurance covered, according to a new survey from Policygenius, an online insurance marketplace.

Policygenius' research suggests people are increasingly confused about their coverage. For instance, this year’s survey found more than 85% of respondents don't know the basic benefits that health insurance plans must cover under the ACA, compared to 80% in 2018 and 78% in 2017.

“The survey data suggest the reason people avoid care is because they don't fully understand their insurance coverage and would rather avoid a surprise bill,” says Myles Ma of Policygenius.

Related: Three Strategies To Overcome Health Literacy Gaps

Americans are also confused about basic health insurance facts. Only 29.3% of respondents were able to correctly define all three of the most common healthcare expenses-premiums, copay and deductibles. Even among people with health insurance, only 36.1% knew all three terms.

"It's important to read the details in your health insurance policy to get a better understanding of your coverage," Ma says. "You can also call your provider to ask any specific questions you have about your policy."

The third annual Policygenius Health Insurance Literacy Survey also found:

  • Only 11.9% of people knew the correct dates for 2019 federal open enrollment; 

  • Only one in five (21.9%) knew you could get aid to purchase an Obamacare plan-and awareness was even lower (15.6%) among people lacking coverage; 

  • About 80% of people erroneously believed there is still a tax penalty for foregoing health insurance; and

  • 13.2% of people were unsure if they had health insurance.

Policygenius' survey is based on responses from a nationally representative group of 1,500 Americans ages 18 and older. It was conducted through Google Consumer Surveys from Oct. 1 to Oct. 3, 2019. The full report is available here.