The New York Health Insurance Study About Coverage Facts Labels

The Patient Protection and Affordable Care Act has required medical and insurance providers as well as employers to make a way for consumers to easily understand their health insurance options. The health insurance information should be done in a way that any average American could comprehend what each health and insurance plan is about and will be able to compare their options on their own. Insurers should word it in such a way that consumers will have a full grasp of what health insurance terms mean.

The new health care law requires all insurers to include Coverage Facts Labels (CFL) in their health insurance information by 2012. Through these labels consumers will be able to easily understand the benefit package, the terms of the plan, the payment scheme (premiums and cost-sharing) and how to file claims as well as dispute denials. It will even give consumers an idea on how much they will need to pay for the most common conditions like diabetes, breast cancer and pregnancy. The mandate is very clear as to specify the font size. It should not be less than a 12-point type size.

The New York Health Insurance Foundation has supported a study by the Consumers Union to find out if Consumer Facts Label will truly be helpful and effective to consumers. They carried out the survey through cognitive interview. This means that the respondents were asked how they view CFL. The respondents were between the ages of 26 and 64.

Generally, the respondents embraced CFL positively. It was able to show them a clear picture of the medical costs using very common medical conditions like pregnancy, breast cancer, and diabetes. This made them understand what exactly the services they were paying for. They were able to understand cost-sharing more and this made them see the value they get for the portion they pay for. This helped them see the value of having a New York health insurance coverage.

But for the respondents, the sample CFL needed improvement in terms of the presentation of the cost-sharing provision. It wasn’t able to show them a very specific computation of the services. There were some necessary services that were not included in the example. It also showed the importance of defining or simplifying certain medical and insurance terms for the consumers to fully understand their health plan and how cost-sharing was carried out.