Do you have a clear understanding of what your out-of-pocket health care expenses include? If you are not sure, you are not alone. According to a recent study, one in four adults "lacked confidence in understanding" the most basic terms related to health costs such as "premium," "deductible" and "copayment" and 45% don't understand "coinsurance". According to a recent article in the Hartford Courant, many plans sold through the insurance exchange come with high deductibles. What that means is that the insured must spend a specific amount of money, sometimes as much as $5000, before the insurance company will pay any claim benefits. While a number of preventative services are now covered and the deductible does not apply, when a problem is found, the costs can mount rapidly. For people on fixed incomes such as seniors, this can create quite a problem and lead to patients making choices about which of their health care needs they can afford to take advantage of. But these surprises impact everyone. The law mandates that everyone must have health insurance. Portions of the premium cost are covered for those in lower income categories, but there are also penalties for not having insurance. In 2016 they amount to $695 per person, $2,085 per family, or 2.5 percent of income, whichever is greater.

 

Insurers and others involved with policy suggest that by having patients pay more of the cost of their healthcare, and by raising their awareness, it will help to curb the runaway costs of care because they will make smarter choices. The problem is that, even if they can afford to cover the cost of their care, patients often don't have enough information to make the best informed choices about which policy is best for them as well as their actual health care choices. Unlike when we buy a car and have different buying guides available, information is simply not readily available to help us with health care choices. It is important to note that in Connecticut, a recent survey showed that 36% of the enrollees have not used their health insurance at all. Additionally, according to Karen Pollitz, a senior fellow at the Kaiser Family Foundation, one in four Americans is struggling with medical bills they cannot pay. It is clear that more thought and more work must go into ways to make healthcare, not just insurance, available to everyone. It is certain that simply having insurance is not the complete answer.