Confusion was noted among most surveyed regarding prescription copays. Only about one in four enrollees knew that the amount is not the same for all groups of prescriptions. Image: Ivan Anta/Shutterstock.com
“Health plan knowledge is often lacking” among health insurance enrollees, with more than a tenth having misunderstandings about basic features such as premiums and even more about features such as prescription drug coverage, a survey has found.
While the survey by the Employee Benefit Research Institute did not focus on the FEHB and PSHB programs, most of those who participated also have their health care through an employer-sponsored program.
Said a summary, “Most enrollees understand premiums and deductibles but not prescription drug copays or maximum out-of-pocket limits. Eighty-six percent understood that premiums are the amount paid for health insurance, regardless of using care, and 82% understood that the deductible is the amount you have to pay out-of-pocket before your plan begins to pay for care.”
“Confusion was noted among most surveyed regarding prescription copays. Only about one in four enrollees knew that the amount is not the same for all groups of prescriptions. There also was confusion about out-of-pocket maximums,” it said.
It said that two-thirds of respondents said they were satisfied or extremely satisfied with their health coverage, with others most commonly citing overall costs and specifically the out-of-pocket costs for prescription drugs.
It also found that during annual enrollment open seasons, most enrollees spent less than two hours on their enrollment decision, with half spending less than an hour and a third spending less than 30 minutes. Half reported using annual employee benefits guides to help them decide.
Further, about four-tenths meanwhile said they currently use phone apps, wearable devices “or other technology that includes the ability to sense or track activity for the purposes of managing health.” However, it found that such data is not being shared with their doctors or their health insurance companies.
“Health insurance enrollees are taking the minimum time to make their health plan decisions. More education is needed. While they are definitely taking advantage of new tech opportunities to make informed decisions, they also seem to need additional input from their health care providing team,” it said.
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