Do You Speak Health Insurance? It's Not Easy (2024)

FAQs

Is health insurance complicated? ›

Health insurance can be confusing and complicated, with lots of new terms and definitions so we put this page together to help you!

If you don't have health insurance, those stories can sure get you thinking, Do I need health insurance? The answer—yes! Health insurance has a reputation for being expensive and confusing, but it can also be the only thing standing between you and financial disaster if you ever need medical care.

About half (48%) of insured adults worry about affording their monthly health insurance premium and large shares of adults with employer-sponsored insurance (ESI) and those with Marketplace coverage rate their insurance as “fair” or “poor” when it comes to their monthly premium and to out-of-pocket costs to see a ...

It's generally never a good idea to skip health insurance coverage due the financial risk of ending up with whopping medical bills.

The researchers say today's complex insurance plans, with intricate cost calculations and complicated language and terminology, can be very difficult to understand, even for people with a college education.

Unfortunately, insurance companies are notorious for using complicated verbiage that is nearly impossible for policyholders to understand what is covered and excluded. Insurance companies are aware that policyholders don't understand the complex and lengthy legal text packed into policy pages.

Financial consequences

Without health insurance you may get charged much more for care that would otherwise be covered by your plan. This is because no one—usually the insurance company—will be subsidizing your cost of care. As a result, you may have to pay higher charges for the same services.

The Share of Americans without Health Insurance in 2022 Matched a Record Low. In 2022, 26 million people — or 7.9 percent of the population – were uninsured, according to a report in September 2023 from the Census Bureau.

uninsurance has been attributed to a number of factors, including rising health care costs, the economic downturn, an erosion of employer-based insurance, and public program cutbacks. Developing effective strategies for reducing uninsurance requires understanding why people lack insurance coverage.

Why do people not want health insurance? ›

Why are people uninsured? Despite policy efforts to improve the affordability of coverage, many uninsured people cite the high cost of insurance as the main reason they lack coverage. In 2022, 64% of uninsured nonelderly adults said that they were uninsured because the cost of coverage was too high.

Without health insurance coverage, a serious accident or a health issue that results in emergency care and/or an expensive treatment plan can result in poor credit or even bankruptcy.

Health insurance facilitates access to care and is associated with lower death rates, better health outcomes, and improved productivity.

Healthcare system complexity

This complexity often results in administrative inefficiencies, increased paperwork, and higher operational costs for both healthcare providers and insurers. These added expenses are eventually passed on to consumers in the form of higher insurance premiums, deductibles, and copayments.

The U.S. healthcare system is highly complex. There are separate rules, funding, enrollment dates, and out-of-pocket costs associated with the various forms of health insurance, whether it's employer-based, private insurance, or government-provided plans like Medicaid and Medicare.

Fifty-one percent of working-age Americans struggle to afford their health care and about one of three (32%) are saddled with medical debt, according to findings from a Commonwealth Fund survey released today.

Basic health insurance terminology – A quarter of all insured adults say they have difficulty understanding specific terms, such as “deductible,” “coinsurance,” “prior authorization,” or “allowed amount.” Among Marketplace enrollees, about one-third (32%) say they find these terms difficult to understand.

Health literacy is a critical need in the United States, with research consistently demonstrating that more than one-half of the U.S. population does not understand basic health insurance terms (American Institutes of CPAs, 2013; Kenny, Karpman & Long, 2013; Paez et al., 2014; Quincy, 2012).