Unless you’re fluent in healthcare, selecting health insurance at the workplace or on your own is and has been a difficult undertaking. Adding your spouse and children to the coverage certainly increases the complication factor. When it’s necessary to see a doctor, specialists, more visits to more doctors, fill prescriptions — how much does it cost and who pays?
Of course these are standard questions that anyone will ask. That said, however, understanding the vocabulary, accessibility of care, restrictions and limitations often involve a translator. Until now, an employer or insurance company was not required to distribute an easy to understand summary of plan benefits and glossary of terms, or offer a help line to answer questions.
Beginning in March, all health insurance issuers and group health plans will be required to offer a summary of benefits and coverage in addition to a uniform glossary to consumers. In the past, health care plans provided materials that were promotional in nature and didn’t give individuals a thorough description of the plan features. Armed with more details prior to enrolling in an employer sponsored health care plan or buying outside coverage, people can make an informed decision on health benefits. The summary will also include a set of standard scenarios to help people identify which health insurance may work best for them. Should there be a change in benefits, individuals must be notified within 60 days through an updated summary of benefits
In order to effectively convert health care vocabulary into understandable concepts, a new Uniform Glossary of Terms provided by insurance companies and group health plans will assist consumers in comparing similar health insurance plans and making the best selection. Simple explanations of terms will be very useful in understanding benefits.
Although there may still be some adjustments to these regulations, speaking health care is an invaluable language skill. For additional information, contact Ellen at EAB HealthWorks.