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New challenge for Obamacare: Enrollees don’t understand their insurance plans
Washington Post ^ | July 16, 2014 | Lena H. Sun

Posted on 07/16/2014 2:18:05 PM PDT by Second Amendment First

Nine months after Americans began signing up for health insurance under the Affordable Care Act, a challenging new phase is emerging as confused enrollees clamor for help in understanding their coverage.

Nonprofits across the country are being swamped by consumers with questions. Many are low income, have never had insurance and have little knowledge of the health-care system. The rampant confusion poses a potential hurdle for the success of the health law: If many Americans don’t understand health insurance, that could hurt their ability to use their benefits — or to keep their coverage altogether.

Community organizations are scrambling to keep up with the larger-than-anticipated demand but are stretched thin. A federal program to help consumers has also run out of money.

“We are hearing this in probably every state that we work in,” said Christine Barber, a senior policy analyst with Community Catalyst, a Boston-based advocacy organization that works with community groups in more than 40 states. “‘Okay, I have my card, what do I do now?’ ”

Health insurance, with its jargon and complicated fee structure, has long been confusing for many consumers, but experts say the literacy gap poses an especially big problem now. Before the opening of the marketplaces, people buying coverage on their own tended to be individuals with higher incomes and more familiarity with how insurance works.

“So what you’ve got is an insurance industry that did not do a good job in gearing up for a population that has never had health insurance before, an Obama administration that did a horrible job on the back-end, resulting in a flood of calls to insurer call centers, and a population that is low-income and is not health-insurance literate.

(Excerpt) Read more at washingtonpost.com ...


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To: Second Amendment First
My friend — an Obama true believer and unemployed — procured an Obamacare policy for something like $30 a month. All I heard about for months was what a wonderful plan it was and how I was an idiot for not paying homage to King Obama for this most wonderful benefit.

Then she sustained an injury and had to go for rehab. One night she called me all upset. The physical therapy practice billed her $1200. Seems she didn't realize that wonderful benefit from her idol king included a $1500 deductible.

For days afterwards my tongue was sore from biting it. It was all I could do to prevent myself from saying, I told you so.

21 posted on 07/16/2014 3:07:24 PM PDT by fatnotlazy
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To: steve86
I wouldn't expect the average man-in-the-street to automatically understand concepts like deductible, copay, co-insurance, MOOP, or capitation, among others.

Most people that have had health insurance at one time or another would understand those concepts. What they may not understand is Obamacare. I was talking today to a 60 year old lady that was laid off a couple months ago from her job. I brought up the subject about what she going to do about health care. She said the Cobra coverage was way too expensive. I didn't want to pry too much into her affairs, but I got the sense she had no clue about the implications of Obamacare or even what kind death care she was eligible for....

22 posted on 07/16/2014 3:08:00 PM PDT by EVO X
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To: Second Amendment First

They still don’t have health insurance, they have Medicaid and a good number of them are not only illiterate, they don’t speak English and they don’t have citizenship.

It’s a big problem. Many of these illiterate, non English speak in insures gained their coverage by joining one branch or another of the SEIU.


23 posted on 07/16/2014 3:10:09 PM PDT by Eva
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To: Theodore R.

Well, there’s one thing you can count on, guaranteed, and that is, they’ll blame it all on the EEEVIL insurance companies.


24 posted on 07/16/2014 3:12:26 PM PDT by COBOL2Java (I'm a Christian, pro-life, pro-gun, Reaganite. The GOP hates me. Why should I vote for them?)
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To: ken5050

At least she puts out. Everybody is going to get some.


25 posted on 07/16/2014 3:13:06 PM PDT by Lurkina.n.Learnin
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To: Second Amendment First
“‘Okay, I have my card, what do I do now?’ ” Uh... read that book that came with it. It'll give you something to do while you're sitting in the waiting room at the E.R. waiting to get your cold treated. What? Oh, okay, then have somebody read it to you.
26 posted on 07/16/2014 3:30:18 PM PDT by ArmstedFragg (Hoaxey Dopey Changey)
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To: grania

Full benefit? Have you looked at those policies? They amount to high deductible major medical with free physicals and birth control. Ninety percent of the newly insured won’t receive any significant benefit from them.


27 posted on 07/16/2014 3:35:36 PM PDT by ArmstedFragg (Hoaxey Dopey Changey)
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To: ArmstedFragg
Ninety percent of the newly insured won't receive any significant benefit from them

The benefits they do receive will be geared to "what's covered". When I was hospitalized with a lung situation five years ago, it was a constant battle with "my" medical team. It was appalling how they'd provide services I neither wanted nor needed because my coverage allowed it. I can't imagine those unsophisticated about their situation getting the care they need.

28 posted on 07/16/2014 4:07:26 PM PDT by grania
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To: Second Amendment First
It tends to get your attention when you discover your "free" health insurance is costing you $4,000 up front.

The Gibsmedats aren't used to that sort of unfair treatment. Usually they just show up, get treated, and leave without having to pay a cent - or even give their correct names.

Just imagine how upset they would be if they had to file income tax returns and send the IRS a check instead of getting a free one back!

29 posted on 07/16/2014 4:13:30 PM PDT by Gritty (Obama's governing as president of a Latin American republic, where only the president matters-MSteyn)
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To: steve86

Your post is spot on. Most people don’t understand deductibles and co-pay. My company is self insured and I am pretty amazed at the number of people who pop a cork about paying a deductible and out of pocket charges....even though we have a low monthly premium, low deductible and oop. And good coverage. This insurance is CRAPPY they will tell me. Someday, I’m gonna have to tell these folks to hit the market place and see how crappy the insurance our very generous employer is providing.

I read an article (and received notices at work) that there is legislation in place that will allow insurance companies and OCare to cap what they will pay on various procedures. And if a provider is chosen that exceeds the benefit amount...it won’t apply to the out of pocket or deductible. That sure isn’t going to muddy the waters will it?


30 posted on 07/16/2014 4:34:57 PM PDT by berdie
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To: grania

Essentially what the (relatively) poor are paying for is protection from a life event that is probably the most unlikely one of a whole series of events that could wipe them out. And it’s also one where the “safety net” provides considerable protection through Medicaid and similar government programs. The real beneficiaries in those instances of catastrophic illness visiting the poor are going to be the hospitals that are providing uncompensated care and the taxpayers who are subsidizing that care.

And the fact is that the deductible and the co-pay would probably still be enough to wipe them out, so they’re not really well protected anyway.


31 posted on 07/16/2014 8:02:08 PM PDT by ArmstedFragg (Hoaxey Dopey Changey)
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To: Second Amendment First
But he doesn’t understand why he is getting charged for hospital bills when he already pays the insurance company every month.

Before Obamacare, people like this would simply go to the Emergency Room any time they needed healthcare, but would not pay the bill. Now that we have Obamacare, these same people go to the Emergency Room any time they need healthcare, but don't pay the bill.

32 posted on 07/16/2014 8:16:08 PM PDT by Hoodat (Article 4, Section 4)
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