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22 Oct 2014
Brief

A Little Knowledge Is a Risky Thing: Wide Gap in What People Think They Know About Health Insurance and What They Actually Know

Kathryn Paez
Coretta Mallery

Under the 2010 Affordable Care Act, millions of Americans gained health coverage in 2014 through Medicaid or subsidized private coverage in state and federal insurance marketplaces. Coverage is key to accessing affordable, high-quality care, but consumers who struggle to understand how health insurance works and how to estimate out-of-pocket costs are at risk of going without needed care even if they are covered.

Snapshot of health literacy coverWhile about three out of four Americans aged 22-64 believe they know how to use health insurance, only about one in five could correctly calculate how much they owed for a routine doctor visit, according to new findings from a 2013 national survey by AIR designed to measure health insurance literacy.

Generally, younger people, those who use fewer healthcare services, minorities, people with lower incomes and those with less education have more difficulties navigating health insurance. This brief outlines identifies what health insurance aspects pose the greatest problems for consumers, which groups need more assistance to enroll and use benefits, and what topics and skills consumer-counseling efforts should focus on.

The findings that older people and those who use more services have higher levels of health insurance literacy suggest that people learn about health insurance by doing, so creating tools that simulate real-life examples of how to use insurance are likely to be most effective.

Health Insurance Literacy Infographic from AIR Survey findings: 3 in 4 people said they have the knowledge to use health insurance, however only, 1 in 5 people could calculate their out-of-pocket costs

PDF icon A Little Knowledge Is a Risky Thing: Wide Gap in What People Think They Know About Health Insurance and What They Actually Know

Related Projects

Project

Measuring Health Insurance Literacy

Health insurance coverage is key to accessing affordable, high-quality care. But do most Americans have the knowledge and skill they need to navigate or get the most out of their insurance plans? To answer this question, AIR researchers developed The Health Insurance Literacy Measure©, which consists of 21 self-report questions assessing self-confidence and behaviors associated with choosing and using health insurance.

Related Work

22 Oct 2014
News Release

Many Americans Fail to Ask Basic Questions Before Signing Up for Health Insurance, National Survey Finds

With the Affordable Care Act open enrollment period starting in November, a national survey by AIR finds that three out of four Americans are confident they know how to use health insurance, but 42 percent say they are not likely or only somewhat likely to review a plan’s details before signing up for coverage. The survey found wide gaps in Americans’ health insurance literacy, with only 20 percent able to calculate correctly how much they owe for a routine doctor’s visit.
20 Feb 2013
Brief

Developing a Measure of Health Insurance Literacy: Understanding Consumers’ Ability to Choose and Use Insurance

This issue brief describes the findings from interviews with health insurance counselors and other stakeholders about problems consumers face in selecting and using health insurance. It also lays out a strategy to develop an important new tool: a measure of health insurance literacy.

Topic: 
Health
14 Oct 2014
Report

Development of the Health Insurance Literacy Measure (HILM): Conceptualizing and Measuring Consumer Ability to Choose and Use Private Health Insurance

Understanding health insurance is central to affording and accessing health care in the United States. Efforts to support consumers in making wise purchasing decisions and using health insurance to their advantage would benefit from the development of a valid and reliable measure to assess health insurance literacy. This article reports on the development of the Health Insurance Literacy Measure, a self-assessment measure of consumers' ability to select and use private health insurance.
Topic: 
Health, Patient, Family, and Stakeholder Engagement, Patient-Centered Quality & Performance Measurement

Further Reading

  • Development of the Health Insurance Literacy Measure (HILM): Conceptualizing and Measuring Consumer Ability to Choose and Use Private Health Insurance
  • Many Americans Fail to Ask Basic Questions Before Signing Up for Health Insurance, National Survey Finds
  • Measuring Health Insurance Literacy
  • How Much Do People Really Know About Their Health Insurance?
  • AIR Index: Health Insurance Literacy in America
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Contact

Kathryn Paez

Managing Researcher

Coretta Mallery

Principal Researcher

Topic

Health
Patient, Family, and Stakeholder Engagement
Patient-Centered Quality & Performance Measurement
Redesigning Healthcare Delivery

RESEARCH. EVALUATION. APPLICATION. IMPACT.

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