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Open Enrollment is Here; Consumer Advocates Say 'Buyer Beware'

Only 32% of people in a recent survey said they knew "very well" what their health care insurance covers for in-network hospital services. (Rawpixel.com/Adobe Stock)
Only 32% of people in a recent survey said they knew "very well" what their health care insurance covers for in-network hospital services. (Rawpixel.com/Adobe Stock)
November 1, 2019

HARTFORD, Conn. – The open enrollment period for health insurance under the Affordable Care Act begins Friday, and health care advocates are advising people to read the fine print before deciding on a new policy.

The advocacy group Consumers for Quality Care sponsored a survey that found just over half of respondents said they understand "very well" their health insurance coverage for routine doctor visits.

But according to consumer advocate Jason Resendez, a Consumers for Quality Care board member, only 22% said they understood what is covered for out-of-network hospital services or in the event of an accident.

"It's really important for consumers to understand what exactly their plan covers, and really thinking about how to avoid things like surprise medical bills," he stresses.

The open enrollment period for health insurance under the Affordable Care Act ends on Dec. 15.

Resendez particularly advises to watch out for "short-term, limited-duration" insurance plans. He notes these low-cost plans are exempt from many of the coverage requirements of the Affordable Care Act and may leave people with huge medical bills.

"These are plans that often exclude coverage for pre-existing conditions,” he points out. “They're not required to cover preventative services, and have a host of other substantial risks for consumers. So, these are really 'junk plans.'"

Massachusetts, New York and New Jersey have banned the sale of short-term, limited-duration plans.

Even for people with experience in this field, health insurance plans can be hard to understand and are often confusing.

Resendez says the best thing to do when shopping for a new plan is to be your own consumer advocate.

"Get as much information as you can when you're making these decisions,” he advises, “not being afraid to call your insurer and ask questions and then, making the best decision for you and your family."

Andrea Sears, Public News Service - CT