Health insurance policies are confusing patients, say emergency physicians

health insurance plans

A recent American College of Emergency Physicians report said decisions are made based on misunderstandings.

A new report issued by the American College of Emergency Physicians has revealed that the vast majority of patients don’t understand their health insurance policies and it is causing them to make choices based on the wrong information.

The report said that a survey of ER physicians showed that 90 percent of their patients don’t understand their coverage.

The concern these physicians expressed was over the fact that some insurers sell some highly affordable health insurance policies in terms of the monthly premiums payments, but those plans don’t cover very much. When that is combined with the fact that many patients don’t understand their health plans at all, this can be a worrying combination and can lead people to make decisions based on misinformation.

Eight out of every ten physicians had to attend to patients whose health insurance policies had held them back.

health insurance policiesThe American College of Emergency Physicians reported that of every 10 ER physicians, 8 had said that they were seeing patients who had health insurance coverage but who had still either delayed or foregone receiving recommended care due to the size of the out of pocket costs they would have been facing if they had followed up on those recommendations for medical treatment.

According to the president of the Louisiana chapter of the ER physician’s group, Dr. Mark Rice, “Certainly, the patients I encounter on a regular basis don’t have much of a clue about what their insurance covers. … They know they purchase health insurance, but when it comes to knowing who they can see when, where and how, there’s definitely a large disconnect.”

John Maginnis, a spokesperson for Blue Cross and Blue Shield of Louisiana explained that the insurance company works hard to educate patients. A primary focus for this effort is to encourage patients to make sure they have a regular primary care doctor who can help them with the majority of their general medical needs when they are injured or ill. This also includes education about health insurance policies in order to allow people to know how they can best consult with their physicians and avoid ER visits unless absolutely necessary.

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