Embed Size (px)
Citation preview
Millennials:Health Insurance Literacy & Utilization
What is health insurance literacy?
“The capacity to find and evaluate information about health plans, select the best plan given financial and
health circumstances, and use the plan once enrolled.”
3
What we know… •Only 29% of young adults were very or somewhat confident in understanding of key health insurance concepts, compared to 50% for older adults
•Consumers with low literacy present similar behaviors as uninsured and delay medical care
•Newly insured make incorrect and often unchallenged assumptions about their plan
•Millennials prefer retail (34 percent) and acute care clinics (25 percent) double that of boomers (17 and 14 percent respectively) and seniors (15 and 11 percent respectively).
•Millennials are more inclined to request and receive estimates before undergoing treatment.
Focus Groups
Complete◦ 11 focus groups with >50 participants
◦ NY, Chicago, DC, Northern VA, FL and CA
Upcoming◦ Heath literacy focus groups with young parents in CA, CO, FL, TX and VA
Focus Group Data•Confusion on: oHealth insurance card oTerminologyoWhere to go for care & cost comparisons oType of doctoroServices that are covered oFiling claims
•Little knowledge of mobile resources
•Lack of understanding of preventive care
What is preventive care?
Keeps you from getting
sickHealthy diet Exercise Yearly physical
Drinking water
Going to the doctor Breast exams Dentist
Blood work Flu shot Sleep‘I’ve never heard the
term before’
What’s involved in preventive care?
“Sometimes you need to go to McDonalds late at night, but at least get
the healthier option, the grilled chicken not the burger.”
“Smart decisions & not consistently staying up late”
What are some barriers to preventive care?
“No instant gratification”
Where would you go to learn more about preventive care?
Internet My parents ‘Doctor is too busy to talk’
Professors Hospitals or clinics
Young Invincibles!
Key Takeaway 1•“Free preventive care” does not resonate w/ young adults
•But, when we broke the term down & gave examples, participants saw the value & were excited they could access these services
• Akin to young adults’ response to the phrase “financial assistance available”
Key Takeaway 2Belief that the doctor’s office is not the place for prevention◦ Doctor’s office as a place for treatment
◦ Doctor’s ‘don’t have time’ to explain prevention
Will take work from both consumers & the health care system to build a culture of wellness
Health Insurance Literacy Education HEALTH INSURANCE BASICS THROUGH WORKSHOPS AND OUTREACH
HIL Workshop Content • Terminology such as
• Co-pay, Co-insurance, Out-of-pocket maximum, In-Network and Out-of-network: PPO, HMO
• Where to go for care (ex: ER vs. Urgent Care)
• Thorough overview of reaching your deductible
• Preventive care specifics
• Understanding insurance card
• Scheduling appointments
• Cost of care with and without insurance
• Value of health insurance
Workshop Results • Direct education to over 100 young adults
• Outreach to over 5,000 young adults
• Average pre test score: 48
• Average post test score: 62
• Florida, California, Illinois, Virginia
Top learning outcomes
That pap smears are free
Medi-cal IS health insurance
Reasons to go to the ER
Which payments come out of your pocket
STD’s and birth control are free
Difference between co-pay and co-insurance
How to use your benefits
Can’t max out on insurance
Gaps of knowledge Areas where more education is needed:
• State specific Medicaid plans
• Explaining narrow networks
• Comparing plans
• LGBTQ specific health information
• Cost sharing reduction plans
Messaging EXPLAINING COMPLICATED TERMINOLOGY
Adult Learning Styles
Adults learn differently: • Visual – pictures, demonstrations,
and visually appealing pictures • Auditory – discussions, use of
videos, reiterating key points • Kinesthetic – hands on and case
examples
• Have a variety of “tools” to explain complex terminology or concepts
Figure 1: Example of explaining deductible.
Explaining Deductible • Same concept as reaching your deductible for car insurance or your cell phone
• Caveat – SOME services are FREE or will only require the co-pay even before deductible is met
• Understanding co-insurance and out-of-pocket maximum are essential
• “You will have to pay your $1,000 deductible before your co-insurance kicks in.”
• “You will have to pay your $1,000 deductible before your health insurance begins sharing the costs with you.”
• Have pictures handy while you’re enrolling
Explaining Co-Pay and Co-Insurance • Co-pay = entrance fee to the doctor
• Co-pay = set dollar amount you pay for a service or product
• Co – Insurance = your portion of what you owe to your health care provider
• Provide examples• Specialists requires a $50 entrance fee or co-pay
to see them • If stiches cost $100 and you have an 80/20 plan,
you will pay $20. (Assuming they met their deductible.)
Explaining Preventive Care • Specifics of preventive care (contraception, STD/HIV screenings, cholesterol screenings…)
•Using analogies • “When you purchase car insurance, do you get a
free tune up? Oil change? Tire rotation? With health insurance, preventive care is your free ‘tune up.’” – Navigator, Miami, Florida
• Early screenings for: • High blood pressure• Cancer screenings • Diabetes
• When health care is not important for the individual, it may be important for their family: • “Health insurance ensures you can maintain your
health so you can be around for your family.”
Preventive Care
Source: CDC http://www.cdc.gov/aca/images/aca-infographic-large.jpg
With & Without Health Insurance • Lack of knowledge on cost of care without insurance
• Medical debt is extremely difficult to get rid of
• Provide examples of types of care with and without insurance
Health Insurance Card • Have a sample health insurance card
• Review pertinent information: • Name of health insurance company • Member ID• Group ID• Co-pay amounts • Primary account holder • Type of plan: HMO or PPO• Important telephone numbers on the back of
the card
Choosing a PCPChoosing a Primary Care Physician
•Must be “in-network” or “in your plan”
•Can go for check ups or when your sick
•HMO – PCP can refer you to specialists
•PPO – do not need referral
Scheduling an appointment • ZocDoc to schedule appointments
• What information is important?: • In network • Type of plan • Information on your insurance card
• Show consumers how to schedule their primary care visit with their insurance card
• Remind them to bring their insurance card with them
Where do I go for care? KNOW WHERE TO GO
Where to go for care? • Many newly insured consumers are still seeking unnecessary care at the ER
• Important to explain WHEN and WHAT TYPE of care they should seek
• Four main types of care: • PCP• Urgent Care or 24 hour emergency clinic • Retail clinics – available in places like CVS or
Walgreens • Emergency Room
• The costs at ER are astronomically different from a PCP or Urgent Care
iTriage & YI Presents: HealthGetsReal
Where Should I Go?
Flu Symptoms, High Fever Ankle Fracture Pap Smear
Heart Attack Head Injury Sinus Infection
Young Invincibles’ Mobile App: Health YI
•Health checklist
•ZOC DOC
•Ask a question of health care experts
