DATA Highlights Health Insurance Literacy Survey 2020

DATA H I G H LI G HTS

Health Insurance Literacy Survey 2020

By Hanna Horvath

Introduction

Health Insurance Literacy Survey 2020

Health care is a major voter issue in America. However, Americans’ understanding of health care plans — and the laws that govern them — remains low, especially for the uninsured, according to the results of Policygenius’ fourth annual Health Insurance Literacy Survey. This year’s findings are essentially unchanged from our 2019 survey, suggesting American’s health literacy has not improved, even in an election year.

The following results are based on a survey of a nationally representative sample of 1,501 adults conducted by Google Surveys from Sept. 23 through Sept. 28, 2020.

2

3

Have you ever avoided care or treatment because you were unsure of what your insurance covers?

Health Insurance Literacy Survey 2020

Annual income

Yes

Answer:

No

Less than $35k

65%

35%

$50-74k

65%

35%

$35-49k

60%

40%

$100-124k

75%

25%

$75-99k

67%

33%

$125-150k

83%

17%

More than $150k

80%

20%

Around one in four Americans avoided care because they didn’t know what their health insurance plan covered. Americans with lower incomes are more likely to avoid care: 36% of people making less than $75,000 annually said they avoided care because of uncertainty over what their health insurance covered, compared to 24% of those making more than $75,000.

4

Have you ever avoided testing, care or treatment for COVID-19 because you were unsure of what your insurance covers?

Health Insurance Literacy Survey 2020

More than 8% of respondents said they avoided COVID-19 testing, treatment and care because they were unsure whether it was covered. Like health insurance coverage, COVID-19 is a key election issue: More than one in five voters say the pandemic is their top issue, according to a September poll by the Kaiser Family Foundation.

Annual income

Yes

Answer:

No

Less than $35k

85%

15%

$50-74k

94%

6%

$35-49k

88%

12%

$100-124k

93%

7%

$75-99k

89%

11%

$125-150k

91%

9%

More than $150k

93%

7%

5

When does open enrollment for the federal health insurance marketplace take place?

Health Insurance Literacy Survey 2020

Dec. 1 – Jan.31

Nov. 1 – Dec. 31

None of the above 36%

12%

7%

64%

9%

2%

45%

10%

6%

Nov. 1 – Dec. 15 16% 9% 13%

Oct. 15 – Dec. 31

Nov. 15 – Jan. 31 8%

20%

8%

9%

8%

18%

Has health insurance

Doesn’t have health insurance

All respondents

Open enrollment for Healthcare.gov, the federal health insurance marketplace, takes place from Nov. 1 through Dec. 15, 2020. These dates have remained unchanged since 2017. While some states have their own exchanges and extended deadlines, the majority use Healthcare.gov to enroll individual residents. Still, around 87% of Americans could not identify the correct time to sign up for a plan.

Correct answer

Incorrect answer

Key:

6

Which statements about U.S. health care law are true?

Only 37% of respondents knew Affordable Care Act plans covered those with pre-existing conditions, a defining characteristic of the law and a political flashpoint during the 2020 election season. An estimated 19% to 50% of non-elderly Americans have a pre-existing health condition, according to the Centers for Medicare and Medicaid Services.

Health Insurance Literacy Survey 2020

Medicaid programs vary by state

ACA plans cover pre-existing conditions

You can get aid to buy an ACA plan

None of the above

29%

26%

45%

43%

14%

49%

22%

28%

25%

36%

37%

35%

There’s no tax penalty for forgoing coverage

20% 15% 17%

Kids can stay on their parent’s plan until age 26

Short-term health plans can least three years

12%

55%

6%

19%

10%

45%

Has health insurance

Doesn’t have health insurance

All respondents

The first six answers are true, but only 5% of Americans could correctly identify all six. More than a third of Americans said none of them were true.

Correct answer

Incorrect answer

Key:

7

Plans sold through Healthcare.gov must cover:

The Affordable Care Act requires all plans, not just those sold on the federal and state marketplaces, to cover 10 essential health benefits, including the six above. More than four in 10 Americans believe plans sold on Healthcare.gov cover none of the above benefits. Around 22% of people were able to correctly identify all six benefits.

Health Insurance Literacy Survey 2020

Maternity and newborn care

Substance abuse rehabilitation

Pediatric care, including vision and oral care

42%

34%

48%

14%

13%

16%

33%

27%

38%

Ambulatory services

36% 13% 29%

Hospitalization

Mental health care 39%

53%

15%

22%

32%

42%

None of the above 33% 59% 44%

Has health insurance

Doesn’t have health insurance

All respondents

Health care plans must cover all six of these benefits.

Correct answer

Incorrect answer

Key:

8

What is a copay?

Health Insurance Literacy Survey 2020

A fixed amount you pay for a covered expense (correct answer)

Answers:

The amount you pay before coverage kicks in

The amount you pay each month for insurance

None of the above

30%

18%

3%

49% 42%

17%

39%

2%

3%

29%

19%

50%

Doesn’t have health insurance

Doesn’t have health insurance

All respondents

All respondents

Has health insurance

Has health insurance

What is a deductible?

60%

10% 10%

50%

35%

5%

28%

9%

53%

11% 24%

5%

The amount you pay before coverage kicks in (correct answer)

Answers:

None of the above

The amount you pay each month for insurance

A fixed amount you pay for a covered expense

9

What is a premium?

Premiums, copays and deductibles are three of the most common health care expenses people pay, yet only 32% of respondents were able to correctly define all three terms. Even among those with health insurance, only 38% knew all three terms. Like most of the survey, these findings were not significantly different from our 2019 survey results.

Health Insurance Literacy Survey 2020

5% 6%

5%

55%

34%

6%

32%

11%

51%

7% 24%

65%

The amount you pay each month for insurance (correct answer)

Answers:

None of the above

The amount you pay before coverage kicks in

A fixed amount you pay for a covered expense

Doesn’t have health insurance

All respondents

Has health insurance

Policygenius is the nation’s leading online insurance marketplace, with headquarters in New York City and Durham, North Carolina. We’ve helped more than 30 million people shop for all types of insurance like they shop for everything else — online — and have placed over $60 billion in coverage. Policygenius launched in 2014 and is one of the early insurtech pioneers. Policygenius launched wills and trusts through a new mobile app in 2020. Policygenius was named to Forbes’ list of Best Startup Employers (2020), Crain’s Fast 50 (2019) and Inc. Magazine’s Best Workplaces (2018, 2019, 2020).

About Policygenius

For more information: Brooke Niemeyer Associate Director of Media Relations [email protected]

About the author

Survey methodology

Hanna Horvath is a health insurance expert at Policygenius. She previously worked at WNBC in New York and her work has appeared in NBC News, Business Insider and MSN.

The second annual Policygenius Health Insurance Literacy Survey is based on responses from a survey of a nationally representative sample of 1,501 people. It was conducted by Google Surveys from Sept. 23 through Sept. 28, 2020, with a margin of error of 4%. Percentages are rounded to the nearest whole number for simplicity, so some responses may not add up to 100.