Millennials: Health Insurance Literacy & Utilization

Transcription

1 Millennials: Health Insurance Literacy & Utilization

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3 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

4 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.

5 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

6 Focus Group Data Confusion on: o Health insurance card o Terminology o Where to go for care & cost comparisons o Type of doctor o Services that are covered o Filing claims Little knowledge of mobile resources Lack of understanding of preventive care

7 What is preventive care? Keeps you from getting sick Healthy 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

8 What s involved in preventive care? Smart decisions & not consistently staying up late Sometimes you need to go to McDonalds late at night, but at least get the healthier option, the grilled chicken not the burger. What are some barriers to preventive care? No instant gratification

9 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!

10 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

11 Key Takeaway 2 Belief 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

12 Health Insurance Literacy Education HEALTH INSURANCE BASICS THROUGH WORKSHOPS AND OUTREACH

13 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

14 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

15 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

16 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

17 Messaging EXPLAINING COMPLICATED TERMINOLOGY

18 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.

19 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

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21 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.)

22 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.

23 Preventive Care Source: CDC

24 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

25 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

26 Choosing a PCP Choosing 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

27 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

28 Where do I go for care? KNOW WHERE TO GO

29 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

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31 itriage & YI Presents: HealthGetsReal

32 Where Should I Go? Flu Symptoms, High Fever Ankle Fracture Pap Smear Heart Attack Head Injury Sinus Infection

33 Young Invincibles Mobile App: Health YI Health checklist ZOC DOC Ask a question of health care experts

34 Questions? Kristin McGuire