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WEDNESDAY, NOVEMBER 25, 2009
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 OPINION 
9

Let's Make Health Insurance Policies Readable

Legal mumbo-jumbo means patients can't tell what they're covered for

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(Newser) – There’s one important health care issue that’s generated little chatter: the oft-inscrutable language of insurance policies, writes Rhode Island health official John Cogan in the New York Times. Policies are penned at a grad-school level, which led his state to require, as of next year, that they be written at the level most people in Rhode Island read at: eighth-grade. But it's not just the policy holders who have trouble.

Cogan cites the case of a client who couldn't figure out why his chemo wasn't being covered: The insurance company said it was "still sorting through the policy" and "needed more time. Even the insurance company had trouble understanding its own contract." The man's care eventually got covered, but "but people—especially when they are sick—shouldn’t need to rely on state agencies to help them decipher their insurance policies." The federal government, says Cogan, should step in and follow Rhode Island’s example.

The plan covering the patient as a dependent child of a person whose date of birth occurs earlier in the calendar year shall be primary over the plan covering the patient as a dependent of a person whose date of birth occurs later. - how a plan might read now

If your child is covered under more than one insurance policy, the policy of the adult whose birthday is earlier in the year pays the claim first. - how it would read at an 8th-grade level

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9 comments
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Timinator2K
Aug 20, 09 8:41 AM CDT
The same reason laws are written in a convoluted manner, its totally by design. Keeps lawyers employed and people give up trying to ferret-out answers...which is THE prime idea. Reply
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+6
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odowd80
Aug 20, 09 8:59 AM CDT
Tim are you actually supporting government regulation here?? But health insurance is all run by the PRIVATE sector. I thought they were superior in every way to government programs and should be free to screw over people as they wish? Its the free market system, baby!
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+2
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Fondue
Aug 20, 09 9:15 AM CDT
However rare, Tim does make reasonable statements. Thumbs up man.
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+6
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Corona_Kinq
Aug 20, 09 9:31 AM CDT
Tim, I usually disagree with almost all of your posts, but I am giving you a thumbs up for this one. Well done.
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+5
long7000
Aug 20, 09 8:50 AM CDT
This is health reform that is definately needed. Reply
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+3
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