Do Consumers Know How Their Health Plan Works?

Consumers tend to overestimate plan restrictions, especially regarding access to medical Specialists.

March/April 2001
Health Affairs , Vol.20, No.2 (March/April 2001): 159-166
Peter J. Cunningham, Charles Denk, Michael Sinclair

xpanding consumer choice of plans is beneficial only to the extent that consumers make informed choices. Using data from the 1996 -97 Community Tracking Study (CTS), this study compares consumers’ responses on four key attributes of their health plan with information provided directly by the plan. Plan attributes relate to choice of providers and access to specialists. Although the accuracy of reporting some individual attributes was fairly high, fewer than one-third of consumers accurately reported all four health plan attributes. In general, consumers tended to overreport plan restrictions, especially the need for approval to see specialists.

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