Q. My wife and I have Blue Cross Blue Shield individual health insurance. How can find out what is covered or what medical expenses will be applied to our deductible?
A. Now you will, thanks to a provision of the Affordable Care Act that starts today. It requires insurers selling individual coverage like you have, as well as plans available through people's jobs, to provide a standardized Summary of Benefits and Coverage that will answer questions like your. For instance, if there's a separate deductible for prescription drugs, you'll be able to see that easily. If certain expenses are not applied to your deductible you'll be able to see that, too.
Here's what the form will look like, along with our comments on what to pay special attention to.
Added to the law, I'm proud to say, thanks in part to efforts by our advocacy arm, Consumers Union, the SBC will bring some order to health plans' presentation of basic coverage information that has, as you've discovered, all too often been confusing or downright impenetrable.
"These new tools empower consumers to make informed decisions about their health coverage options," said Health and Human Services Secretary Kathleen Sebelius in a prepared statement marking the debut of the new form.
You can find information about that and other changes coming on the health reform front in our new article on health insurance, out today. The article also contains rankings of a record 984 health plans nationwide from the National Committee for Quality Assurance (NCQA), a nonprofit heath care accreditation and quality measurement group.