It’s about time! Easier Health Insurance Summaries


Dedicated to affordable, quality healthcare and coverage for all Americans.

By Consumers Union on Friday, September 21st, 2012

Another piece of the health reform law has fallen into place – new uniform, easy-to-use health insurance summaries that will help keep you from pulling your hair out over trying to understand your insurance policy. Available to over 170 million consumers with private health insurance coverage, this is the most far reaching reform to date.

Beginning September 23, 2012, all private insurers must provide a description of their health policy in a standard way. Plan descriptions will look like this example (page 1, at least): 

We personally conducted consumer testing on the form to be sure it mades sense to people before it was finalized and much of our feedback went into the final product.

This testing shows it is much better than the confusing and varied health plan summaries we had before. When you get yours, look for:

We’ve included more information in this handy guideto the form.

  • Definitions of key insurance terms like deductible and out-of-pocket limit.
  • Plan benefits that are always organized the same way, so you can more easily compare your options.
  • A list of services that aren’t covered all in one place.
  • A new way of explaining how the plan covers certain medical scenarios, called Coverage Examples 

Got ideas about how to improve your form? We plan to work closely with the federal agencies in charge of this form to improve it even more over time and we are collecting feedback from real consumers like yourself. After you get YOUR COPY of the form (not the image above), go to to tell us what you think. If you enrolled in health insurance coverage this Fall (but not Medicare) and DIDN’T see this form, we want to know that to.

You have a right to this form and it may help you shop for coverage, so be sure to ask your insurer or employer for it.  However, you won’t see this form if you’re shopping for Medicare (coverage for seniors and people with disabilities), Military coverage (like TRICARE or Veterans) or state Medicaid and CHIP programs.  These insurers are not required to provide it.


Leave a Reply

Your email address will not be published. Required fields are marked *