Only a fraction of Californians with consumer-directed health plans knew their policies included free or low-cost preventive visits and tests, according to a survey by Kaiser Permanente researchers.
The survey also found many consumer-directed plan holders largely misinterpreted certain arrangements of their deductibles.
The researchers surveyed 456 high-deductible plan members at Kaiser Permanente Northern California, an integrated healthcare delivery system with about three million members. Those surveyed had acquired the plans through their employers, with annual deductibles between $1,500 and $2,700 for individual coverage and $3,000 and $5,450 for families.
The researchers found that only 18 percent of respondents fully understood the health plan's cost sharing arrangement -- an annual deductible, with exemptions for a no-cost or $10 co-pay annual preventive office visit and certain preventive diagnostic tests, like diabetes and colon cancer screenings.
A significant number of plan members surveyed misunderstood their deductible arrangements. About 30 percent thought neither preventive nor nonpreventive office visits were subject to the deductible, and some were unaware they even had a deductible. About 50 percent mistakenly thought that all office visits and all medical tests applied toward their deductible, whether the visit was for preventive services or not.
About 18 percent of respondents said they had delayed or avoided a preventive office visit because of cost, and a similar percentage cited cost concerns as a reason for avoiding at least one of the preventive tests or screenings.
[See also: HIX Digest: multi-state plan rules, NY integrating elgibility systems]
Almost 20 percent of U.S. workers are enrolled in qualified high deductible health plans, and all of the services recommended by the U.S. Preventive Services Task Force are available to everyone under the Affordable Care Act.
The sample of Californians suggests a need for better consumer understanding of insurance, wrote the authors, led by Mary Reed, a staff scientist at the Kaiser Permanente Northern California Division of Research, writing in the journal Health Affairs.
"Education and consumer decision support to increase awareness of the detailed benefit design features will be extremely important to truly remove the cost barrier for preventive care."