In these difficult economic times, it is more important than ever for consumers to get smart about their health insurance coverage. However, the latest Insurance IQ survey by the National Association of Insurance Commissioners (NAIC) finds that some consumers are unaware of some key aspects of their health insurance coverage that can have a significant effect on their wallets.

In the survey of 1,000 consumers conducted Oct. 21-26, 2009, only six in ten consumers (61%) understand their rights to appeal a denied health insurance claim, and fewer than one in three consumers strongly understands the cost factors that determine their health insurance premiums.

In this economic environment, consumers need to understand all of the factors that impact the cost of their health insurance. Getting smart about your health insurance policies and tapping into available resources will help you become more confident about your insurance choices and learn to make cost-effective decisions without sacrificing important coverage needs.

How to Improve Your Health Insurance IQ

Conduct a Coverage Checkup

Create a Rainy Day Fund


By getting smart about their health insurance coverage, you can better understand the cost implications of various procedures and services. For example, going to an out-of-network doctor versus in-network traditionally costs a consumer much more for the same type of service. Do your homework, research all the options available and review your insurance policy before making any decisions.

It is crucial for consumers to put aside savings into a rainy day fund in case an emergency happens. One way to do that is with a Flexible Spending Account (FSA). Health insurance policies do not always pay for such procedures as allergy tests or braces, but an FSA can help save on these out-of-pocket costs by allowing you to set aside pre-tax dollars for uninsured medical expenses and child care. Ask your human resources department about your employer's FSA and what types of expenses can be reimbursed through the program. Be aware, however, that any unused money in an FSA does not roll over to the next year, so try to estimate your costs carefully at the beginning of the year.

Take Advantage of Open-Enrollment Periods

Use the Division of Insurance Website


Open Enrollment refers to the time period when members of a group health insurance plan can enroll in a new plan or change certain programs and benefits in their current plan. During this period, insurance carriers are required to accept all applicants of the group without underwriting or evidence of insurability. It is also a good time to review your coverages, deductibles and provider or prescription drug lists. Generally, open enrollment occurs just once a year and, if you miss that time, you likely will not be able to enroll in your employer-sponsored health insurance program or make changes to your options until the following year. Check with your human resources department to see when your company's open enrollment period begins and ends, and when your policy goes into effec

The Division of Insurance is ready to help with any question or complaint a consumer may have about coverage. Many health insurance policy policies and rules are developed and managed at the state level. Consumers can access the Division's website - www.mass.gov/doi - to find lists of companies offering different types of health insurance products as well further consumer information on health insurance.


Survey Methodology

The NAIC conducted the Health Insurance IQ study Oct. 21-26. The participant sample included a nationally representative sample of 1,000 American adults ages 18 and older with a margin of error +/- 3.1 percent in 95 out of 100 cases.

Contact the Division of Insurance

If you have any questions regarding travel insurance, contact the Division of Insurance by calling (617) 521-7794 or visiting www.mass.gov/doi for more information on this or any other insurance topic.