Look at this and see if you have any idea what it’s saying.
No lawyers allowed.
Benefits are payable for Covered Medical Expenses (see “Definitions”) less any Deductible incurred by or for a Covered Person for loss due to Injury or Sickness subject to: (a) the Maximum Benefit for all services; (b) the maximum amount for specific services; both as set forth in the Schedule of Benefits; and (c) any coinsurance amount set forth in the Schedule of Benefits or any endorsement hereto. The total payable for all Covered Medical Expenses shall never exceed the Maximum Benefit stated in the Schedule of Benefits. Read the “Definitions” section and the “Exclusions and Limitations” section carefully.
While we were worrying about the fiscal cliff, something happened.
Starting January 1st, health insurance companies can no longer use legalese and gobbledygook in describing their policies.
A provision of ObamaCare says from now on, health insurers will have to provide you with information in plain English – and in no more than four pages – about what their policies cover and how much you’ll have to pay out of your pocket when you get sick.
And they’ll have to provide it in a standard format that will enable you to make apples-to-apples comparisons among health plans.
Here’s what it’s supposed to look like.
Did the insurance companies fight it?
They’ve made a ton of money for years by using descriptions no one could understand.
Some say they also purposely withheld information you really needed to make informed decisions.
There’s more: insurers must also provide an estimate of how much a given policy will pay for “having a baby (normal delivery)” and “managing type 2 diabetes” and also how much the policyholder will have to pay.
In years to come, additional examples will have to be provided, such as for a heart attack or breast cancer.
Love or hate ObamaCare – this is a good thing.