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DATA HIGHLIGHTS
Health Insurance
Literacy Survey 2020
By Hanna Horvath
Introduction
Health Insurance
Literacy Survey
2020
Health care is a major voter issue in America. However,
Americans’ understanding of health care plans — and the laws
that govern them — remains low, especially for the uninsured,
according to the results of Policygenius’ fourth annual Health
Insurance Literacy Survey. This year’s findings are essentially
unchanged from our 2019 survey, suggesting American’s health
literacy has not improved, even in an election year.
The following results are based on a survey of a nationally
representative sample of 1,501 adults conducted by Google
Surveys from Sept. 23 through Sept. 28, 2020.
2
3
Have you ever avoided care or
treatment because you were unsure
of what your insurance covers?
Health Insurance
Literacy Survey
2020
Annual income
Yes
Answer:
No
Less than
$35k
65%
35%
$50-74k
65%
35%
$35-49k
60%
40%
$100-124k
75%
25%
$75-99k
67%
33%
$125-150k
83%
17%
More than
$150k
80%
20%
Around one in four Americans avoided care because they didn’t
know what their health insurance plan covered. Americans
with lower incomes are more likely to avoid care: 36% of people
making less than $75,000 annually said they avoided care
because of uncertainty over what their health insurance covered,
compared to 24% of those making more than $75,000.
4
Have you ever avoided testing, care
or treatment for COVID-19 because
you were unsure of what your
insurance covers?
Health Insurance
Literacy Survey
2020
More than 8% of respondents said they avoided COVID-19 testing,
treatment and care because they were unsure whether it was
covered. Like health insurance coverage, COVID-19 is a key
election issue: More than one in five voters say the pandemic is
their top issue, according to a September poll by the Kaiser Family
Foundation.
Annual income
Yes
Answer:
No
Less than
$35k
85%
15%
$50-74k
94%
6%
$35-49k
88%
12%
$100-124k
93%
7%
$75-99k
89%
11%
$125-150k
91%
9%
More than
$150k
93%
7%
5
When does open enrollment for
the federal health insurance
marketplace take place?
Health Insurance
Literacy Survey
2020
Dec. 1 – Jan.31
Nov. 1 – Dec. 31
None of the
above 36%
12%
7%
64%
9%
2%
45%
10%
6%
Nov. 1 – Dec. 15 16% 9% 13%
Oct. 15 – Dec. 31
Nov. 15 – Jan. 31 8%
20%
8%
9%
8%
18%
Has health
insurance
Doesn’t have
health insurance
All
respondents
Open enrollment for Healthcare.gov, the federal health
insurance marketplace, takes place from Nov. 1 through Dec.
15, 2020. These dates have remained unchanged since 2017.
While some states have their own exchanges and extended
deadlines, the majority use Healthcare.gov to enroll individual
residents. Still, around 87% of Americans could not identify the
correct time to sign up for a plan.
Correct answer
Incorrect answer
Key:
6
Which statements about U.S. health
care law are true?
Only 37% of respondents knew Affordable Care Act plans
covered those with pre-existing conditions, a defining
characteristic of the law and a political flashpoint during the
2020 election season. An estimated 19% to 50% of non-elderly
Americans have a pre-existing health condition, according to
the Centers for Medicare and Medicaid Services.
Health Insurance
Literacy Survey
2020
Medicaid
programs vary
by state
ACA plans cover
pre-existing
conditions
You can get aid to
buy an ACA plan
None of the above
29%
26%
45%
43%
14%
49%
22%
28%
25%
36%
37%
35%
There’s no tax
penalty for
forgoing coverage
20% 15% 17%
Kids can stay on
their parent’s plan
until age 26
Short-term health
plans can least
three years
12%
55%
6%
19%
10%
45%
Has health
insurance
Doesn’t have
health insurance
All
respondents
The first six answers
are true, but only 5% of
Americans could correctly
identify all six. More than
a third of Americans said
none of them were true.
Correct answer
Incorrect answer
Key:
7
Plans sold through Healthcare.gov
must cover:
The Affordable Care Act requires all plans, not just those sold
on the federal and state marketplaces, to cover 10 essential
health benefits, including the six above. More than four in 10
Americans believe plans sold on Healthcare.gov cover none
of the above benefits. Around 22% of people were able to
correctly identify all six benefits.
Health Insurance
Literacy Survey
2020
Maternity and
newborn care
Substance abuse
rehabilitation
Pediatric care,
including vision
and oral care
42%
34%
48%
14%
13%
16%
33%
27%
38%
Ambulatory
services 36% 13% 29%
Hospitalization
Mental health care 39%
53%
15%
22%
32%
42%
None of the above 33% 59% 44%
Has health
insurance
Doesn’t have
health insurance
All
respondents
Health care plans must
cover all six of these
benefits.
Correct answer
Incorrect answer
Key:
8
What is a copay?
Health Insurance
Literacy Survey
2020
A fixed amount
you pay for a
covered expense
(correct answer)
Answers:
The amount
you pay before
coverage kicks in
The amount you
pay each month
for insurance
None of
the above
30%
18%
3%
49%
42%
17%
39%
2%
3%
29%
19%
50%
Doesn’t have
health insurance
Doesn’t have
health insurance
All
respondents
All
respondents
Has health
insurance
Has health
insurance
What is a deductible?
60%
10% 10%
50%
35%
5%
28%
9%
53%
11%
24%
5%
The amount
you pay before
coverage kicks in
(correct answer)
Answers:
None of
the above
The amount you
pay each month
for insurance
A fixed amount
you pay for a
covered expense
9
What is a premium?
Premiums, copays and deductibles are three of the most
common health care expenses people pay, yet only 32% of
respondents were able to correctly define all three terms.
Even among those with health insurance, only 38% knew all
three terms. Like most of the survey, these findings were not
significantly different from our 2019 survey results.
Health Insurance
Literacy Survey
2020
5% 6% 5%
55%
34%
6%
32%
11%
51%
7%
24%
65%
The amount you
pay each month
for insurance
(correct answer)
Answers:
None of
the above
The amount
you pay before
coverage kicks in
A fixed amount
you pay for a
covered expense Doesn’t have
health insurance
All
respondents
Has health
insurance
Policygenius is the nation’s leading online insurance marketplace, with
headquarters in New York City and Durham, North Carolina. We’ve helped
more than 30 million people shop for all types of insurance like they shop
for everything else — online — and have placed over $60 billion in coverage.
Policygenius launched in 2014 and is one of the early insurtech pioneers.
Policygenius launched wills and trusts through a new mobile app in 2020.
Policygenius was named to Forbes’ list of Best Startup Employers (2020),
Crain’s Fast 50 (2019) and Inc. Magazine’s Best Workplaces (2018, 2019, 2020).
About Policygenius
For more information:
Brooke Niemeyer
Associate Director of Media Relations
[email protected]
About the author
Survey methodology
Hanna Horvath is a health insurance expert at
Policygenius. She previously worked at WNBC in New
York and her work has appeared in NBC News, Business
Insider and MSN.
The second annual Policygenius Health Insurance Literacy Survey is based on
responses from a survey of a nationally representative sample of 1,501 people.
It was conducted by Google Surveys from Sept. 23 through Sept. 28, 2020,
with a margin of error of 4%. Percentages are rounded to the nearest whole
number for simplicity, so some responses may not add up to 100.