The Affordable Care Act, which has sometimes been referred to as Obamacare, added some rights and protections which allow consumers of health care to more easily understand their health plan’s coverage. Every health plan must now provide a summary of benefits and coverage (SBC). This document must be written in plain language and must be easy-to-understand. Here is an example of what an SBC looks like. As you can see, the document not only breaks down the amount of co-pays you will have to pay for various treatments, but also gives you coverage examples.
The idea behind the SBC is to create a standard document which allows you to compare health plans as you are shopping for coverage on the exchange. However, it is also a great tool to have when you are trying to prepare yourself for your next doctor’s visit. No matter if you bought insurance on the exchange, or already have insurance through your employer, every health plan has to provide a SBC. You can ask your insurance company for a copy at any time. Along with the SBC, your insurance company will also be able to provide you with a uniform glossary of all the terms you will come across in the SBC- to make understanding it a little easier.
If you are nevertheless struggling with understanding your coverage, call your insurance company customer helpline!