For most Americans, health care expenses are still an unwelcome surprise and burden. A majority of U.S. consumers don't understand various aspects of their health care insurance costs, while many aren't actively planning for the health care expenses, according to HSA Bank's Annual Health and Wealth Index, a survey of 2,000 U.S. consumers conducted in the fall of 2019.

Only around 42% of survey respondents were classified as being at least "highly engaged" with preparing for their health care expenses and taking an active role in their physical health. There is, however, some hope for the future—Generation Z was the most engaged with health care expenses and their physical health, while millennials came in second, followed by Baby Boomers, and Generation X.

But Generation Z was also the least educated about the costs involved in their health plans. To be sure, all consumers in general struggled to understand the different types of health care expenses. Only 15% understood their coinsurance costs, for example, while 25% knew about their out-of-pocket maximums, and 37% their deductible expenses. Meanwhile, 42% were knowledgeable about their monthly premium costs, while 46% also understood their copay expenses.

Kevin Robertson, senior vice president and chief revenue officer for HSA Bank explained that the lack of engagement and education about health care costs is due the fact that many are not focused on the issue until they have to be. "It comes down to lack of the incentive to do something about it today, and it's easy to kick that can down the road."

Engagement and understanding varied depending on the type of health insurance plan one purchased. Consumers with high-deductible health plans, for instance, were the most engaged, while those with Medicare or Medicaid were the least engaged. Medicare and Medicaid recipients were also the least informed about their plans cost, while those with traditional PPO health plans were the most educated.

Aside from education, many consumers across the country could also use help with planning for medical expenses when, and after, they retire. The survey found that slightly over one-third of consumers in the South and Northeast regions of the U.S rarely save money for future medical expenses, while 31 percent in the Midwest and 27% in the West region said the same. What's more, 37% of those over the age of 65 rarely save for future health care expenses, while a majority of that age group, 83%, worry about future medical bills.

Robertson noted that the widespread lack of education and financial planning presents opportunities for health insurance providers. However, "what it comes down to is a challenge to make it interesting to people."

He advised that to get people more engaged with health care costs, insurers should focus on "experiences rather than education."

The most successful efforts, he noted, are when people " are not asking what expenses you want, what out of pocket costs you want… [but] they're saying tell me about your life experiences, how do you interact [with the health care system]?"

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Health care engagement: Consumers continue to 'kick that can down the road'

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