Transparency in Coverage
Health plan price transparency helps consumers know the cost of a covered item or service before receiving care. Beginning July 1, 2022, most group health plans and issuers of group or individual health insurance will begin posting pricing information for covered items and services. This pricing information can be used by third parties, such as researchers and app developers to help consumers better understand the costs associated with their health care. More requirements will go into effect starting on January 1, 2023, and January 1, 2024, which will provide additional access to pricing information and enhance consumers’ ability to shop for the health care that best meet their needs.
How to Get the Most Out of Transparency in Coverage
For too long, Americans have been in the dark about the cost of their health care until after they obtain services and received a bill. These requirements will empower consumers to shop and compare costs between specific providers before receiving care. Consumers have an important role to play in controlling costs, but consumers must have meaningful information in order to create the market forces necessary to achieve lower health care costs.
Before receiving care, learn what potential out-of-pocket costs you can expect for health care items and services. To do this, you can use an online tool, or request information on paper from your health care provider.
When plans and issuers make their costs available online, consumers are given the power to compare prices. In addition to the self-service tool and machine-readable files from plans and issuers, third-party developers may also create price transparency tools. Use this information to select the plans, services, and health care providers that work best for you.