NEW YORK, Mar 12 (Reuters Health) - One idea for improving the US healthcare system has been to offer the public greater choice in health plans. But, a new study shows, most Americans do not understand the details of their current health insurance--a potential obstacle if they are to choose from a range of plans, researchers report.

"Allowing consumers greater choice of health plans is seen by many as the key to both higher quality and lower costs," Peter J. Cunningham and his colleagues write in the March/April issue of Health Affairs. "A basic assumption behind this view is that consumers can and do make informed choices about the types of health plans they enroll in."

However, in a survey of nearly 11,000 Americans, Cunningham's team found that fewer than one-third knew all the major details of their health coverage--including whether they could visit a doctor who was not a member of the plan and whether they needed a referral to see a specialist. Cunningham is a researcher at the Center for Studying Health System Change in Washington, DC.

Among the more significant discrepancies, more than half of respondents thought their plan required a referral for specialist care when it did not. And 40% of those in plans that refused to cover visits to "out-of-network" doctors were unaware of the policy.

And surprisingly, Cunningham and his colleagues report, individuals with significant health problems knew slightly less about their coverage than healthier respondents did.

"These results," they write, "suggest the need for more consumer information and education about how health plans work, particularly the 'managed care' features that are more typical of health plans today."

As health plan rules become increasingly complex, consumers will need to be aware of changes to their own plans and to the health insurance market in general, the authors conclude.

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