Health Insurance Literacy


Since the passage of the Affordable Care Act (ACA), Cooperative Extension has played an active role in educating consumers on how to choose and use health insurance. In 2011, the Consumers Union, University of Maryland College Park, and American Institutes of Research (AIR) hosted a roundtable to define health insurance literacy and how to measure it. Health insurance literacy is defined as the “… knowledge, ability, and confidence to find and evaluate information about health plans, select the best plan for his or her family for their own or their family’s financial and health circumstances, and use the plan once enrolled” (Quincy, 2012).

In 2012, University of Maryland Extension and University of Delaware Cooperative Extension collaborated to launch the Health Insurance Literacy Initiative (HILI). HILI has produced evidence-based, empowerment programs intended to reduce confusion, increase capability, and increase the confidence of consumers to make a smart choice and use decisions about health insurance.


Health Insurance literacy is a way to build up people's skills so they can better find, understand, evaluate, communicate and use the information to make an informed decision.  Our formula or hypothesis is to reduce confusion, increase capability, and increase confidence equals making a smart choice (the best choice for you and your family).  We used this formula as a framework or hypothesis when we began the creation of our research and theory-based curriculum now known as Smart Use / Smart ChoicesTM for Health Insurance.

  • Health Insurance Literacy

    Health Insurance 4U

    Online resources through the university of Delaware Cooperative Extension

COVID-19 and Your Health Insurance

Have you lost your job-based health insurance due to the pandemic? Learn what options may exist to help you in this short video.

Available Modules with the Smart Choice / Smart Use™ Program

Smart Choice Health Insurance ™ - Basics

Choosing the right health care insurance plan makes you a smart consumer. Increase your understanding of health insurance and learn strategies for selecting a health care plan that will meet your health care needs and fit your spending plan.

  • Understand why health insurance helps prevent large unexpected health care expenses

  • Learn what to compare to understand health insurance costs and coverage

  • Identify information needed to make a smart choice health insurance decision

Smart Choice / Smart Use Health Insurance™ - Health Insurance in Your Senior Years

Knowing your health insurance options as you enter your senior years will make you a smart health care consumer.  Identify smart actions that will help you become a Smart User of health insurance.

  • Understand what you need to know about health care cost in your senior years

  • Know where to go for information about Medicare and supplemental insurance options

  • Review strategies and use tools to help you estimate health care costs

  • Identify what options there are within these plans to cover long term health care

Smart Use Health Insurance™ - Managing Health Insurance and Resolving Conflicts

Do you know what to do if you are denied coverage for care? What if you think you have been billed incorrectly? Learn how to manage the process for handling disputes with your health insurance company and how to avoid them.

  • Use and manage health insurance to protect your health and your finances

  • Resolve health insurance conflicts

  • Avoid conflicts in the future

Smart Use Health Insurance™ - Smart Actions

Knowing how to use your health insurance will make you a smart health care consumer.  Identify smart actions that will help you become a Smart User of health insurance.

  • Understand how to use health insurance

  • Learn how to manage health care expenses

  • Identify tools to solve a problem

Smart Use Health Insurance™ - Understanding and Estimating Health Care Costs

Taking control of your health care costs makes you a smart health care consumer. Better understand and estimate your health care expenses so you can plan for future health care costs.

  • Explore the types of health care costs

  • Learn how to determine what your health care costs might be

Smart Use Health Insurance™ - Your Health Insurance Benefits

Do you know what your health insurance covers? Understanding your health insurance benefits will make you a smart health care consumer. Learn strategies for understanding, getting and using your health insurance benefits.

  • Discuss health insurance benefits

  • Explain how you can get these benefits for you and your family

  • Understand why it is important to use these benefits to manage your health and finances

Smart Choice-Smart Use Basics Health Insurance™ (In Spanish)

Información básica sobre el seguro de salud (Health Insurance Education Basics in Spanish)

 Our Health Insurance Literacy Initiative Team and Partners

University of Maryland Extension -  Bonnie Braun, Ali Hurtado, Jesse Ketterman, Jinhee Kim, Lynn Little, Lisa McCoy, Dorothy Nuckols, Carrie Sorenson and Chenzi Wang.

University of Delaware Cooperative Extension – Maria Pippidis

Smart Choice and Smart Use Health Insurance by University of Maryland Extension is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.