Inaccessible Insurance Docs Penalize Blind Customers

Blind woman’s coverage suspended due to inaccessible insurance documents

According to an NPR article in December of 2022, a blind woman in California has had her health insurance coverage suspended every year since 2010 because they mail her “verification of benefits” forms in print format that she can’t read. Even after she contacted a lawyer, the issues have persisted. 

Inaccessible insurance documents mean customers miss information

These accessibility issues are neither new nor unique situations for many blind and low-vision customers. Insurance companies save and distribute many documents in print or PDF formats for the sake of ease and consistency, neither of which are accessible to clients with visual and other disabilities. Without accessible PDFs, many people with disabilities may not be able to access necessary documents to keep their healthcare bills and benefits organized and up to date. 

Print documents aren’t accessible

“…sending me small-print mail is like hiring a mime to communicate to me from outside my window.”

That’s how one CoxHealth insurance customer described the process of accessing his insurance information. Stuart Salvador of Missouri, who has low vision, has ended up in the health system’s debt collection program several times after receiving printed medical bills, which he can’t read. Salvador has only residual vision and when he tries to read the bills, he says “I can tell something is there, but I have no idea what I’m supposed to be getting from that.” He would prefer to access the information via Braille, but it takes as long as 6 hours to convert a printed medical bill into that format. Because of the overdue debt, his insurance premium was raised by 11%.

Inaccessible digital documents aren’t helpful either

Even when documents are sent via email or otherwise made available digitally, assistive technology users often can’t access them. Kate Kelly of Indiana is visually impaired and has hearing loss. She requested large-print bills, but often these arrived months too late.  Next, she attempted to access the documents online, but the website and documents were not accessible, and “her screen reader could not read certain numbers and other information.”

Documents that need to be accessible:

Insurance companies provide their clients with important health and financial information that they need to be able to read and understand. When a person is unable to access those inaccessible insurance documents, it can lead to delays or barriers to coverage and necessary healthcare. 

PDFs can include:

• Explanations of Benefits
• Billing statements
• Provider lists/ Physician Directories
• Policy manuals
• Coverage information

Which laws apply?

Accessibility is legally required whether you’re a public or private company. It’s necessary to provide the best service for all of your clients.

If you receive federal funding through Medicare or Medicaid

If your insurance company provides federally funded services like  Medicare or Medicaid, Section 508 and Section 504 of the Rehabilitation Act apply to you.  Section 508 requires that federal government websites and all files on websites, which most often include PDFs, be accessible to both employees and the general public who may access them. Section 504 requires organizations that receive federal funding to make their resources accessible as well.  Your documents must be accessible to everyone or you may lose your contracts and funding from government agencies.

If you receive federal funding from DHHS

Section 1557 of the Affordable Care Act prohibits discrimination against protected classes by any healthcare providers that receive financial assistance from the Department of Health and Human Services, the Health Insurance Marketplaces, and the health programs administered by the Department of Health and Human Services. That includes hospitals, doctors, and any other healthcare provider that accepts Medicare or Medicaid payments. Under Section 1557, covered healthcare entities must ensure that any communication with people with disabilities is as effective as communication with other patients. All programs and services available digitally must be accessible to all patients, including those with disabilities. Like Section 508, Section 1557 also applies to any PDFs available to your patients and website visitors.

If you’re privately funded

If your insurance company does not receive federal funding, it is likely considered a place of public accommodation, which is covered by the Americans with Disabilities Act (ADA). 

According to district court rulings, which were upheld by the Supreme Court, your website and all the files it contains need to be accessible to both employees and customers.

Results of Noncompliance 

Your clients and employees- as many as 25% of them- won’t be able to access important healthcare and financial documents.“Think about your own daily life and how much you use the internet,” said Chris Danielsen, the Director of Public Relations at the National Federation of the Blind, and a blind person himself. “And then imagine almost every day you encountered something that you literally could not do.” Healthcare documentation can be complex. When you can’t even read the documents because they are inaccessible, it puts your health and financial stability at risk. 

Avoiding litigation and reaching every client:

Every insurance company distributes mass-produced documents like billing statements, explanations of benefits, and other documents that they must send to every client multiple times. Those templatized PDF documents can easily be made accessible instantly using a custom-built, high-volume integrated solution like the one offered by Equidox. 

Individual inaccessible insurance documents can easily be made accessible as well with Equidox PDF remediation software. Content creators can make individual documents such as marketing materials, plan details,  quickly and easily remediated in-house after just an hour of training, which is included in the software purchase. The process is so easy that any content creator can quickly learn it and can be responsible for the accessibility of their own content.

If you haven’t approached PDF accessibility yet, the time is now to start. Be proactive and make your website and everything on it accessible so your clients and employees can access necessary information. Equidox can help make the process fast and easy for any content creators so every document can be accessible from their creation.

Nina Overdorff

Nina comes to Equidox with years of sales and marketing experience from a variety of industries and holds a BS in Language Arts Education. Nina has a passion for words, storytelling, and information, which she believes everyone should have access to regardless of ability. After spending time as a teacher with a blind student, she became much more aware of the limitations and abilities of web accessibility, and how essential it is to those experiencing disabilities. “Being able to access information equally ensures that everyone has an equal opportunity for education, employment, and success in life.”