Even though more people than ever are using digital tools to manage their healthcare – from comparison shopping medical service to purchasing insurance – that doesn’t mean they like it, or even fully understand it. In fact, most Americans have a limited knowledge of basic health insurance terms or the cost range for specific medical services.

According to a new poll of 1,011 US adults by UnitedHealthcare (using market research firm ORC International's telephone omnibus service) nearly a third of participants said they used websites and mobile apps during the last year to comparison shop fror healthcare. While this is a significant increase since the 14 percent who reported the same activity four years ago, it doesn’t necessarily mean their understanding of healthcare is improving – only seven percent of respondents could successfully define all four basic health insurance concepts: plan premium, deductible, co-insurance and out-of-pocket maximum. (To be fair, most could define the first two terms).

The lack of understanding could stem from the perceived unpleasantness of signing up for health benefits. A quarter of respondents said they would rather file their annual income taxes than select a health plan.

Craig Hankins, vice president of digital products for UnitedHealthcare said the survey highlights that, while there has definitely been progress in the adoption and usage of digital tools, there still exist significant challenges in getting consumers onboard with their new role of needing to shop for healthcare.

“The tax analogy is not unfair; shopping for healthcare is a very complex situation where people really feel like, ‘Oh, I’m not an expert, how can I be sure I’m not making a mistake?’” Hankins told MobiHealthNews. “So what we need to do is make these tools that assist them by bringing together cost estimations, consumer ratings and cost efficiency in one place so they can figure out what care they need, what facility they need, all in one place.”

As high-deductible plans are more common, understanding how to shop for healthcare is paramount, especially since, historically, people have not really known the true cost of healthcare.  For example, only 11 percent of survey respondents were able to correctly identify the cost of a knee replacement surgery (around $35,000), with the rest estimating that it was much cheaper.

“Broadly, there is not substantial awareness about the true cost of health care. This is due to the fact that people don’t really need a lot of care,” said Hankins. “If you aren’t receiving care, it’s not like pretending to shop for cars just for fun and going around and seeing the price. You don’t do that with healthcare.”

So, it’s promising that those who do embrace apps and websites to increase health literacy and comparison shop are finding the tools useful. Among comparison shoppers, 81 percent described the process as helpful.

But even for their adoption of mobile tools, respondents also still prefer live support when it comes to customer service, with 78 percent of them preferring to speak with a real person. Hankins said UnitedHealthcare is working on a function that would seamlessly take a user from the app to a live support representative.

While they may not be loving the fact that they have to shop for healthcare, consumers are embracing the increasing number of workplace wellness programs, such as those that use wearable devices to encourage activity. More than half of respondents said they would be interested in wearing a fitness tracker as part of a workplace wellness program, which ties into the estimate by technology consultancy firm Endeavors Partners that more than 13 million fitness trackers are expected to be incorporated into workplace wellness programs by 2018.

Which is why, in the face of the necessity for comparison shopping and health literacy to increase, everyone needs to be on board with adoption of new tools, Hankins said.

“It’s all the parties involved—payer, consumer, employer, provider,” he said. “We all have a stake in what happens aside from just the two parties giving and receiving. Everyone needs to be aware about the costs and the financial burdens.”

Health plans need to make concerted efforts to inform their members of costs, providers need to know the costs, and employers need to understand all tools at their disposal to make their employees’ healthcare shopping more informed, such as fully understanding health reimbursement accounts, Hankins said.

“Because not everyone engages in healthcare at the same time," he said. "It’s a societal conversation, and we’re hoping to contribute to that conversation.”