New Insurance, New Doctor: A Story Told in Pictures

This post is also available in: Portuguese (Brazil), Spanish

By Katen Singleton

The United States health care system demands a high level of health literacy that vulnerable groups and the public at large typically do not have. With the implementation of the Affordable Care Act (ACA), there is a new level of complexity right as millions of people are, perhaps for the first time, getting access to meaningful health care. These individuals will need easy-to-understand information that teaches them how to get the most out of their health care.
This Picture Story, “New Insurance, New Doctor,” is meant to help adult education instructors teach students how to navigate the health care system, and to learn the vocabulary and concepts they will encounter. The Connecticut Health Foundation is sharing this Picture Story with permission from Kate Singleton, the author.

Picture Story: “New Insurance, New Doctor”

This health literacy picture story was created in February 2014 to help English for Speakers of Other Languages (ESOL) teachers explain basic information to adult English language learners about:

  • the Affordable Care Act (ACA) and how it applies to learners.
  • how to use insurance if you are not experienced with it; insurance terminology.
  • what non-clinical communication tasks to expect when seeing a U.S. doctor or other healthcare provider for the first time.
  • strategies to improve communication in a doctor’s visit.

The story may also be helpful in other educational and healthcare settings to raise awareness of patients and providers alike to issues of communication, information, culture and overall mutual understanding that are likely to intensify with current healthcare system changes.

So how would you use this Picture Story?

The Basic Story

Frame 1: Ana applies for new insurance on It’s her first time getting insurance.

Frame 2:  Ana receives her new insurance card about a month later. She is ready to make an appointment for a check-up.

Frame 3: Ana goes to her appointment and presents her new insurance card at the front desk (reception). She has many questions about how to use the card and what she needs to do now that she is at the doctor’s office.

Frame 4: The receptionist says a lot of things that Ana doesn’t understand. Ana feels more confused.

Frame 5: The receptionist gives Ana many forms to fill out. Ana feels even more confused.

Frame 6: Ana is now very confused. She says, “I’m so confused! Please explain!”

Introducing the Story

Tell learners they will be working on a story called “New Insurance, New Doctor.” Say that many things are changing about going to the doctor and paying for health care in the United States, and the story will help them talk about this.

Ask them what they have done in the past in their native country or in the United States to get health care or to pay for health care:

  • Where did they go?
  • What did they have to do to get to see a doctor or other healthcare provider?
  • How did they pay for it?
  • Have they had experience with medical forms, insurance and making medical appointments in the past?

To get the full set of instructions, we encourage you to review this article at It has a list of vocabulary words for the student to learn, and additional questions to ask the student as they read through the Picture Story.

Kate Singleton, LCSW, is a Virginia-based health literacy consultant who creates Picture Stories, which are a teaching tool for adult education instructors working with English for Speakers of Other Languages learners.

For more information about this article, please contact Maryland Grier, senior communications officer at the Connecticut Health Foundation (CT Health) at (860) 724-1580, ext. 21 or visit

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