Consumers Say Their Health Plans Fall Short on Coverage

Forty-one percent of consumers say that their health plan does not offer enough coverage for routine visits, serious illness or injury, health and wellness programs, routine diagnostics, or drug coverage. Concerns over not having enough health coverage reduces satisfaction by 133 points, more than any other coverage-related issue, according to the J.D. Power 2014 Member Health Plan Study. The study also reveals the following:
• 55% have experienced a cost increase in 2013, which has reduced cost satisfaction.
• 35% received a notice of changes in their coverage, networks, or rates from their health plan in the past 12 months.
• 74% maintained their preferred physician, and 83% retained their same hospital network.
• 75% submitted a claim in the past 12 months.
• The average monthly premium in 2013 was $285.
• 49% say their plan does not offer the most common types of health and wellness discount/incentive programs.

“On average, members wait eight days for communication from their provider after a pre-approval request has been submitted. Health plans must look for ways to promptly communicate pre-approvals and cost in order to minimize member anxiety and mitigate concerns about access to care, ultimately increasing customer satisfaction,” said Rick Johnson, senior director of the healthcare practice at J.D. Power.

Satisfaction is highest among health plan members in California and Michigan. Kaiser Foundation Health Plan ranks highest among health plan members in the California region for a seventh consecutive year, with a score of 756. No other plans in this region perform above the region average. For more information, visit http://www.jdpower.com/about/index.htm

Last Updated 09/16/2020

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