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

Last Updated 08/10/2022

Arch Apple Financial Services | Individual & Family Health Plans, Affordable Care California, Group Medical Insurance, California Health Insurance Exchange Marketplace, Medicare Supplements, HMO & PPO Health Care Plans, Long Term Care & Disability Insurance, Life Insurance, Dental Insurance, Vision Insurance, Employee Benefits, Affordable Care Act Assistance, Health Benefits Exchange, Buy Health Insurance, Health Care Reform Plans, Insurance Agency, Westminster, Costa Mesa, Huntington Beach, Fountain Valley, Irvine, Santa Ana, Tustin, Aliso Viejo, Laguna Hills, Laguna Beach, Laguna Woods, Long Beach, Orange, Tustin Foothills, Seal Beach, Anaheim, Newport Beach, Yorba Linda, Placentia, Brea, La Habra, Orange County CA

12312 Pentagon Street - Garden Grove, CA 92841-3327 - Tel: 714.638.0853 - 800.731.2590
Copyright @ 2015 - Website Design and Search Engine Optimization by Blitz Mogul