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Members Confused By Coverage Details

MANAGED CARE June 2008. © MediMedia USA
News and Commentary

Members Confused By Coverage Details

MANAGED CARE June 2008. ©MediMedia USA

Nearly 50 percent of members report that they don’t fully understand how to use their health insurance coverage and member services, according to the J.D. Power and Associates 2008 National Health Insurance Plan Study, which measured member satisfaction with 107 health plans in 17 regions through the United States.

Members were surveyed on seven key factors: coverage and benefits; choice of doctors, hospitals, and pharmacies; information and communication; approval processes; insurance statements; and customer service. Information and communications came out lowest.

Helping members understand critical plan details, such as how to locate physicians and how to appeal coverage denials, can lead to higher satisfaction ratings for insurers.

Interestingly, the top insurers were in the western part of the United States with BlueCross BlueShield of Arizona, Kaiser Foundation Health Plan of California, and Kaiser Foundation Health Plan of Colorado taking first, second, and third place, respectively.