September 17, 2010
Health-plan details elude most Americans
55% in survey fuzzy on critical aspects of coverage
Fifty-five percent of U.S. health-plan members don’t fully understand “critical details” of their insurance coverage, including prescription benefits, how to find the right doctor and appeal-coverage denials, a survey found.
The majority of respondents rated their insurer lowest on communications and information provided to help them understand their plans, according to the survey released Wednesday by J.D. Power & Associates.
The quality and availability of health care is being debated in the presidential campaign, with the three major candidates promising to revamp the health care system and help those who can’t afford insurance. Health plans perform worse in customer satisfaction than hospitals and pharmacies, and do better than vision plans, according to J.D. Power.
“Health care is very complicated in our country, and the process of accessing it is very complicated,” David Stefan, executive director of J.D. Power’s health-care practice, said in an interview.
“When you get materials from a plan, they’re written to be complete and, in some cases, almost legal-like agreements, and they can be very hard for members to understand.”
The second annual survey, which measures satisfaction with 107 commercial health plans nationally, includes responses from 37,060 members, according to J.D. Power.
Members were surveyed online in November and December.
J.D. Power, based in Westlake Village, Calif., also surveys customer satisfaction for cars, electronics and other goods and services. J.D. Power is part of McGraw-Hill Cos.
For the second year, the survey found that not-for-profit health plans, including regional Blue Cross/Blue Shield organizations, more frequently scored highest on overall satisfaction.
In some regions, publicly traded companies scored best, including United Healthcare Group Inc. in New York-New Jersey and Humana Inc. in Ohio.