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NAVIGATION PNHP RESOURCES
Posted on May 2, 2008

Understanding your own insurance

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J.D. Power and Associates Reports: Satisfaction with Health Plans Varies Dramatically From Region To Region, Largely Due to Poor Communication From Insurance Providers

J.D. Power and Associates
April 30, 2008

Nearly 50 Percent of Members Say They Don’t Fully Understand the Details of Their Health Insurance Plan

The study finds that the majority of health plan members rate their insurer lowest for the communications and information that are provided to help them understand their plan. Only 45 percent of members reported they fully understand how to use their health insurance coverage and member services. Enhancing member understanding with critical plan details—such as prescription coverage, co-pays, how to locate physicians and how to appeal coverage denials—can lead to higher satisfaction ratings for insurers.

http://www.jdpower.com/corporate/news/releases/pressrelease.aspx?ID=2008045

Comment:

By Don McCanne, MD

Although this was a J.D. Power study of consumer satisfaction, it does reveal a very important point. Only 45 percent of health plan members self-reported that they understood their health insurance coverage. The other half didn’t, and that was correlated with lower satisfaction ratings.

Although the politicians are proposing that “you can keep the insurance you have,” it is difficult to see why someone would want to continue with a plan that they can’t even understand.

Also, those that report that they do understand their plans are mostly healthy individuals who have little need to use their coverage. Yet we are inundated daily with anecdotes of individuals who thought that they had excellent insurance, only to discover that when they needed to use it, what they really had was underinsurance. What they thought was good coverage left them exposed to financial hardships.

When so many don’t understand their insurance plans, and many others fail to realize that they don’t have insurance but instead have underinsurance, it makes you wonder why the politicians continue to imply that private insurance is better than what you would receive through a public insurance program. Do you think that the politicians really understand their own health care plans?