Read about out-of-pocket costs consumers face and how satisfied they are with their health insurance plans.
If you REALLY want to know, check out http://HowDoesAmericaUseObamacare.com
We also asked important questions like how happy people are with their health insurance provider, and how you feel about your out-of-pocket spending. You can see all the data nicely displayed and easy to access.
Leading up to the Affordable Care Act’s 2016 open enrollment period for individual and family health insurance, eHealth also published two reports suggesting how customer satisfaction may be shaped by out-of-pocket costs.
The reports also shed light on just how much of a burden some consumers face in out-of-pocket costs for prescription drugs and other medical care.
eHealth’s Consumer Satisfaction & Spending for Prescription Drugs and Medical Care report shows how personal expenditures for prescription drugs and medical care can affect consumers’ satisfaction with their health plan and their sense of being valued as a customer by their insurer:
On satisfaction and prescription drug costs:
- 23% of those who spent more than anticipated on prescription drugs felt valued by their insurer
- Only 15% of those who spent more than $2,000 on prescription drugs felt valued by their insurer
On satisfaction and out-of-pocket spending:
- 44% of those who spent up to $1,000 toward medical care felt valued by their insurer
- Only 28% of those who spent more than $2,000 toward medical care felt valued by their insurer
On satisfaction by type of medical care received:
- 60% of those who had major surgery felt valued by their insurer
- 39% of those who received maternity care felt valued by their insurer
- 38% of those who received only preventive medical screenings felt valued by their insurer
- 37% of those who received emergency care felt valued by their insurer
- 35% of those who received care for chronic disease management felt valued by their insurer
- 29% of those who reported receiving out-of-network care felt valued by their insurer
- 40% of those who only saw network medical providers for care felt valued by their insurer
On satisfaction and access to government subsidies:
- 52% of those who said they were receiving government subsidies felt valued by their insurer
- 29% of those who said they were not receiving subsidies felt valued by their insurer
eHealth’s Coverage Satisfaction and Utilization Snapshot report provides a glimpse into how many health insurance consumers face unexpected out-of-pocket costs and what they are actually spending when it comes to prescription drugs and medical care.
On spending for prescription drugs:
- 35% said they faced unanticipated prescription drug costs in 2015
- $848 was the average estimated amount spent out of pocket among those with unanticipated drug costs
- 22% said they spent more than $1,000 out of pocket on prescription drugs
On spending for medical care:
- 35% said they used their health coverage for non-preventive medical care in 2015
- 91% of those receiving non-preventive medical care paid out-of-pocket costs in the form of deductibles, co-pays, coinsurance and/or out-of-network charges, etc.
- $2,380 was the average estimated amount spent among those who reported paying out-of-pocket for medical care
Average estimated out-of-pocket costs by medical care received:
- $3,738 for a major surgery
- $3,101 for maternity care
- $2,723 for a minor surgery
- $2,696 for an unexpected illness
- $2,042 for emergency care
- $1,989 for mental health care
- $1,798 for chronic disease management
Utilization & Satisfaction with Provider Access
Among those who reported having used their health insurance coverage for medical care, respondents expressed satisfaction with their access to medical providers overall and based on the kinds of medical care they had received, as shown below.
My health plan gave me access to the providers of my choice:
- All respondents – 67% – Agree
- Subsidy recipients – 73% Agree
- Non-subsidy recipients – 66% agree
- Used Preventive care only – 71% – Agree
- Used emergency care – 61% – Agree
- Care for chronic illness – 69% – Agree
- Care for unexpected illness – 69% – Agree
- Minor surgery – 64% – Agree
- Maternity care – 74% – Agree
- Mental health care – 67% – Agree
- Major surgery – 79% – Agree
- “Other” – 62% – Agree
About eHealth’s survey and reports:
eHealth’s reports are based on a nationwide online survey of eHealth customers conducted in July and August of 2015. More than 6,500 responses were collected. All respondents had previously purchased individual or family health insurance plans through eHealth.com, the company’s private online marketplace.
Respondents were invited to rate their agreement with five satisfaction criteria defined by eHealth. For the purposes of this article, when survey participants were asked whether they felt valued by their insurer, “Agree” and “Strongly Agree” responses were combined.
Additional questions were asked about coverage utilization and out-of-pocket costs. For more information about the survey, refer to the Methodology section at the end of each report.