Health insurance

Insured adults give their health plans positive ratings, but most report problems

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Dive Brief:

  • Most adults with health insurance rated their coverage positively, but those in poor health were more likely to give lower scores, according to a survey on consumer experiences by KFF. 
  • The report found 81% of insured adults rated their health plans’ performance as “excellent” or “good.” Medicare beneficiaries, which included both traditional Medicare and Medicare Advantage, were the most positive, with half rating their plans as “excellent.”
  • Still, nearly 60% reported experiencing a problem with their coverage in the past 12 months, like their insurer paying less than expected or not being able to schedule an appointment with an in-network doctor. Nearly half who reported problems said it wasn’t resolved or they weren’t satisfied with the outcome. 

Dive Insight: 

The survey included more than 3,600 adults, including those who were insured under an employer-sponsored plan, those who bought coverage through the Affordable Care Act marketplace and adults on Medicaid or Medicare. 

Though 84% of respondents who described their health as at least “good” rated their insurance positively, only 68% with “poor” or “fair” health did.

Those responses tended to vary by insurance type. Only 15% of adults with Medicare and 11% of adults with Medicaid reported a time in the past year where their insurer paid less than expected for a medical bill compared with 35% of those with employer-sponsored insurance and 28% on marketplace plans. 

But 33% of adults on Medicaid said an in-network doctor they needed to see didn’t have available appointments, compared with only 18% of Medicare beneficiaries, 28% of those on employer-sponsored plans and 23% of those on marketplace insurance. 

Mental healthcare coverage was also a concern. Only about four in 10 insured respondents gave positive ratings for the availability of covered mental health professionals and the quality of therapists. 

Cost, a long-term and steadily growing problem in U.S. healthcare, was reflected in the survey too, with 16% reporting that they had problems paying or couldn’t pay for medical bills last year. More than four in 10 said they had delayed or gone without care due to cost concerns. 

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