More than half, or 58%, of health plan members are “overwhelmed” when it comes to managing their health plans, a new survey found. Many of these members want more straightforward communication from their insurers.
The survey came from Wellframe, a digital health company owned by HealthEdge that partners with health plans. It included responses from more than 1,000 health plan members in the U.S. When broken down by plan type, 43% had Medicare, 26% had Medicaid, 20% had employer-sponsored insurance, 9% had private insurance and 2% were covered by Veterans Affairs.
Wellframe found that while 63% of Americans believe their health insurance plan “understands me and cares for my wellbeing,” many don’t understand the information their insurers provide. About 27% said they “sometimes,” “rarely” or “never” understand all of their health plan communications.
Those who are newly insured especially struggle. Of respondents who have had health insurance for five years or less, 60% said they’re “always,” “often” or “sometimes” confused by the communication from their health plans. By contrast, this was true for 42% of all respondents.
“This confusion could be fueled by the shift in benefits offerings based on market demands for health plans to modernize their offerings and integrate technology,” the report said. “In addition, health plans must alter their benefits to adhere to new regulations, making it harder for members to keep track of what health resources are available.”
Members with chronic conditions also struggle when managing their health plans, the survey found. Of those with a chronic condition, 65% said dealing with their condition increased anxiety, depression or both.
There are certain benefits members are completely unaware of. For example, more than 44% of respondents said they didn’t know they had access to a team of nurses for no cost through their health plan, and 75% said they’ve never used the nurse hotline service before. Additionally, 46% of respondents have never heard of a care manager and 56% said they don’t know what a care manager does. Wellframe said that in order to build trust with members, it’s essential for health plans to make it clear that they can reach out to medical professionals.
“If members aren’t aware of their benefits, they can’t use their benefits,” the report stated. “This could be a major reason why health plan members are overwhelmed.”
Wellframe said to make it easier for members, it’s important to share updated information in easily accessible ways. The best way to reach members is often through smartphones or tablets, the survey stated. The information provided also needs to be written at an “accessible reading level,” it added.
Photo: Feodora Chiosea, Getty Images
