Magazine article Medical Economics

What Patients Think of Their Health Plans

Magazine article Medical Economics

What Patients Think of Their Health Plans

Article excerpt

For the most part, patients said their insurance coverage pulled no punches. A solid majority -- 65 percent -- felt that the care they receive is what they expected when they signed on. More than 25 percent reported that their insurance plans were better than expected, and only 9 percent complained that they were worse.

Some typical comments: "The PPO's policy was explained before we took it out, and they're standing behind their agreement," acknowledged an Arkansas factory worker. A Pennsylvania homemaker said, "The HMO was very explicit about what they cover and do not cover." An Illinois 69-year-old summed it up with a terse "Medicare is Medicare."

Unfortunately, the question also elicited a great deal of cynicism, with some patients responding that their health plans met their expectations simply because their expectations were rock-bottom. "What can you expect from an insurance company?" asked an Iowa woman with indemnity insurance. "Nothing much good." This zinger -- "It's lousy, as expected" -- came from a California homemaker, who's enrolled in a PPO.

A 24-year-old New Jersey bank teller asked, "I expect these new HMO type things to be filled with less than topnotch doctors. How can I expect good treatment?"

In fact, knee-jerk distrust of "these new HMO type things" seemed to be widespread, which probably explains why prepaid patients were the mast likely to report being pleasantly surprised. Thirty-four percent said their coverage was better than they'd expected.

"HMOs are very big, and we thought they were impersonal, too. But we haven't had that experience," said a 39-year-old woman from Colorado. A 33-year-old Californian thought she had good reason to be apprehensive, but her experience proved otherwise. "When I was growing up, Kaiser had a bad reputation," she recalled. "Now, though, I've found the care to be thorough, friendly, prompt, and affordable, with an emphasis on education and prevention. …

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