Customer Satisfaction With Obamacare Health Insurance Plans: eHealth Report Shows Out-of-Pocket Costs Have Highest Impact

eHealth sheds light on how a person’s out-of-pocket expenditures for
premiums, prescription drugs and medical care impact their satisfaction
with their health insurance plan

MOUNTAIN VIEW, Calif.–(BUSINESS WIRE)–Today eHealth, Inc. (NASDAQ:EHTH) (eHealth.com),
which operates the nation’s first and largest private online health
insurance exchange, published a report demonstrating how consumers’
personal expenditures for insurance premiums, prescription drugs and
medical care correlate to overall satisfaction with their health
insurance coverage. The report also sheds light on how much people with
health insurance are spending out of pocket for prescription drugs and
medical care.

eHealth’s latest Consumer Satisfaction Index report surveyed over 2,100
eHealth customers who had a qualifying life event allowing them to buy
health insurance during a special election period between February 1 and
September 30, 2016. The survey found that the number one predictor of
consumers’ satisfaction with their health plan is how much money they
spend out of pocket on premiums, prescription drugs and medical care.

eHealth’s Coverage Satisfaction Index: How do
costs impact customer satisfaction?

According to the survey, people were significantly happier with their
health insurance plan if they had lower monthly premiums, fewer
out-of-pocket costs for medical care and prescription drugs, and were
able to use in-network doctors.

Monthly premiums – eHealth customers who received advanced
premium tax credits (also known as Obamacare subsidies) were almost
twice as likely to be satisfied with their health plan (48% satisfied)
as those who did not receive a subsidy (only 25% satisfied).

Out-of-pocket costs – The highest swing in customer satisfaction
was driven by out-of-pocket costs for medical care. People with little
or no out-of-pocket costs for medical care were more than twice as
likely to be satisfied with their health plan than those who had to pay
out-of-pocket costs (51% satisfied vs. 21% satisfied).

Prescription drug costs – People who had to pay more than they
expected for prescription drugs were significantly less satisfied with
their health plan. People without unexpected prescription drug costs
were far more likely to be satisfied with their health plan than those
who did have unexpected drug costs (41% satisfied vs. 29% satisfied).

Access to doctors – Finally, people who had to go out of network
to receive medical care were less satisfied with their health plan.
People who received “in-network” care were more likely to be satisfied
with their health plan than those who had to go out of network (38%
satisfied vs. 26% satisfied).

Survey Data

 
Did you use receive an advanced premium tax credit (also called
an Obamacare subsidy) to help you pay for your health insurance?
Yes   No

52%

48%
 
Survey responses filtered by use of premium tax credits

People who received premium tax credits (Obamacare subsidies): Do
you agree or disagree with the statement?

 

“My health insurance company treats me like a valued customer”

Net Agree: 48%

 

Net Disagree: 25%

 

People who did not receive premium tax credits (Obamacare
subsidies):
Do you agree or disagree with the statement?

“My health insurance company treats me like a valued customer”

Net Agree: 25%

Net Disagree: 46%

 
Among the 38% of survey responders who used their health
insurance plan in 2016

Customers with little or no out-of-pocket costs: Do you agree
or disagree with the statement?

“My health insurance company treats me like a valued customer”

Net Agree: 51%

Net Disagree: 29%

 

Customers with higher than expected out-of-pocket costs: Do
you agree or disagree with the statement?

“My health insurance company treats me like a valued customer”

Net Agree: 21%

Net Disagree: 36%

 
Survey responses filtered by unexpected Rx costs
Customers who had no unexpected Rx drug costs in 2016: Do you
agree or disagree with the statement?

“My health insurance company treats me like a valued customer”

Net Agree: 41%

Net Disagree: 31%

 
Customers who did have unexpected Rx drug costs in 2016: Do
you agree or disagree with the statement?

“My health insurance company treats me like a valued customer”

Net Agree: 29%

Net Disagree: 42%

 
Survey responses filtered by use of use of network/non-network
doctors
Customers who did not have to go out-of-network for medical care: Do
you agree or disagree with the statement?

“My health insurance company treats me like a valued customer”

Net Agree: 38%

Net Disagree: 29%

 
Customers who did go out-of-network for medical care: Do you
agree or disagree with the statement?

“My health insurance company treats me like a valued customer”

Net Agree: 26% Net Disagree: 46%
 

eHealth’s Coverage Satisfaction Index: How does
utilization of coverage impact customer satisfaction?

According to the survey, people were not significantly happier with
their health insurance plan if they actually used their coverage in 2016.

Plan use – 62% of eHealth customers did not use their health
insurance plan last year; 8% only used their coverage for preventive
care; 30% used their coverage for treatment of an injury or illness.
However, those who didn’t use their insurance at all were only slightly
happier with their coverage (38% satisfied) than those who used it for
preventive care (35% satisfied) or to treat injuries or illnesses (36%
satisfied).

Maternity care – Customers who used their health plan for
maternity care were significantly less satisfied with their health
coverage than other customers. Only 19% of customers who needed
maternity care in 2016 said they were happy with their Obamacare health
plan, compared to 57% who said they were unhappy with their coverage. In
addition, only 24% of customers who needed maternity care in 2016 were
happy with their access to doctors, compared to 45% of all other
customers who said they were satisfied with their access to doctors.

Survey Data

 
Did you use your health insurance plan last year?
No, I did not use my health insurance plan   Yes, I used my health insurance plan for preventive care only   Yes, I used my health insurance plan to treat and injury or
illness
62% 8% 30%
 
Survey responses filtered by how people used their coverage
Customers who did not use their health plan: Do you agree
or disagree with the statement?

“My health insurance company treats me like a valued customer”

Net Agree: 38%   Net Disagree: 34%
 
Customers who used their health plan for preventive care only: Do
you agree or disagree with the statement?

“My health insurance company treats me like a valued customer”

Net Agree: 35% Net Disagree: 31%
 
Customers who used their health plan for to treat injury or
illness:
Do you agree or disagree with the statement?

“My health insurance company treats me like a valued customer”

Net Agree: 33% Net Disagree: 36%
 
Survey responses filtered by people who used maternity care
specifically
People who used their health plan for maternity care: Do you
agree or disagree with the statement?

“My health insurance company treats me like a valued customer”

Net Agree: 19% Net Disagree: 57%
 
People who used their health plan for medical care (maternity
care excluded):
Do you agree or disagree with the statement?

“My health insurance company treats me like a valued customer”

Net Agree: 36% Net Disagree: 34%
 
Survey responses filtered by people who used maternity care
specifically
People who used their health plan for maternity care: Do you
agree or disagree with the statement?

“My health insurance plan gives me access to the medical care
providers of my choice”

Net Agree: 19% Net Disagree: 57%
 
People who used their health plan for medical care (maternity
care excluded):
Do you agree or disagree with the statement?

“My health insurance plan gives me access to the medical care
providers of my choice”

Net Agree: 36% Net Disagree: 34%
 

Out-of-pocket costs

Utilization of coverage – Altogether, 30% of survey
participants said they used their health coverage for non-preventive
medical care in 2016. Among these, 89% had to make out-of-pocket
payments in the form of deductibles, co-pays, coinsurance and/or
out-of-network charges, etc. The average amount spent out of
pocket in 2016 was $2,786 for non-preventive medical care.

Type of care used – Among those who used their health coverage to
treat a medical illness or injury (non-preventive care) one-in-four
(25%) used the Emergency Room, one-in-four (26%) needed care for a
chronic illness, one-in-ten (10%) needed mental health care, and
one-in-ten (10%) needed care for an unexpected illness.

Estimated average out-of-pocket costs by medical care received:

         
Care received   Percent of customers surveyed who used medical care*   Estimated average out-of-pocket costs
Chronic Care Management 26%* $2,564
Emergency Care 25%* $2,915
Major Surgery 8%* $3,640
Maternity Care 5%* $4,520
Minor Surgery 10%* $3,443
Mental Health Care 10%* $2,564
Unexpected Illness 10%* $3,402
Overall 30%* $2,786
*This data is a subset of those 30% of eHealth customers who
reported receiving non-preventive medical care in 2016

eHealth’s report is based on a voluntary nationwide online survey of
eHealth customers between February and September of 2016. More than
2,100 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.
Additional questions were asked about coverage utilization and
out-of-pocket costs.

eHealth

eHealth, Inc. (NASDAQ:EHTH) owns eHealth.com, the
nation’s first and largest private online health insurance exchange
where individuals, families and small businesses can compare health
insurance products from leading insurers side by side and purchase and
enroll in coverage online. eHealth offers thousands of individual,
family and small business health plans underwritten by many of the
nation’s leading health insurance companies. eHealth (through its
subsidiaries) is licensed to sell health insurance in all 50 states and
the District of Columbia. eHealth also offers educational resources and
powerful online and pharmacy-based tools to help Medicare beneficiaries
navigate Medicare health insurance options, choose the right plan and
enroll in select plans online through Medicare.com (www.Medicare.com),
eHealthMedicare.com (www.eHealthMedicare.com)
and PlanPrescriber.com (www.PlanPrescriber.com).

For more health insurance news and information, visit eHealth’s Consumer
Resource Center
.

Contacts

DMA Communications for eHealth, Inc.
Sande Drew, 916-207-7674
sande.drew@ehealth.com
or
eHealth,
Inc.
Nate Purpura, 650-210-3115
nate.purpura@ehealth.com