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

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, CA – October 31, 2016 – 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.

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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.