Biggest Challenges Using Insurance Benefits

[skash]

Hi, I'm trying to learn more about the challenges that newly insured face, and the services that awesome insurance agents provide. I'm wondering if I can talk to anyone who might be interested in answering some of my questions. A mini phone interview?

Primarily I'm wondering-
1. What are the biggest complaints people have in using their health insurance benefits?
2. What are common reasons people call their insurance company or agent?
3. What are the biggest roadblocks for subscribers trying to navigate their plans post purchase? Are insurance agents involved post-purchase, and if so, what do they typically aid with?
4. What are services people NEED post-purchase of plan, and things people WANT?


If you'd rather just answer in text, I would still really appreciate all of ya'lls insight!

Thanks!

 

[KennyWest]

Others will chime in as well I am sure.. Here are our experiences..

1. What are the biggest complaints people have in using their health insurance benefits?

Couple of most common are networks, i.e. finding a provider in the network or their current doctors are not in. This is exacerbated if they enrolled in an HMO though in any case can be reduced by ascertaining prior to enrollment if their current doctors are in the network or not. Second most is deductible sticker shock.

2. What are common reasons people call their insurance company or agent?

See answer to number 1 above. Other than that most common has been the premium payment process (or lack thereof since many carriers were slow and/or issues with those who enrolled directly through healthcare.gov and info being lost or delayed. Can be reduced drastically by various means such as direct enrollment through carriers websites (though unless you do enrollment via "side-by-side" process or an enrollment platform plugged into CMS like ours, cannot get them subsidies). Getting enrollees on automatic pay plans resolved a lot of it for us.

3. What are the biggest roadblocks for subscribers trying to navigate their plans post purchase? Are insurance agents involved post-purchase, and if so, what do they typically aid with?

Frankly, not that many issues here other than those which apply above. Have had some in large population areas and in very low population areas where getting appointments with providers has been a challenge at times though this is frankly rare.


4. What are services people NEED post-purchase of plan, and things people WANT?

An agent! In short someone who can guide them, be an intermediary is what they want in our experience.

 

[kgmom219]

1. Biggest service right now is premium payments. Second is provider education. Third is pharmacy/medical deductibles.

2. Networks/deductible sticker shock is due to lack of knowledge. People who use an agent don't tend to have those issues. I have a few HMO clients, but they knew exactly what they area getting. I'm not getting complaints in that area.

 

[Newby]

Hi, I'm trying to learn more about the challenges that newly insured face, and the services that awesome insurance agents provide. I'm wondering if I can talk to anyone who might be interested in answering some of my questions. A mini phone interview? Primarily I'm wondering- 1. What are the biggest complaints people have in using their health insurance benefits? 2. What are common reasons people call their insurance company or agent? 3. What are the biggest roadblocks for subscribers trying to navigate their plans post purchase? Are insurance agents involved post-purchase, and if so, what do they typically aid with? 4. What are services people NEED post-purchase of plan, and things people WANT? If you'd rather just answer in text, I would still really appreciate all of ya'lls insight! Thanks!

What they NEED is answers and a human that communicates well. Most people can't understand the 5,000 word answers on the websites and publications. When they have a question they want a real person to answer it.

Same reason we start pushing zero when when get trapped in any company's phone system.