Many with private insurance dissatisfied with coverage

HealthDay News — Individuals with private insurance plans reported more negative experiences and less satisfaction compared with patients on Medicare, a report published in Health Affairs reveals.

“Policy makers should consider these findings when determining what options should be available to people buying insurance through the state exchanges mandated to begin in 2014,” study researcher Karen Davis, PhD, from the Commonwealth Fund in New York City, and colleagues wrote.

They used the results from a national health insurance survey conducted in 2010 to compare the experience of people covered under Medicare with those of nonelderly adults covered by employer-sponsored plans and non-group insurance. Results were also compared with those of a survey conducted in 2001.

Compared with Medicare beneficiaries, individuals with employer-sponsored coverage were more likely to forgo needed care, experience access problems due to cost and experience medical bill problems, the researchers found.

These individuals were also less satisfied with their coverage. For the subset of beneficiaries aged 65 years and older, those enrolled in the private Medicare Advantage program were less likely to have premiums and out-of-pocket costs exceeding 10% of their income, compared with those in traditional Medicare. However, these patients were also more likely than those with traditional Medicare to rate their insurance poorly and report cost-related access problems.

“The survey results suggest that simply shifting more beneficiaries into private plans could leave them at increased risk for negative insurance experiences,” the researchers wrote.

Such policy options should address potential problems with accessing needed care, as well as patient difficulties with paying medical bills, they added. “As the debate continues on how to reform the health care system to reduce costs and put the federal budget on a more sustainable track, it is critical to realize that problems faced by the health care system are not limited to Medicare.”