Consumers on Holiday

Many consumers found themselves talking about their health over the holidays with family and friends. Given the recent press—good, bad, and ugly— about healthcare coverage, here were a few examples:

• First-time parents were relieved that their employer-sponsored health insurance plan’s network included “the best” maternity hospital in the area. The plan met their growing family’s needs at this time even though its monthly premium was more expensive than other options.

• A gig worker covered through ACA had difficulty accessing mental health services. The plan carved out behavioral health benefits to a third party. The individual had to coordinate care between the primary care physician and specialists, which took a lot of time and effort.

• Empty nesters worked as independent contractors and, for years, enjoyed coverage with a grandfathered health plan. Given network changes that made it increasingly difficult to see specialists, they recently bought into a concierge medical practice to improve timely access to medical care.

• Parents shared that their disabled adult child had Medicaid coverage. In addition to management of activities of daily living, they all struggled with the administration required to maintain her coverage and obtain her care through the managed care plan.

• A retiree raved about her coverage by Original Medicare, a Medigap plan, and a drug plan. She was lucky to be able to spend several hundred dollars per month for the plans. Some friends with more limited resources enrolled in Medicare Advantage plans to save money, but expressed concerns about access and quality.

Over the holidays, families and friends talked about their health and their coverage. For some, their coverage was not necessarily easy nor affordable. Nonetheless, these consumers were Mastering Health Insurance.

Photo: Holiday on Lake Michigan