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Customer Service and Health Plan Reviews

Reviewing Health Plan Customer Service


This category is increasingly important in today’s world as it is sure to draw much ire from many health plan reviewers and raters alike.  Health insurance customer service.  It’s likely to raise your blood pressure just thinking about it.    Customer service in general has taken a downturn that’s decade long across most industries and unfortunately, insurance and health insurance specifically, are not immune.  Let’s take a look at how to review health plan customer service.  Please press 1 to continue.  Just kidding.


An intro to health plan customer service

So what is customer service as it applies to health insurance?  First, we’re not including claims.  That’s carved out on the Hoodles health plan review site separately since it’s so important.  Customer service would refer to any other interaction you would have with the carrier.  This may be phone, email, fax, or mailings that deal with underwriting (the process of enrolling), membership (changes, updates, billing), and benefits (questions on what your plan covers and how to use it).  How do we rate and review these different interactions to help other health insurance shoppers better understand what to expect?


Key drivers of good customer service

There are many different elements that make up a successful customer service experience for health plans.  Let’s break it down by channel.

Phone contact.  Although the most direct way to address an issue, most people dread having to call a large company’s customer service line.  First, how complicated is it to get to your desired department?   How many transfers does it require?  Is there an easy way to opt out of the “press #” labyrinth if you need to speak to someone.  Do calls get dropped?  Once you get through, is the person helpful, knowledgeable, or how about just friendly?  Can they resolved your issue or does it require more follow up (and worst yet, more calls).  We have all been on both sides of spectrum related to phone customer service and it can surprisingly easy or frustrating to no end.  Review your health plan experience accordingly.

Email contact.  Does the health plan carrier allow communication and simple changes by email (and if not, why not!!)  Do you get a confirmation back that your email was received and how long does it take to get a response?  Was the responder able to resolve your issue or is more follow up required?  The health plan carriers have only recently started to allow more correspondence by email so be patient on this front.  It’s ultimately coming as phone customer service is an expensive alternative.   Fax interaction falls in the same category as email since it works the same way (or should, anyway).

Mailing contact.  A great deal of correspondence is going the way of the internet in the form of email, ect with health plans but much is still governed by archaic State laws which require physical mailings to you.  You’ll typically see this for more important notifications such as rate or benefits changes.  Again, a lot of this information is governed by State law so there may be quite a bit of legalese involved (which is actually required).  That being said, can you understand what they’re trying to convey?  Is it clear if you need to do anything as a result?  Is contact information provided right there for you to follow up by phone or email?  These are key requirements of a good mailing.

When you rate your health plan or read other’s health plan reviews, consider these various points above and judge accordingly.  Keep in mind that not need to use a company’s customer service is probably the best approval of all.  It means their plan worked as advertised.

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