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KFF Survey Finds Most Consumers Across Types of Insurance Had Problem with Coverage in Past Year

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Most (58%) people with health insurance say they encountered at least one problem using their coverage in the past year, with even larger shares of people with the greatest health care needs reporting such problems, finds a new KFF survey of consumer experiences with health insurance.

Such problems vary across types of insurance but include such things as denied claims for care they thought was covered, difficulty finding an in-network doctor or other provider, and delays and denials of care that involved an insurer’s prior authorization.

At least half within each of four major types of health coverage – employer, Medicaid, the Affordable Care Act’s marketplace, and Medicare – say they had a problem using their coverage in the past year.

Such problems are more common among people with greater health care needs. For example:

  • Two-thirds (67%) of consumers who rate their own health as “fair” or “poor” encountered a problem in the past year.
  • About three-quarters (74%) of those who received mental health treatment in the past year reported a problem.
  • More than three-quarters (78%) of those who received a lot of health care (more than 10 provider visits in the past year) reported a problem.

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