Think tank researchers who question the quality of many individual health insurance policies have reported survey data hinting that individual health policies may pay claims more promptly.
A team led by Michelle Doty published the data, based on a 2007 health insurance survey conducted by Commonwealth Fund, New York, in a paper released by the Commonwealth Fund.
The survey participants included in the Doty paper were ages 18 to 64 and had private health coverage throughout the year.
The researchers assert in the paper that buying individual health insurance is not a viable option for most U.S. families, and they note that individual health coverage holders face higher premium costs and higher out-of-pocket health care costs.
About 36% of the survey participants with individual health coverage said they had faced expensive medical bills not covered by insurance, compared with 27% of the participants with group coverage.
The percentage of participants who faced “balance billing” – the need to make up the difference between what a doctor wants to charge for care and what an insurer wants to pay — was 39% for the participants with individual coverage and only 28% for group plan participants.
But only 32% of the holders of individual health coverage said they had had to contact the insurer because the insurer had denied payment or failed to pay a bill promptly, compared with 37% of the group plan participants.
About 20% of the individual coverage holders reported having trouble with paying medical bills in the past year, compared with 17% of the group plan participants.
When the researchers asked about actual use of care, 26% of the individual coverage holders said they avoided visiting a doctor or clinic when they had a medical problem, compared with 19% of the group plan participants.
But only 10% of the individual coverage holders said they had failed to get the specialist care they needed, while 12% of the group plan participants said they had gone without specialist care.
The researchers also found that the incomes of the individual coverage holders and the group plan participants were roughly comparable, with 60% of the group plan participants and 55% of the individual coverage holders having incomes over 300% of the federal poverty level.