To what degree are health insurance enrollees in the Netherlands aware of the restrictive conditions attached to their policies?

Autor: Frank J.P. van der Hulst, Laurens Holst, Anne E.M. Brabers, Judith D. de Jong
Přispěvatelé: Health Services Research, RS: CAPHRI - R2 - Creating Value-Based Health Care
Rok vydání: 2021
Předmět:
Zdroj: Health Policy, 126(7), 693-703. Elsevier Ireland Ltd
ISSN: 1872-6054
0168-8510
Popis: BACKGROUND: Within the Dutch healthcare system of managed competition, health insurers can contract healthcare providers selectively. Enrollees who choose a health insurance policy with restrictive conditions will have to make a co-payment if they consult a non-contracted provider. This study aims to gain insight into enrollees' awareness of the conditions of such health insurance policies.METHODS: In August 2020, an online questionnaire was sent out via health insurers to their enrollees with restrictive health plans. In total 13,588 enrollees responded.RESULTS: One fifth of the respondents appeared to be totally unfamiliar with the policy conditions. Men, younger people, people with a low level of education, a lower income, a poorer health status and non-care users were found to be less familiar with the conditions. Of those who have been in the situation that they wanted to visit a healthcare provider whose care was not fully reimbursed, 62% went to that provider. Of those who had to pay extra because hospital care was not fully reimbursed, 62% did not know this in advance and 30% indicated that paying extra was a serious problem.CONCLUSIONS: Not all enrollees who choose a policy with restrictive conditions are aware of the consequences of receiving care from non-contracted providers. Increased awareness among enrollees will benefit the functioning of the healthcare system based on managed competition.
Databáze: OpenAIRE
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