Less-than-perfect care
Enrollees also have plenty of complaints about their plans. Among those who suffered serious medical problems in the last
year, 29 percent of survey respondents and their family members in HMOs and 23 percent in PPOs said they had difficulty obtaining
the care they needed. Seventeen percent of HMO members said they had difficulty seeing doctors, typically because they had
to wait for an appointment. By contrast, only 12 percent of PPO members reported such a problem.
Billing remains a pain for PPO members. Among those who contacted their health plan (56 percent of HMO members and 58 percent
of PPO members), 63 percent in PPOs said they had to contact their plan about bill or claim status, compared to only 26 percent
of HMO members. And PPO enrollees experienced more difficulties with customer support, complaining that they had to phone
or write the plan repeatedly and that solving the problem took an unreasonable amount of time.
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