91% of consumers factor in service experience when choosing healthcare plans
- Artificial intelligence (AI) is gaining traction in the healthcare insurance experience: 73% of consumers are comfortable using chatbots for routine tasks.
- Three-quarters (77%) of respondents prefer speaking to humans about claims, highlighting the need for a balanced approach between AI efficiency and human empathy.
- Consumers aged 18-24 are the most critical of the healthcare insurance experience, with a third (34%) likening the current experience to “pulling teeth.”
The survey paints a picture of an industry grappling with several customer service issues. Many United States consumers surveyed (44%) liken their provider’s customer service to “an extended family Thanksgiving—difficult but tolerable.” Primary pain points include long wait times to reach a representative (31%), inconsistent information from different agents (20%), and lengthy and complex decision-making processes (14%).
In response to these challenges, consumers are increasingly open to AI-powered solutions. More than half (55%) of respondents cite AI tools as central to making the healthcare insurance experience more efficient, with a notable gender divide—66% of men versus 46% of women believe AI will improve efficiency across all generations. Nearly three-quarters (73%) express comfort in using chatbots for routine tasks such as finding in-network providers or checking prescription coverage. Additionally, 41% believe an AI assistant would help them better manage their health and well-being.
The survey also reveals, however, that the human touch remains crucial, particularly for complex tasks and emotional support. A significant majority (77%) would rather speak to a human about claims, and 72% prefer human interaction for tasks requiring empathy or complex decision-making. Interestingly, while respondents said humans (48%) are more courteous and respectful than AI overall, more than half (55%) believe humans are more likely to discriminate against someone with a sensitive health query.
The survey uncovers significant generational differences in attitudes toward healthcare insurance services. Consumers ages 18-24 stand out as the most critical of the industry’s customer service, often comparing the experience to “pulling teeth” (34%). They’re also the most likely to report feeling discriminated against by their provider (36%). In contrast, consumers over age 54 are the most satisfied with their current services and the most motivated to improve their well-being (63%). Respondents ages 25-44 show the highest interest in AI-assisted health management (53%).
While about two-thirds (68%) of respondents feel they have adequate information about their care options and coverage, there are concerning gaps. Nearly a quarter (24%) have been prevented from receiving care due to complex insurance processes, and more than a quarter (29%) believe they’ve overpaid for healthcare services due to confusion.
On a positive note, more than half of the respondents (55%) feel motivated by their providers to engage in health and wellness activities. There’s also a growing trend of personalized care, with 44% receiving customized offerings and educational materials from their providers, which AI can support more consistently.
