Putting Healthcare into the Consumers’ Hands

As smartphone adoption grows, health plans are looking to leverage mobile apps to give members simplified access to the information they need to understand and maximize their benefits. Traditionally, members have had to struggle to gain quick and clear insight into their essential benefits information. Through investment in mobile app development, plans are taking a significant step in improving information access and digitally transforming the once paper-based customer experience.

Despite the fact that many health plans have invested significant time and resources in mobile app advancement though, recent studies reveal that payers are failing to deliver the app launch awareness campaigns and informational content required to drive downloads, resulting in low adoption rates or apps not being used to their full potential. According to a HealthSparq study, only 36% of consumers enrolled in commercial health plans have downloaded their health insurer’s app, and only 13% of that group are actively using them to manage their health.

Plans looking to craft a mobile strategy in response to growing CMS e-delivery flexibilities and digital customer experience demands should look to the apps of mobile leaders in the payer space.

Payers that have been most successful in optimizing app utilization among their members have focused on building three primary functionalities into their apps:

Shareable Health Information

Two of the very basic pieces of information that providers need to get from their patients is their insurance information and their personal health background. This is why it’s vital to have your insurance card on you, as well as a way to store your biometric information in an accessible and secure place. Having these two tools in your personalized mobile dashboard, and allowing for the option to make changes, is a basic, yet necessary capability. Most health insurance apps have the ability for patients to see a copy of their insurance card on their phone, but the MyWellCare app includes a feature that allows patients to send their WellCare member ID cards to their providers electronically.

As the health care industry becomes increasingly integrated, it’s become easier for doctors to share test results to specialists that may need this information. Instead of having to sign into additional accounts to view and upload this information to a provider’s website, Aetna Mobile allows their members to view their personal health records, emergency information and prescription details, and share it with their health care team. Additionally, members can view alerts and reminders, ensuring they don’t miss an important vaccination, screening or annual appointment.

Cost Comparison Tools

A study by Accenture gives us a look into why price transparency is so important for patients. According to their 2016 Patient Price Transparency study, 91% of patients say it’s important to know their out-of-pocket costs up front, but only 2% of them reportedly use health plan cost estimation tools. Both myCigna and the Health4ME app by United Healthcare offer multiple tools to help members find specialists and facilities covered by their plan and estimate the cost of the visit. The cost estimation tools allow members to calculate the expenditures of doctor visits, procedures and medications, enabling more cost-effective benefits utilization and informed health care decision making. The myCigna app takes the cost estimation tool one step beyond the rest though, calculating not just co-pays for visits or procedures, but also factoring in a multitude of other individual plan benefits factors, such as a member’s co-insurance, deductible and funding available in their health savings account amounts.

User Friendly EOBs

Explanation of Benefits (EOB) can seem like a different language and become overwhelming for patients trying to understand their claim details and payment statuses. Health4Me by United Healthcare, myCigna and Aetna Mobile are the leaders when it comes to simplifying EOB terminology confusion for their members. By breaking the EOB down into sections, patients can understand their Explanation of Benefits with ease. Each app delivers a snapshot of the health plan, covering the basics of who is covered and what is covered under the health plan. Within the claims section, members can view, search and bookmark recent claims to verify the accuracy of their medical costs. Aetna Mobile also offers support on how to file complaints, appeals and check benefit payments on disability claims. Additionally, one of the most valuable tools these apps offer is the ability to view health fund balances. This allows insight into your maximums, deductibles and what funds you have available in various health savings accounts.

Mobile applications are fundamental to maximizing health benefits understanding and utilization. With apps like these, health plans have begun to empower members with the digital tools needed to optimize access and understanding of health care costs and benefits when and where care is received. It’s not enough to simply build an application with these slick features and tools though. Building an app with a great user interface and diverse functionalities is one thing, but selling the benefits of the app members is the second challenge plans grapple with. Payers looking to enter the mobile arena need to develop marketing campaigns that sell the benefits of the app in compelling ways, personalized to the demographic at-hand. They also need to insert step-by-step app download and “getting started” instructions into new member welcome kits and other essential member on-boarding materials to increase awareness at the onset, in addition to providing customer service and sales reps. with training on how to promote the app.

The payers who can demonstrate that the app is the fastest and easiest vehicle for getting accurate health plan benefit answers can empower members to more actively engage in their health and make smarter choices that deliver savings back to the organization. Being able to electronically deliver member materials is a great start to bringing health care into the digital era, but driving to an app that transforms static PDFs into digitally interactive, easily navigable content is truly bringing healthcare into the consumer’s hands.


Accenture. “Show Me the Money. Why Price Transparency for Patients is Good for Providers, Too.”2017

Brohan, M. “Cigna updates its mobile app with better security, easier access.” 2017.

Healthsparq. “What members really want: Engaging people to drive the use of digital health care tools.” 2018

WellCare Health Plans. “WellCare Mobile App Offers Convenient Healthcare Information For South Carolina Medicaid Members on the Go.” 2017.




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