Health Plan Member Experience
Coverage clarity, claims, provider access, and the phone call nobody wants to make.
5 questions · 1 page · about 2 minutes to answer · fully editable after you start
Health-plan members interact with their insurer at life's worst moments, and remember exactly how it went. This member survey measures the interactions that define the plan: understanding what is covered before care, finding in-network providers, claims processed without combat, and the service call – reaching a human who could actually resolve.
The surprise-bill question is the loyalty killer to watch: members hit by uncovered costs they believed were covered churn at renewal regardless of premium.
Template preview
This is a picture of every question as a respondent would see it, so nothing on it can be clicked or typed into. Use this template to get your own editable copy.
Opens in the Light theme, or in your own default theme if you have set one — change it anytime to any of the 4 built-in looks, or build your own on a paid plan.
Page 1
Your plan experience
This survey asks how your health plan is working for you. Your answers help us improve the plan and the service you receive. It takes about 2 minutes. This form is not an emergency service. If you need urgent medical help, call your local emergency number.
Q1.How long have you been a member of this plan?
- Less than a year
- 1 to 3 years
- More than 3 years
Q2.How would you rate each part of your plan?*
| Poor | Fair | Good | Excellent | Not applicable | |
|---|---|---|---|---|---|
| Understanding what is covered | |||||
| Finding in-network providers | |||||
| Claims handled smoothly | |||||
| Reaching helpful humans on the phone |
Q3.In the past year, were you surprised by an uncovered cost?*
- No
- Once - minor
- Yes - significant
Q4.How likely are you to keep this plan at renewal?
Q5.Describe your most frustrating interaction with the plan this year.
More Healthcare & Wellness templates
Browse all Healthcare & Wellness templates
Health Risk Screening Questionnaire
Lifestyle screening for wellness programmes: activity, smoking, sleep, and readiness to change.
Home Care Visit Feedback
Care in the client's home: punctuality, consistency of carers, and dignity.
Hospital Food Service Feedback
Meals as care: temperature, choice, dietary accuracy, and actually eating.