April 3, 2020

The Changing Shape of the Health Insurance Customer Journey During and After COVID-19

As the COVID-19 crisis continues, health insurance payers will need to evaluate new risks and opportunities:


Declines in payrolls will result in a retrenchment in the commercial insurance space. Declines in small business and 1099 resiliency will also lead to a decline in individual policies and exchange-sourced acquisitions. 


The growing number of potential Medicare Advantage members who are entering the market (roughly 20,000 people per day) represents an attractive opportunity, even in the midst of the COVID-19 crisis. Those aging into Medicare are looking for robust coverage in an environment where health risk is top of mind and robust coverage is more attractive than ever. States will have heightened awareness of having adequate servicing and coverage for their Medicaid populations.  

Consumer behavior will change

As the COVID-19 crisis drives the shifts described above, consumers will also adopt new offerings, including tele-health for convenience and safety, online pharmacies for reliable supply, and wellness programs to improve personal resiliency. Ensuring this crisis-driven adoption translates into enduring habits will also be important.   As payers navigate the crisis, presenting the right messaging and right language at the right time will be critical to realizing the opportunities the crisis has presented and help consumers navigate the healthcare insurance marketplace during this sensitive and anxiety-ridden period.

Leadership mindsets need to adapt

Leaders in the insurance space will need to take a mindful and data-driven approach to nurturing, preserving where possible, and even expanding these consumer relationships. These relationships may be substantially altered, but with the right messaging and language at the right point in time in the crisis, these relationships can endure.  The framework outlined in this discussion document can help you engage customers in a compelling way as we all navigate from the acute crisis to a new business-as-usual and as customers navigate their own journey with your organization. The exact approach will differ by company and by stage.

Identify how the customer journey may change at each stage of the crisis

To make the four phases toward a new normal actionable and practical, outline the specific challenges (problems to be solved), desired outcomes, and key use cases that need to be addressed at each moment in the customer journey in each stage of the crisis. Take the time to clearly articulate what the challenges, outcomes and actions look like in that context for your business.

For example, during the crisis phase for an insurance sub-sector like health insurance, consider the challenges, outcomes, and communication use cases for the following journey moments:


  • Challenges: Health insurance customers may want to “backslide” to lower-cost policies. Distracted or anxious customers may forget to add coverage for vision or dental that aren’t part of a core policy. On the other side of the spectrum, customers may want to acquire or upgrade coverage, but feel overwhelmed by their options.
  • Desired outcomes: Insurers want to close prospects at the bottom of the sales funnel. Look to provide more robust policies for legitimately underinsured customers, as well as cost-saving add-ons like vision, dental, or mental health coverage. 
  • Key use cases: Equip agents and insurance marketplaces with clear and helpful information. Use direct messaging and email to communicate directly with customers, and drive them to well-designed websites with clear information — research shows that customers are more likely to buy when they feel confident about their decision, which insurers can enable with information that’s easy to find.


  • Challenges: Insurance policies are hard to parse in the best of circumstances. Distracted consumers will need more guidance from call center agents to navigate their coverage for doctor’s appointments, specialists, pharmacy benefits, physical therapy, mental health benefits, etc. Participation in wellness programs that require gym or fitness class attendance will decline. 
  • Desired outcomes: Build awareness and adoption of high-value and cost-beneficial features like automatic prescription refills and wellness visits with a primary care provider. Encourage use of online tools to reduce the burden on call center agents. Drive long-term retention by setting policyholders up from the outset to get the most from their coverage. Facilitate adoption of automatic payment methods to drive collections and reduce service volumes.
  • Key use cases:  Provide pre-emptive education and awareness of key features and self-service capabilities. Provide clear resources such as FAQs, reminders and prompts to drive adoption of value-added functionality like sign up for automatic payments and automatic refill.


  • Challenges: Consumers will have questions and concerns about availability and coverage for COVID-19 testing, treatment and hospital stays. Policyholders may confront shortages of maintenance medication for asthma or inflammatory disease (some of these show promise in COVID-19 treatment). The call center will be overwhelmed with questions and support needs.
  • Desired outcomes: Allay customer concerns and ease the burden on the contact center.
  • Key use cases: Offer direct, targeted messaging to answer high-frequency questions and reduce traffic to the call center. Proactively communicate about policy changes such as free testing (and where) and payment plans. Craft clear and consistent call center scripts to help agents navigate customer interactions and fulfill requests.


  • Challenges: Furloughed consumers could look to decrease their expenses and comparison shop for more streamlined coverage. Customers who qualify may want to seek more complete coverage to make sure they have what they need if they get sick.
  • Desired outcomes: Maintain high margin, multi-product relationships. Support strong retention and eventually drive broader service adoption. Improve brand equity through accommodations made to support policyholders.
  • Key use cases: Launch pre-emptive retention campaigns to remind customers of available services. Craft clear call scripts that help communicate policy changes  Finally, A/B test offers to target segments to expand coverage and benefits as the crisis subsides.

Note: This framework is part of a set of guiding principles for communicating effectively with customers on the path to a new normal.

Related Articles