Check if a service is covered and if so, what the cost will be
User Persona
Eric Miller
The "Just Need the Basics" User
A 27-year-old leasing agent who only engages with insurance when absolutely necessary (e.g. urgent care).
Behavior: Eric is a reactive user. He avoids the app because he finds terms like "co-insurance" confusing, often delaying care or calling support just to get a simple cost estimate.
Goal
Quickly find/verify a covered healthcare service, and easily get an estimated cost for the service upfront.
User Story
As a younger adult at an urgent care visit, I want to quickly check if a recommended service is covered by my insurance and get a cost estimate, so I can confidently go forward with treatment and understand my potential financial responsibility.
Contextual Information
What prompted the persona to begin the task?
Eric was sick, and so he visited an urgent care in-network. While there, they recommended a strep-throat test be administered.
What prior knowledge does the persona possess about the process?
Eric does not interact with his health insurance very often, so he is not the most knowledgeable about insurance terminology and processes. He has however had a previous bad experience with unexpected bills following an appendectomy — so he is considerably cost-conscious and wants to explicitly know how much services will be when it comes to healthcare.
What additional information does the persona need to complete the task?
Eric may need to know or, more likely, confirm with his provider what exact tests or services are going to be administered (possibly even verifying the CPT codes)
What tools will the persona require?
Eric should be able to utilize his phone to accomplish his goal. He should not have to access Google or otherwise do any external research outside the app.
What else?
Estimates of the cost of the service would need to take into account Eric’s current benefit phase — for this scenario, we will assume Eric has fulfilled his deductible (following the earlier appendectomy) and is in his co-insurance phase.
Task Flow
Success Criteria: The task is finished when the user successfully finds and verifies a service is covered and is able to estimate the cost of the service.
- Logs in to app
- Navigates to the "Check Coverage" feature
- Searches for "strep test"
- Selects "strep test" from results
- Reviews the displayed coverage information for the "strep test" (e.g., if it's covered).
- Views the estimated out-of-pocket cost for the "strep test" based on his current plan benefits (co-insurance phase).
User Flow
Card Sorting Exercise
Overview
- Goal: To understand users' mental models and determine the most intuitive navigation structure for the Blüm app.
- Method: A hybrid card sort conducted via UXtweak.
- Participants: 15 respondents.
- Scope: 20 cards sorted into 3 default categories (Health Records, Benefits, and Search), resulting in 17 unique user-created categories.
Card Sort Example
Card Sorting Results
Results
Standardization Grid
Similarity Matrix
Insights
The Need for a Centralized Dashboard
- Finding: Users frequently created custom categories like "Profile" or "Quick Access" to group high-priority items like their ID Card, Coverage details, and Prescriptions.
- Refinement: Validated the necessity of a dedicated "Home Dashboard" to serve as a jumping-off point for high-frequency tasks, rather than burying them inside deeper navigation menus.
"Health Profile" over "Health Records"
- Finding: While users successfully grouped record-based cards together, they felt "Health Records" sounded too clinical, often creating their own "Health Profile" category instead. Furthermore, users overwhelmingly sorted the "Care Team" card into this grouping rather than under "Benefits."
- Refinement: Renamed the primary navigation tab to "Health Profile" and moved "Care Team" under this umbrella to better align with user expectations of personal health management.
Distinct Search Flow: "Get Care"
- Finding: The default "Search" category was too vague. Users consistently grouped provider lists and medical services together under new, action-oriented labels like "Get Care."
- Refinement: Accounted for a direct search flow that specifically and exclusively is used for finding providers and services. A separate, global search function will be retained for general app queries.
Other General Learnings: I could have done a better job of indicating what content was personalized in the exercise. For example, "Vaccinations" (meant to be the user's personal records) was often confused with "Medicines List" (a general library). This is something to consider for UX copywriting. It's also possible this problem solves itself in the final UI, where seeing "Vaccinations" on a "Health Profile" page provides the necessary context.
Sitemap
By synthesizing the user flows and the card sorting data, I constructed the final Sitemap. I flattened the hierarchy to ensure critical tasks entry points were never more than a couple taps away from the home screen.
Sketches
I sketched out screens that were critical to the core features of the product, which aligned with user needs. I annotated these sketches so that stakeholders could understand functionality and expected behavior without requiring the time commitment of higher fidelity design work.
