Getting good health insurance

September 24, 2012

Consumer Reports is also releasing an analysis of almost a 1,000 health care plans to help consumers choose the best options. Consumer Reports analyzed 984 private, Medicare and Medicaid health-insurance plans ranked by the National Committee for Quality Assurance, or NCQA, a nonprofit accreditation organization. The rankings take a number of factors into consideration, including customer satisfaction and how good a job the plan does on treatment and prevention.

On the plus side, the quality of care has improved. But Consumer Reports says there are troubling trends as well. There are treatments and tests that have been shown not to be helpful, yet research shows many are still being overused. That's not only a waste of money, but you could end up getting treatments that are unnecessary, and sometimes even dangerous. Turns out the providers of the top ten private plans are all non-profits which means they don't have to worry about turning a profit for investors, they only have to worry about pleasing their customers. In the rankings, big name for-profit companies-- UnitedHealthcare, Aetna, and Humana--had more private plans at the bottom than at the top.

A note about the rankings Consumer Reports used in its analysis - insurance company plans that are accredited by the NCQA are allotted a certain number of points. Not all insurance plans are accredited - and some are accredited by another organization. There is a fee involved for any accreditation. Consumer Reports says getting accredited is an important step because it shows insurers are willing to report on their plans performance and that has led to improved performance.

More information on choosing health insurance and how the new Affordable Care Act will affect you is available here.

Additional information:

Top-ranked Medicare and Medicaid plans with the overall highest scores for each state in our area:

Medicare:
PA – Geisinger Health Plan - HMO
NJ – Aetna Life Insurance - PPO
DE – Aenta Health (Pennsylvania) - HMO

Medicaid:
PA – UPMC For You
NJ – Horizon NJ Health
DE – Delaware Physicians Care

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