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Help Guide – Before You Select a Health Plan – Three Steps (READ ME)

1. Compare the health insurance plans you are interested in by visiting the NCQA website to see if they are accredited, and how their quality scores compare.
2. Visit at least one of the state-specific reports to find out what the rate of complaints is for the health plan you’re interested in, what hospitals it uses, and information about quality measures. Note: Every state or regional report may be different. If your state is not listed here, see what other states make available. Even if it’s not online, the data probably are collected by your state.
3. Visit the federal Marketplace Exchange (link below), or your state exchange to see what ratings, prices and comparisons exist among the plans you are interested in.

NCQA Health Insurance Plan Ratings and Report Card 2023-2024 Editor's Pick

NCQA ratings and report card for 2023 on health insurance plans. Before you select your plan for 2024, compare quality ratings for HMOs and PPO health insurance plans. Aetna, Anthem Blue Cross, Cigna, Humana, Kaiser, United Healthcare – they’re all here, as are many non-profit regional plans. Star ratings and number of enrollees shown for accredited commercial, Medicare and Medicaid plans. Two private commercial plans received the highest possible 5-point star rating: Independent Health Association (NY) and Kaiser Foundation Health Plan of the Mid-Atlantic States.  Seventy (70) accredited plans (commercial, Medicare and Medicaid) received ratings of 4.5 stars. NCQA (National Committee for Quality Assurance) is a private nonprofit organization that sets standards for quality of care and service that health plans provide to their members. NCQA Accreditation is a nationally recognized seal of approval. Updated October 2023.

Find Health Insurance Plans and Prices on the Marketplace Exchange – healthcare.gov Editor's Pick

Find individual health insurance plan options and prices at healthcare.gov. This is the ONLY health insurance site to use if you want (and qualify for) the federal subsidies for affordable health insurance AND your state participates in the federal marketplace exchange. Compare plans on monthly premium prices, deductibles, plan features and star quality ratings. The federal marketplace exchange shows Bronze, Silver, Gold and Platinum metal levels. It first opened for 2014. People who don’t get subsidies can also choose a plan and enroll at healthcare.gov. Open enrollment for everybody (except Medicare) between November 1 and December 15, 2023 for coverage starting Jan. 1, 2024. This year, the federal exchange is again open for an additional month (to Jan. 15, 2024) for coverage starting Feb. 1, 2024. Select See Health Plans and Prices – Search Now – if you just want to scan the plans before you create an account. At minimum, enter your age, or you may get false prices. If you enter your income, the site will estimate how much lower your monthly premium will be with a “premium tax credit” that the government will pay on your behalf. If you lose coverage during the year, you may also qualify to enroll outside of the Nov.-Dec. open enrollment. Links are provided to your state marketplace if your state has its own health insurance website. Use the filter of “easy pricing” within bronze or silver tiers to compare a handful of plans with identical benefits such as size of deductible. However, some of the other plans in that tier may suit your needs better. Nonetheless, this site is Editor’s Pick.

Link to Your State Insurance Department Site (all states)

List of state Insurance Departments for all states. If you like to browse, your state’s site may have additional information about health insurance. These links are provided by the National Association of Insurance Commissioners (NAIC), the organization of insurance regulators from the 50 states, the District of Columbia, Puerto Rico and the other four U.S. territories. The NAIC site has a Consumer Information Source to find medical loss ratios, financial information, and complaint information on the exchange, HMOs and other health insurance plan providers.

California – 2021-2022 HMO, PPO, & Medical Group Ratings Report Card Editor's Pick

Find California HMO, PPO and Medical Group ratings report card for 2021-2022. Kaiser Permanente HMO Plan of Southern California received the highest ratings for Quality. Sharp Health Plan HMO received the highest ratings for member satisfaction. Two plans got the lowest ratings (Poor, one-star) for member patient experience: Health Net Life PPO and United Healthcare PPO. Compare 16 largest California HMO health insurance plans: Aetna, Anthem Blue Cross HMO, Blue Shield, Cigna, Health Net, Kaiser Permanente Northern and Southern CA regions, Sharp Health Plan, United Healthcare and Western Health Advantage. Compare 6 of the largest PPOs: Aetna, Anthem Blue Cross, Blue Shield, Cigna, Health Net Life Insurance Company, United Healthcare. Clear, simple star system (5 stars = excellent; 4 stars = very good; 3 stars = good, 2 stars = fair; 1 star = poor) used for overall rating. Actual performance scores are not given, but may be available through NCQA. Quality measures (based on HEDIS scores) for asthma, cancer screening, child health, chlamydia screening, diabetes, heart care, maternity care, behavioral and mental health, and other expected care. Member satisfaction stars also shown. Complaint rates are reported for health plans in a separate report. Nearly 200 Medical Group ratings also provided by county for the larger groups of doctors. For example, nearly 60 different Kaiser Permanente medical groups are included; Sutter, Scripps, Sharp and many more.  Prepared by the California state Office of the Patient Advocate (OPA).

Florida Health Insurance Plans – Quality Ratings & Satisfaction

Find Florida health insurance plans member satisfaction and quality ratings. Topics may vary from year to year. They usually include cancer screening, diabetes, prenatal care, well child care, children’s dental care, high blood pressure for HMOs, Medicare HMOs and Medicaid. Aetna, AvMed, Better Health, Capital, CIGNA, Clear Health Alliance, Community, Coventry, Florida Health Care, Freedom Health, Health First, Health Options, Humana, Molina, Neighborhood, Positive, Prestige, Simply, Staywell, Sunshine, United Healthcare, Children’s Medical Services and others. Search by county. Member satisfaction for Aetna, AvMed, Capital Health Plan HMO (highest member satisfaction), Cigna, Coventry, Florida Blue, Florida Health Care Plan, Golden Rule PPO (lowest member satisfaction), Health First, Humana, Molina, Neighborhood, Sunshine Health, United. Easy to read. Choose stars or actual scores / ratings. Member satisfaction is recent (2020) for Medicaid plans, but old (2017) for commercial health plans. FL reports from floridahealthfinder.gov.

Georgia Health Insurance Plan Ratings and Comparisons 2023

Find Georgia health insurance plan ratings and comparisons for 2023. Scroll to the bottom to find External Quality Review Organization (EQRO) which lets consumers read about performance of health plans in GA.  Large report using HEDIS measures. Compare quality ratings and member satisfaction scores for Medicaid, Amerigroup, including 360 (Anthem); CareSource, Peach State Health Plan, and GA Families Statewide. Covers asthma care, cancer screening, immunizations, dental visits, ER visits, diabetes care, heart care, prenatal care, 7-day followup after mental health admission, member satisfaction (CAHPS) and more using 2021-2022 performance scores. Other reports are at this website that may have more information. Released in April 2023 by Georgia Dept. of Community Health at dch.georgia.gov

Illinois HMO and Health Insurance Complaints 2020 by Consumers (pdf)

Find HMO and health insurance plan complaints in Illinois for 2020. Click on Consumer Complaint Complaint Ratio Reports to find rate of complaints for health insurance companies. HMO complaints are separate from Individual plans and Group health plan complaints. The worst Group Health complaint ratio for 2020 in plans that had at least 1 million policies in force, was Blue Cross Blue Shield of IL (Health Care Service Corp) (over 6% market share). Blue Cross Blue Shield also had the highest HMO complaint rate.  The most common insurance complaints overall were about claims handling. Complaint record from 2020 is supplied by the Illinois Dept. of Insurance. Updated April 2022.

Indiana Health Insurance Complaint Index 2021

Compare complaint index rates for Indiana health insurance companies (health carriers). Highest (worst) 2021 Health Complaint Index of the 15 largest companies (each with at least $60 million in premium) was for Guardian Life Ins. Co. of America.  Best were Aetna Life Ins. Co. and UnitedHealthcareIns. Co. From IN Department of Insurance. Updated 2023.

Maryland HMO & Health Insurance Plan Ratings 2020-2022

Find the latest Maryland HMO and PPO Health Insurance Plan Ratings. The only plan to get a full 5-star rating was Kaiser Permanente HMO. Compare KP with Aetna HMO and PPO, CareFirst BlueChoice and GHMSI, Cigna, MAMSI PPO, MD-IPA, Optimum Choice and United Healthcare HMO and PPO. Member satisfaction (CAHPS), getting appointments, flu shots, and many clinical measures of care such as Diabetes, breast cancer screening, behavioral health, well child care are some of the measures. Quality scores are 80% of the overall performance rating. Check Consumer Ratings, Clinical Ratings and Provider Network Ratings that make up the total score. Most scores reflect what happened in 2021. They were published in October 2022. Maryland Health Plan guide is by the Maryland Health Care Commission.

Maryland: HealthChoice (Medicaid) Health Plan Ratings

Maryland HealthChoice Medicaid Health Insurance Plan Ratings are shown in this 2022 Report Card for Consumers. Written in English and Spanish. Compare Aetna, Amerigroup Community Care, CareFirst Blue Cross Blue Shield Community Health Plan (formerly University of Maryland Health Partners), JAI Medical Systems, Kaiser Permanente, Maryland Physicians Care, Medstar Family Choice, Priority Partners and United Healthcare. No plans received 3 stars (the best) across the board. Click on Consumer MCO Report, updated 2022.

Minnesota HMO and Health Insurance Plan Ratings

Minnesota HMO and Health Insurance Plan 2021 Ratings. Quality (HEDIS 2020 scores) for HMOs show various quality ratings, but report for each health plan is 166 pages. No side-by-side comparisons available, nor average scores to make it more user friendly. (See NCQA instead). Financial data and enrollment reports also linked. Compare health insurance plan performance for Blue Plus, HealthPartners Group Health Plan (combined), Hennepin Health, Itasca Medical Care, Medica, PreferredOne, Prime West, Sanford, South Country Health Alliance, and UCare. Site by MN Dept. of Health. Data refreshed October 2022.

New York State 2022 HMO Comparisons (Ratings) Editor's Pick

Find the most recent New York statewide HMO comparison ratings. Compare over HMO, PPO or Medicaid managed health insurance plans in NY, including Affinity, CDPHP, Empire Blue Cross Blue Shield, Excellus, Fidelis, HIP (EmblemHealth), Healthfirst, Highmark, Independent Health, MVP, Molina,  UnitedHealthcare, Univera. Topics include member satisfaction, opinions about access, cardiovascular care, diabetes care, mental health, maternal health & much more. Actual scores do not seem to be readily available, as they once were on a statewide report. Regional reports show general star level. Consumers can sort the health plans by highest overall performance (last column on the right). Prepared by the state of New York for 2022, using 2021 member data. health.ny.gov

Rhode Island – Top Ratings for Health Insurance Plans (NCQA)

Find top NCQA ratings for health insurance plans in Rhode Island. No plans earned the top 5.0 rating from NCQA this year. 2022-2023 Ratings. Based on Quality, Member Satisfaction and accreditation results. Five health plans earned 4.5 stars. Updated October 2022.

South Carolina Medicaid Health Insurance Plan Ratings 2023

Find health insurance plan ratings for South Carolina Medicaid, 2023. Compare five South Carolina Medicaid health plan ratings (one to five stars) for Absolute Total Care, First Choice by Select Health of SC, Healthy Blue by BlueChoice of SC, Humana Healthy Horizons, and Molina Healthcare of SC. One total rating only; no detail on specific illnesses, screening, mental health or consumer member satisfaction. No plan received a full 4 stars or 5 stars. South Carolina Healthy Connections Choices are listed at SCchoices.com.

Texas – Compare Texas HMOs 2020-2021 – Consumer Ratings (OPIC)

Compare HMO (Health Maintenance Organization) plans for Central Texas, East Texas, Gulf Coast, North TX, Panhandle/Plains area, South Texas, West Texas regions. TX HMO report cards by OPIC for 2020-2021 show Texas consumer ratings of their health insurance plans and the medical care enrolled members received during 2019. Includes plans covering Austin, Dallas, Ft. Worth, Houston, San Antonio, Abilene, Amarillo, Lubbock, Waco, Corpus Christi and Rio Grande. Satisfaction ratings and market share are shown for Christus (the highest rated plan and the highest rated health care), Blue Cross Blue Shield, Cigna, Humana, Aetna Health, FIRSTCARE, Memorial Hermann, Scott and White Health Plan, Community First and United Healthcare. Report by Texas OPIC (Office of Public Insurance Counsel). No updates as of October 2022.

Texas – Guide to Texas HMO Quality 2020-2021 (OPIC)

The Guide to Texas HMO Quality 2020-2021 shows detailed clinical quality comparisons of HMO health insurance plans.  Compare HMOs Aetna, Christus, Cigna, Community First, FIRSTCARE, HMO Blue Texas, Humana Health Plan, Memorial Hermann, Scott and White, and United Healthcare of Texas. Indicators include asthma, childhood immunizations, cancer screening, heart care, high blood pressure, diabetes care, prenatal care, behavioral health, mental illness care and followup, opioid prescriptions, flu shots, antibiotic utilization rates, rates of physician board certification, and more. Lengthy (226 pages) but valuable report. Published by TX Office of Public Insurance Council. No updates as of October 2022.

Utah HMO and PPO Health Insurance Plan 2022 Ratings

Get Utah HMO and PPO health insurance ratings for 2022. Includes commercial health insurance plans Aetna, Cigna, Humana, Regence Blue Cross Blue Shield, SelectHealth, United Health Care; and Medicaid plans (Health Choice Utah, Healthy U, Molina, SelectHealth Community Care and CHIP Molina, CHIP SelectHealth) on on antidepressant medications, back pain, cancer screening, and high blood pressure; diabetes, prenatal & maternity, preventive care, well-child visits & immunizations, and more. Additional information for Medicaid plans on dental visits and mental health followup care. Shows actual performance rates. Quality Measures Performance Report uses 2020 data. By utah.gov Office of Healthcare Statistics, January 2022.

Utah Member Satisfaction Ratings with Health Insurance Plans (CAHPS)

Utah Member Satisfaction ratings with their health insurance plans. Compare ratings among commercial health plans (medical), dental plans, Medicaid plans. Adult and Child Results in separate reports. CAHPS (Consumer Assessment of Healthcare Providers and Systems) survey data from Utah Department of Health Office of Health Care Statistics. Consumers were asked to rate both the health plan, and the health care (and their doctors). Survey also measures satisfaction with doctor, communication, quality of care, how quickly you can get an appointment, and more. Some of the more highly rated plans were Deseret Mutual, PEHP, Tall Tree, Regence (for children’s health plans), SelectHealth Medicaid, Healthy U Medicaid, Steward Health Choice, and Molina CHIP for kids. Results were updated October 2020. No updates as of Nov. 2022.

Vermont – Compare Health Insurance Plan Ratings

Compare Health Insurance plan ratings in Vermont, based on 2021 services. View number of denials, service problems, complaints and grievances on Blue Cross Blue Shield of VT (6.7% claims denial rate), Cigna (8.5% denial rate) and MVP Health Plan (17.1% claims denial rate). Each plan’s report is separate for the year. Act 152 Health Insurer Annual Reports for 2021 were filed with the Vermont Dept of Financial Regulation in 2022.

Virginia – Compare HMOs (Quality and Satisfaction)

Compare Virginia HMOs on both quality and member satisfaction. Easy to use tool to compare insurance plan ratings: Aetna, CareFirst BlueChoice, Coventry Health Care, HealthKeepers (both Peninsula and Priority), Innovation Health Plan, Kaiser Mid-Atlantic, Optima, Optimum Choice, United Healthcare MidAtlantic and River Valley. Choose measures for access, asthma, ADHD, cancer screening, heart, diabetes, immunizations, medications including opioid prescribing, mental health care (e.g., best results for 7-day follow-up after a Mental Health ER visit is Kaiser foundation Health Plan at 54%, compared to Optimum Choice at just 36%), preventive care, spirometry for COPD, prenatal, maternity and newborn care; weight assessment, well child visits and childhood illnesses, member satisfaction for 2020 and more. Also includes number of physicians, number of enrollees, and financial data. Updated February 2022.

WA Clinic and Health Plan Quality Ratings (WACommunityCheckup.org)

Find WA clinic and health plan quality ratings reported at WACommunityCheckup.org. Compare care among nearly 2000 clinics in Washington state. See report called Improving Health Care in Washington State.  Scroll to Quality Composite Scores to see Medical Group or clinic rankings. Highest rated for 2022 were Virginia Mason, Kaiser Permanente Washington, University of Washington Medical Center, and Swedish Medical Group for Commercially insured patients. Evergreen Health Medical Group, MultiCare Rockwood, and Confluence Health Central were highest for Medicaid patients. Other groups include The Polyclinic, UW Physicians, UW Neighborhood Clinics, Northwest Physicians Network, PeaceHealth Medical Group, Cancer Care Northwest, Columbia Medical Associates, Family Care Network, Harborview, Pacific Medical Centers, The Everett Clinic, Memorial Physicians, International Community Health Services, Yakima Valley Farm Workers Clinic and hundreds of others. Details are listed under “Organization Detail” in the pop-up for each clinic. Scores and rankings for health insurance plans may be found in older reports. Community Checkup 2021 report uses 2020 data. The report by Washington Health Alliance was published in March 2022.

Washington – Health Insurance Plan Complaints 2021

Look up and compare numbers of health insurance plan complaints in Washington for 2021. View one company at a time. Aetna, Kaiser Northwest, Options, Coordinated Care, Delta Dental, Kaiser Foundation Health Plan of Washington (HMO), UnitedHealthcare, Regence BlueShield, Regence Blue Cross, Premera Blue Cross, Moda, Lifewise, Molina, Asuris Northwest, Bridgespan Health and more. Select Company Search tab, then Coverage Type Health, Active only, to see a long list of more than 700 health plan companies. Market Share also shown. Washington State Office of Insurance Commissioner OIC

Wisconsin – HMO, Health Plan and Medicare Supplement Grievance Report

Find Wisconsin number and rates of grievances in 2022 for WI HMOs, health plans, and Medicare Supplement plans. A grievance is a written complaint. Online tool shows report for every licensed health insurance plan and HMO plan. Examples included Aspirus, Compcare, Dean, Group Health Coop, Health Traditions, Humana, Medica, MercyCare HMO, Molina, Network, Quartz, Security, UnitedHealthcare, WEA, WPS and more. Medicare Supplement plan grievances for Aetna, American Family, Blue Cross, Cigna, Genworth, Golden Rule, UnitedHealthCare, Thrivent, and more. Be sure to click on the HMO tab or PPO to see your health plan. HMO and PPO Complaints went up in 2022. Complaints on Medicare Supplement plans were down. Delta Dental insurance complaints are also counted here. Updated May 2023 by State of WI, OCI (Office of the Commissioner of Insurance).

New Jersey HMO and PPO Performance Report – Compare plans

Compare six New Jersey health insurance companies (HMO/POS and PPO/EPO health insurance plans). Performance reports from Aetna, AmeriHealth, CIGNA, Horizon, Oxford and United, on quality ratings related to asthma, COPD, cancer screening, heart care, hypertension, diabetes, new moms, immunizations, strep tests, mental health medication and followup; frequency of imaging tests for lower back pain, cardiac cath and tonsillectomies; well child care, more. Easy to read. 2018 report published by NJ Dept. of Banking and Insurance, June 2019. No updates as of mid-October 2022. However, recent enrollment in each health plan is provided through 2021. Quarterly enrollment reports available.

Other Helpful Listings

Accredited Ambulatory Health Care and Surgery Centers (AAAHC)

Find an accredited ambulatory health care facility or surgery center.  AAAHC, the Accreditation Association for Ambulatory Health Care is a nonprofit that currently accredits over 6,600 organizations in a wide variety of ambulatory health care settings, including ambulatory and office based outpatient surgery centers, community health centers, dental clinics, endoscopy centers, lithotripsy centers, some managed health plans, medical group practices, retail clinics, urgent care centers, specialty services, and workplace clinics.  (See also Joint Commission website for hospital-owned ambulatory surgery center accreditation.)

Government Employee 2024 Health Insurance Plan Cost Comparisons (FEHB) Editor's Pick

Health insurance plan cost comparisons in 2024 for Federal government employees. Compare the benefits, member satisfaction, and employee costs for all plans at once. Consumers can also select 3 health insurance plans at one time to see out of network benefits. Web site for Federal Employees Health Benefits (FEHB) Program is from US Office of Personnel Management (OPM). Enrollee premium, deductible, copays and maximum out of pocket costs are shown. Search by zip code; choose local plans and/or national plans. Convenient and current for 2024. Helpful to federal employees and others. The amount that taxpayers and government institutions pay toward the total health care premiums is no longer available, as it was a few years ago.

URAC – searchable database of accredited and certified healthcare organizations

Search the URAC database of accredited and certified healthcare organizations. URAC is a nonprofit organization that performs accreditation and certification work. Its many accreditation programs include, among others, Specialty Pharmacy Accreditation, Pharmacy Benefit Management, Mail Service Pharmacy, Case Management, Health Call Centers, Health Utilization Management and Review, Telehealth, Telemedicine and Workers Compensation Management. This site may help employers determine which companies they want to consider as service providers. In addition, a few health insurance plans have also sought health plan accreditation from URAC. Unfortunately, the search is overly complex for some services.

Wisconsin Health Insurance Cost Rankings 2018

Annual premiums and deductibles (2018) for employee health insurance in various metro markets averaged $10,043 per year for single coverage. Citizen Action of Wisconsin, a coalition of individuals and organizations (such as AFSCME locals, AFL-CIO, WEAC, WI Farmers Union), reports health insurance cost in 18 metro regions, including Twin Cities. Rates in Eau Claire ($10,908 per yr, single) were 20% higher than Madison rates ($9,096 per yr.) Most areas exceeded $10,000 single. Health plan costs shown for Twin Cities, Oshkosh, Green Bay, Appleton, Manitowoc, Sheboygan, Fond du Lac, Janesville/Beloit, Wausau, Stevens Point, La Crosse, Superior, Eau Claire, Kenosha, Racine, Milwaukee, Dubuque, more. Uniform benefits package was used for all areas, however the report does not specify what type of benefits and deductibles were included. The report also does not indicate whether the rates were adjusted for regional differences in age, or healthy behaviors. Shows annual inflation pre-ACA (2000 to 2013) compared to after ACA (2014-2018), with post-ACA so very much lower. However, this summary can be misleading. In 2018, large group rates went down 5%, while individual inflation was up 51% (up 60% in Madison, doubled in Green Bay), and small group inflation was 10% compared to 2017. Large Group information reflects government employee rate paid by State of Wisconsin’s Group Health Insurance Program (GHIP). Published December 2017.

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