our effort to make plan-shopping easier for people who need to get
their own individual or family coverage directly from an insurer or
broker. To rate health plans marketed directly to individuals and
families, U.S. News tapped into a newly available federal database
containing information provided by hundreds of insurance companies about
thousands of individual plans. We have distilled the data and put it
into an easy-to-use online tool that can help you pick the plan that's
right for you and your family by comparing it with others on a range of
costs and covered services.
We measured each plan's coverage against 10 categories of health
benefits deemed essential by such leading institutions as the Institute
of Medicine and adopted as part of the Affordable Care Act, which was
upheld by the Supreme Court in July. You can think of Best Health
Insurance Plans as a national prototype for the state health insurance
exchanges that are scheduled to go into effect in 2014 under the
Affordable Care Act. Our goal is to help you obtain affordable coverage
for the services you need and limit your exposure to expenses you can't
anticipate. Read more in our buyers guide.
Here's how to use this site:
Step 1. Make sure the information is relevant to you. We
only provide information on plans sold by health insurers to individuals
and families. You should use our ratings if you're self-employed or
working for a firm that doesn't offer health plans, if you don't belong
to organizations that offer health coverage to their members, and if
you're not eligible for Medicaid or Medicare coverage.
Step 2. Decide how you want to browse the plans. We've
provided several entry points for the health plan ratings. You can go
right to a personalized search by filling in the blanks in the blue box
near the top of this page. Or if you want a broad panorama of available plans, you can view ratings for plans in your state. Again, start at this page.
Step 3. Scan our listing of plans or your search results.
We've rated plans for individuals and families based on scope of
coverage, giving five stars to plans that cover the broadest range of
essential benefits: prescriptions, emergency care, hospital care,
outpatient care, mental health, substance abuse, maternity,
rehabilitation and habilitation, and certain kinds of pediatric care.
These ratings give you an at-a-glance assessment of the completeness of a
plan's benefits. We also give plans higher marks if they have fewer
hidden costs. For instance, some plans exclude certain charges from the
stated out-of-pocket limit, meaning that you could very well pay much
more than you might think.
Step 4. Try to anticipate the impact of a worst-case
scenario. The whole point of health insurance is to protect against the
kinds of crushing medical costs that can dump families into bankruptcy.
Charges for knee replacement can easily top $40,000; for an
uncomplicated heart bypass operation, $100,000. When choosing any plan,
consider the extent to which it covers the high costs of major
procedures and catastropic illnesses that might require a long hospital
stay. Your medical needs are unique, as is your tolerance for risk and
your budget. U.S. News & World Report's Best Health Insurance Plans
can help you deal with the sheer number of health care plans available,
and help you make an informed buying decision.
Step 5. Consider a plan's potential total cost—monthly
premium plus deductibles, copayment, and coinsurance. We didn't factor
premium amounts into our star ratings. Instead, you can quickly see how a
plan's premium stacks up against that of other plans—we've calculated
each plan's real-world monthly premiums for an average person and put
the plan's premium on a scale of one to five dollar signs from lowest-
to highest-cost. Our star ratings for coverage include an assessment of
each plan's cost-sharing provisions—how much you pay out of pocket
through copays (flat dollar amounts) and coinsurance (percentages of
charges). Coinsurance can be especially costly, because it can range up
to 50 percent or more of the price of an expensive procedure.
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