How to Evaluate Health Insurance Companies
Finding a health policy that meets your cost requirements and coverage needs is a difficult task, but, sorry to say, the work doesn't quite stop there. To ensure the best care, it's extremely wise to evaluate both the company and its affiliate health care network.
Lists three important criteria for evaluating health insurance companies
Suggests sources for paid consumer information about health policies
Explains how you can get much of this information for free!
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There are at least three distinct areas that you'll want to investigate when researching your prospective health insurance company:
the insurer's financial rating
the quality of health care the company provides
the insurance company's overall customer-satisfaction rating
Let's explore each of these topics, one by one:
A company's financial rating
One crucial measure of any health insurance company is its financial reputation. This is easy to research with free resources like Moody's, A.M. Best and Weiss, all of which publish health insurance company ratings and other information.
eHealthInsurance, an excellent and extensive online health insurance marketplace, will give you health insurance company ratings right up front, before you apply. (At some point you should read more about their many health insurance providers.)
Quality of care under a particular policy
What could be more important than the quality of care you receive? Under an indemnity insurance plan, you select your doctor, so if you are not satisfied with the quality of health care you are receiving, it is easy to switch physicians.
Under a managed care health policy, however, the network of doctors you'll be working with is pre-selected. Trusting the physicians in this network and feeling confident about the care you'll be receiving is paramount.
Checking the employment and educational histories of the network's doctors is an important test of the managed care network's commitment to quality health care. The American Medical Association provides information about every physician employed in the USA. The Directory of Medical Specialists, which can be found at your local library, also has information about doctors in the US. Use these free resources to your advantage. (More sources of information to take advantage of are explained a little later on.)
How quickly and efficiently health insurance companies respond to patients' requests and questions is very important.
You'll be in contact with your insurer often enough that good communication can make a huge difference concerning your satisfaction with that company.
Though it is problematic to gague your satisfaction with an insurance company and/or network before you actually purchase your policy, you can still get a sense by calling the health insurance company's customer service representative with a question.
Does it take them long to answer your question? Are you put on hold? If you request information to be sent to you, how long does it take?
You can also try to "test" commitment to satisfaction. Ask a health insurance company representative if you can switch primary care physicians mid policy year? If not, they may be inflexible about other personal concerns and indifferent about your health care needs.
Unfortunately, while financial information about a health insurance company is fairly easy to come by, specific measures of patient satisfaction with a particular health policy are not. You'll probably have to pay for this information.
Consumer Check or Consumer Reports both offer heath insurance company and health policy evaluations for a fee. We recommend applying for a couple of health plans, seeing what fits your budget (and your care needs), then checking them against each other using a paid service.
You can also do your own research into which companies and plans are better for you, by using the questions we provide in our guide to the various types of health plans. This will take some work, but it will help you learn first-hand how health insurance companies differ.
But there is another, easier way:
eHealthInsurance will give the financial rating on all its affiliated health insurance companies when you request a free quote. Choose a policy (or 2 or 3!), apply online, and compare the policy satisfaction numbers once you're approved.
Next: 10 Essential services your policy should not be without