Welcome to Best Health Insurance Plans, 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.
The following articles will help walk you through the steps:
8 Keys to Picking the Best Individual Health Insurance Policy. Your odds of making the right choice increase if you keep a few basics in mind. A little homework may save you thousands and help you get the care you need.