Understanding the Rating Systems for Health Insurance in Houston TX

by | Dec 30, 2015 | Insurance


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When a health insurance company receives a rating, the result that is displayed is based on calculations and data that has been gathered from the rating service. One of the most common of these is the National Committee for Quality Assurance, or NCQA. This is a nonprofit group that is responsible for developing quality measurements and then provides accreditations for various providers of Health Insurance in Houston TX, doctors and other types of organizations.

The factors that various health insurance companies are rated on include the quality of care that is provided, overall customer satisfaction and the commitment to improving their services and the disclosure of health-related information.

How to Get Health Insurance Ratings

Ratings are available for all types of Health Insurance in Houston TX, including public, private and even government plans such as Medicaid and Medicare. In order to determine the particular rating for a health insurance plan across the nation, searchers can utilize an online tool. These tools generally work with the following steps:

• Select a plan category: Medicare HMO or PPO; Private PPO or HMO.

• Select the state.

• Customize the search for comparing the plans’ scores and the performance regarding offerings of preventive services and consumer satisfaction.

Types of Health Insurance Plans that are Rated

The health plans are ranked in three different categories:

• The HMOs that serve Medicaid beneficiaries.

• PPOs and HMOs serving Medicaid beneficiaries who enrolled in Medicare Advantage.

• Private PPOs and HMOs people enroll in from their work place.

Why Would Plans not be Rated?

There are three primary reasons that someone may not see their Health Insurance in Houston TX plan listed. Not all plans will submit data to each rating service. There are some that don’t make results of the ratings public. And there are some plans that do not have sufficient data to make any valid type of statistical comparison.

How Ratings Help in Purchasing Insurance

When the ratings are available, those purchasing insurance will be able to see the track record based on the criteria highlighted above. The ratings of these plans will let shoppers know the overall quality of service offered by certain insurance plans.

Choosing a health care plan with a higher score, will let customers know they are purchasing a higher quality plan. These plans are typically more flexible and offer excellent customer.

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