HealthPocket Personal Score

Too many Americans overpay for health insurance and still don’t get the plan that’s best for them. Selecting the right health plan is an important decision and shouldn’t be based solely on how much you pay for a monthly premium. You need access to three things rolled into one plan: quality medical services, low out-of-pocket healthcare costs and good customer service.

Our Personal Score is unique in the healthcare market. It combines a plan’s quality ratings from unbiased government and nonprofit data along with our own analysis of a plan’s financial value. The HealthPocket Personal Score examines a variety of factors including clinical quality measures on treatment and preventative care, premiums and cost-sharing (e.g. deductibles, co-pays), and customer satisfaction.

HealthPocket uses this information to personalize rankings based on the health plans available in your area. We believe this personalization is important since people typically don’t care about a national ranking of health plans but rather a comparative ranking of the plans available in their area.

Our Personal Score is a ranking from 1 to 10. The higher the score, the better the plan. By comparing Personal Scores, people often learn that plans with similar premiums can have very different quality as well as the most expensive plan is not necessarily the best plan.

A plan will receive an NR Rating (“Not Rated”) if the health plan does not report its clinical quality and customer satisfaction data or if that information was not made public through the government and non-profit entities we examine.

To see the Personal Score in action, use our Individual & Family Health Insurance Tool and Medicare Insurance Tool.

Individual & Family Health Plan Personal Scores

Personal Scores for individual & family health plans follow HealthPocket’s quality/cost/satisfaction methodology and examines factors such as:

  • Clinical quality measures on treatment and preventative care
  • Consumer satisfaction with plan services & physicians
  • Financial considerations (e.g. premiums, deductibles, drug co-pays, etc.)
  • Application rejection rate (% of applicants rejected by a health plan
  • Premium increase rate (% of applicants who are offered a costlier premium than initially quoted)

Medicare Personal Scores

Personal Scores for Medicare insurance plans also adhere to HealthPocket’s methodology of combining performance on quality medical services, out-of-pocket costs, and customer satisfaction and review issues such as:

  • Clinical quality measures on treatment and preventative care
  • Consumer satisfaction with plan services & physicians
  • Personal ratings from the Centers for Medicare & Medicaid Services
  • Financial considerations (e.g. premiums, deductibles, drug co-pays, etc.)

When a person enters medications, the personal score is adjusted for local plans to reflect changes in these plans’ total out-of-pocket expenses (including drug copays) and their relative ranking among one another.

Small Business Personal Scores

Personal Scores for small business health plans follow HealthPocket’s quality/cost/satisfaction methodology and examines factors such as:

  • Clinical quality measures on treatment and preventative care
  • Consumer satisfaction with plan services & physicians
  • Financial considerations (e.g. premiums, deductibles, drug co-pays, etc.)
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