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HPOne Launches Stars Solutions for Medicare Managed Care Plans

Posted on : June 30, 2015 | By : HealthPlanOne | In : Press Releases

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  • Modular program enables Medicare insurers to tailor Stars initiatives to address unique member and physician opportunities
  • Member engagement and data integration key to improving care, goal of CMS Stars ratings

TRUMBULL, Conn. (June 30, 2015) – HPOne today announced the availability of its Stars Solutions program which supports Medicare Advantage plans as they strive to improve their quality of care, as reflected in their CMS Star Ratings.

“The HPOne program enables executives at Medicare Advantage plans to close care gaps and improve medication adherence, leading to an improvement in their performance relative to Star Ratings,” said Bill Stapleton, founder and CEO of HPOne. “We are committed to helping insurers achieve performance improvements, and our pricing takes into account whether our clients have improved their targeted Star measures relative to CMS cut points.”

The HPOne solution is unique because it centers on a connection with the health plan member, backed by state of the art technology in data analytics and CRM. HPOne-trained Care Coordinators reach out to members in targeted outreach campaigns, helping members to make appointments for necessary screenings and tests and to adhere to prescribed medications.  Through partnerships with leading data analytics firms, HPOne works with health plan clients to create accurate patient call lists with a full complement of information to facilitate dialogue. HPOne’s state of the art CRM system enables Care Coordinators to record key information at the point of contact, such as the catalyst for care.

Underlying the effectiveness of the program is HPOne’s expertise in working with members over the phone. In 2014 the company handled over 500,000 calls, from helping seniors navigate the often complicated process of choosing the right health plan to onboarding and retention calls on behalf of national and regional carriers. Through its comprehensive Secret Shopper program, the company assists health plans in configuring their call center operations to achieve 5 Star performance relative to the Centers for Medicare and Medicaid Services (CMS) guidelines for call center performance.

HPOne’s Stars Solutions helps insurers address the key factors that CMS uses to determine Star ratings for insurers’ Medicare plans. The company creates a customized approach for each client, focusing on data analytics, consumer outreach and outcomes intelligence.

  • Four customizable modules of Stars Measures – Insurers can utilize a combination of the following for targeted outreach campaigns to their members:  preventive and screening (including flu vaccines and breast cancer screenings); diabetes (including medication adherence and blood sugar control); member experience (access to care and customer service); and pharmacy (high risk medication and prescription adherence).
  • Member- and patient-focused outreach – While outbound calling is at the core of its outreach programs, HPOne uses a full complement of outreach media and methods including phone and email campaigns, direct mail, and text messaging and can augment the contact strategy with carrier-specific incentives for targeted populations.
  • Care coordination – HPOne provides insurers with the level of support they need to help their members get access to high quality, effective care by addressing both individual barriers to care as well as working with physicians practice groups whose members are not meeting care guidelines.
  • Outcomes analysis – Weekly outcomes reporting keeps insurers up to date on their progress towards established goals for specific Star measures.  The HPOne program also uses the opportunity of member interactions to create robust member profiles, laying the groundwork for improving the overall quality of care across multiple Star measures.

For more information on HPOne’s Stars Solutions, visit http://www.healthplanone.com/stars-solutions.aspx.

About HPOne
Founded in 2006, HPOne is a leading sales and marketing organization that operates across multiple segments of the Medicare and health insurance marketplaces. Using proprietary technology solutions coupled with deep industry knowledge, the company provides a range of outsourced sales, marketing and contact services for national and regional health plans, operates private exchanges for individual consumers  and employer-based group retirees, and manages the largest exclusive Medicare lead generation marketplace in the industry. HPOne’s core differentiation is our exclusive focus on the health insurance industry, bringing innovative and performance-based solutions that address the most pressing challenges facing our clients.  With four state-of-the-art contact centers around the country and a management team with an average of over 15 years in the health insurance industry, HPOne provides our clients with the solutions they need to profitably grow and manage their business. For more information, visit www.HPOne.com

Compare Plans Shopping for Health Insurance

Posted on : December 1, 2014 | By : HealthPlanOne | In : Health Insurance

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Everyone knows the importance of having health insurance, but are you still going about it the old-fashioned way? Comparison shopping is essential because not all health plans are the same. The benefits, costs, and quality of care differ depending on the plan, and each health insurer will offer different plans with varying costs and benefits. For instance, plan A may have a higher deductible than plan B.

Common Terms

There are, of course, some basic guidelines and terms you must know when comparison shopping for health plans. We have picked a few of the most important from dozens of choices:

  • HMO: A health management organization is a plan that gives you coverage within a certain network of doctors. Generally, you choose a primary care physician (PCP) who is your regular doctor and also issues referrals to specialists. If you don’t see a PCP that is part of the HMO network, you will probably have to pay for the treatment yourself.
  • PPO: A preferred provider organization is a network of physicians and specialists who have pre-agreed rates with your insurer. A PPO plan usually costs more than an HMO, but you get a greater level of flexibility.
  • Deductible: In most plans, you will not receive any help from your insurer until you have contributed a certain amount towards your medical treatment each year. This is known as a deductible, and the more you agree to pay, the lower your insurance premium will be.
  • Copayment: A copayment is the amount you are required to spend for each visit to a doctor. The sum is usually $10 to $50 depending on the type of plan you choose.
  • COBRA: This is a government plan that enables you to leave your job but continue using your employer’s health plan for up to 18 months after you stop working at the company. However, you have to pay the full amount of the plan yourself without your employer’s contributions.

Things to Consider

  • Your Medical History: Do you have pre-existing medical conditions? Do you take prescription medicine, etc?
  • Family Coverage: What are your family’s medical needs, and are you covered by your spouse or an employer plan?
  • How Does Your Existing Coverage Compare to Old/New Coverage? If you switch coverage, you may have to switch your PCP or prescriptions.

Information You Will Need

For a quick quote, have the following personal information on hand:

  • Full name
  • Gender
  • Date of birth
  • Address
  • City, county, and state of residence
  • ZIP code
  • Email address
  • Daytime phone number
  • Estimated household annual income
  • Desired date for start of coverage

The Health Plan One comparison service allows you to compare the prices of thousands of health plans in your area. As you can quickly narrow down your choice, be sure to crunch those numbers to see if you are getting more for your money. A health savings account (HSA) may also be worth considering, as it could alleviate some of your extra costs.

The era of spending days and weeks agonizing over your health insurance plan is long gone. Use the Health Plan One comparison tool to zero in on the best plan for you and your loved ones.

HealthPlanOne Celebrates Being Named in the Deloitte Technology Fast 500 for the Fourth Consecutive Year

Posted on : November 21, 2014 | By : HealthPlanOne | In : Miscellaneous

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Deloitte 2014: Technology Fast 500
HealthPlanOne has been named to the Deloitte Technology Fast 500 list for 2014, and its Number 159 ranking makes it the fourth year in succession that the cutting-edge health insurance agency has been placed in this exclusive ranking of North America’s 500 fastest-growing media, life sciences, telecommunications, technology, and clean technology companies. This year’s placing is a further improvement over last year’s ranking of 166, a clear sign of the company’s increased growth.

A Company on the Up

This great news comes hot on the heels of a series of other positive announcements regarding HealthPlanOne. In September, the company was ranked in the prestigious Inc. magazine 500/5000 List, which also rates America’s fastest-growing companies. This is hardly a surprise, however, given HealthPlanOne’s growth since 2010. In the 2010-2013 period, the company has enjoyed a revenue leap of 222 percent while adding 200 jobs. The Inc. honor was also the fourth year in a row for HealthPlanOne.

In 2012, HealthPlanOne surpassed all expectations by reaching the Number 49 spot in the Fast 500 list, as it recorded an extraordinary 2,838 percent growth for the year. In 2013, its Number 166 spot was the result of 679 percent growth, and this year it enjoyed an identical level of growth but moved up seven spots. This, along with the multitude of accolades the company has enjoyed recently, is proof that it’s a business with a bright long-term future.


The CEO of HealthPlanOne, Bill Stapleton, said “We’re honored to once again be recognized on this prestigious list of companies. This achievement reflects the success our health plan clients experience when they partner with HPO. Our innovative solutions reduce the cost of acquiring new members while providing a superior customer experience.”

Continued Growth

The Fast 500 and Inc. 500/5000 lists released this year are among the most competitive in history. The fact that HealthPlanOne not only held its own but actually improved its ranking speaks volumes for the company’s strength. 2014 has been another great year for the company, as it continued to branch out across the United States.

In July, HealthPlanOne announced plans to open a new location in Phoenix, Arizona. It is to be a new sales center that supports the needs of its growing health exchange operations along with its increasing number of health insurance agents and staff.

If HealthPlanOne continues on this path, expect to see it ranking even higher in the Fast 500 in 2015; keep your eyes peeled!

View Deloitte’s 2014 Technology Fast 500 (pdf)

View HPO’s Official News Release

Health Insurance Term Glossary – Health Plan One

Posted on : October 14, 2014 | By : HealthPlanOne | In : Health Insurance

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Access: Refers to the availability of medical care. The quality of any individual’s access is determined by transportation options, location, and the medical facilities available in the area.

Mike was not happy with the lack of access he had to medical care, as the nearest physician was 20 miles away.

Allowed Amount: Also known as allowable charge, maximum allowable, or approved charge, this is the maximum amount that a patient’s payment is based on when it comes to covered health care services. When patients are sick and their health care provider charges more than the allowed amount, the patient must pay the difference. Otherwise, the doctor may have to accept the lower amount, and the rest is deemed to be a “provider write-off”.

Jane was charged $110 by the doctor. However, the doctor had to accept the allowed amount of $80, as he was a member of the health insurance company’s approved list of providers.

Alternative Medicine: A form of treatment that is not generally recognized by the wider medical community. It includes a wide range of practices and services, including homeopathy, acupuncture, and aromatherapy. A lot of health insurance companies will not provide coverage for these kinds of services.

Karen wanted to try alternative medicine to treat her pain but was dismayed to find her insurer would not cover the cost.


Balance Billing: When a provider charges a patient for the difference between the allowed amount and his overall charge. Preferred providers are not allowed to bill in this manner.

The patient was not happy that the physician decided to engage in the practice of balance billing. The allowed amount was $60, but the doctor’s fee was $90, so the patient had to pay the remaining $30 out of his pocket.

Broker: In health insurance terms, a broker works to match applicants with suitable health insurance companies or plans. The insurance company pays a commission to the broker, but the broker represents the patient rather than the insurer.

The broker worked hard to ensure his client received the best-value health insurance provider.


COBRA: This is federal legislation that enables employees or their dependents to keep their group health insurance through the health plan of their employer at their own expense. COBRA stands for Consolidated Omnibus Budget Reconciliation Act and can be extended to 18 months in some cases. COBRA rules normally apply when an employee loses his/her coverage either through loss of employment or a reduction in working hours.

Ann did not receive COBRA coverage after she lost her job because she was fired for gross

Chronic Disease Management: An approach to managing the illnesses of patients, which includes check-ups, screenings, monitoring, patient education, and coordinating treatment. It is possible to improve your quality of life while reducing health care costs if you have a chronic illness by minimizing or reducing its effects.

Chronic disease management worked well for the patient, as he felt less pain and saw a reduction in his medical bills.

Coinsurance: A patient’s share of a covered health care service that is calculated by a percentage of the allowed amount of a service. For instance, if a plan’s allowed amount is $120 and the patient has met his or her deductible, a coinsurance payment of 30 percent would be $36, and the health insurance plan would meet the other $84.

Alan’s health insurance company covered 80 percent of the allowed amount for a service, so he was forced to pay the other 20 percent as coinsurance.

Co-Payment: This is a specific charge a health insurance plan may require a client to pay for a certain medical service or supply.

The patient was liable for a $20 co-payment for a brand-name prescription drug, and his insurance company paid the rest of the cost.


Deductible: A certain dollar amount a health insurance company may ask its client to pay out of pocket each year before the company begins to pay out for claims. Not all health insurance plans require payment of a deductible; HMO plans generally don’t require one, but the majority of PPO and indemnity plans do.

The patient’s health insurance plan had a $1,500 deductible, so he was responsible for paying the first $1,500 towards the cost of his health care services.

Dependent Coverage: Refers to insurance coverage for the policyholder’s family, such as children, partners, or spouses.

Zoe was happy to have dependant coverage because it ensured her children were also protected.

Drug Formulary: A list of prescription medicines that are covered under a health insurance plan. These pharmaceutical drugs are carefully chosen based on their cost-effectiveness, efficacy, and safety.

Doug chose this specific health insurance plan because its drug formulary contained a medication he needed to treat his illness effectively.


Eligibility Requirements: A set of requirements that dictates whether or not patients are deemed to be eligible for insurance coverage.

The patient was concerned about the eligibility requirements and was relieved to be accepted.

Enrollment Period: The period of time during which eligible persons can sign up for a group health insurance plan.

Eric knew he had to sign up quickly because the enrollment period was almost coming to an end.

Extension of Benefits: Some health insurance plans have this provision, which allows you to extend the coverage beyond the scheduled date of termination. This extended coverage is normally only granted when the individual is hospitalized or disabled as of the termination date, and it will only continue until the patient either leaves the hospital or goes back to work.

Carl was hospitalized with a serious illness and was relieved to know the extension of benefits covered him until he went home.


Flexible Spending Account (FSA): An employer normally sets up an FSA through its health insurance plan. It allows employees to set aside money for dependent care and normal medical costs. All FSA funds must be used by the end of the annual term.

The employee’s Flexible Spending Account had qualified costs such as physical rehabilitation, vaccines, and medical tests like x-rays and screenings.


Generic Drug: A drug that is the same as a brand-name prescription drug but can be produced once the patent on the brand-name drug has expired. Generic drugs are generally far cheaper than brand-name ones.

Patients benefitted from the generic drug because it had the same impact on their health and was far less expensive.

Grace Period: A period of time after the due date of a payment where the policyholder can make payment without penalty and his/her insurance coverage remains in force.

As the grace period was coming to an end, it was important for the patient to make the payment as soon as possible.

Grandfathered Plan: Refers to health insurance coverage that existed on March 23, 2010, and is only subject to certain PPACA provisions. Policies sold in the individual health insurance market after that date are not grandfathered regardless of whether the product was on sale prior to that date.

The patient had a grandfathered plan that was exempt from many of the changes required under the new Affordable Care Act.


HIPAA: Stands for Health Insurance Portability and Accountability Act, and it offers citizens a greater level of protection than they would have under state law. It mandates specific privacy practices and laws for health insurance companies and medical care providers and is designed to protect the identity and privacy of health care consumers. It can even help them retain or obtain health insurance under certain circumstances.

As Will was a HIPAA-eligible individual, he enjoyed a higher level of protection than he was entitled to under state law alone.

Health Maintenance Organization (HMO): HMO plans offer health care services to customers but will only cover them as long as they choose an approved primary care provider (PCP). This doctor will provide most of their health care services and will refer them to HMO-approved specialists as and when needed. Unless it is an emergency, patients will not be covered for any care services obtained from a non-HMO-approved source.

The patient made a mistake and received health care from a non-HMO-approved physician, so she was forced to pay the costs out of pocket.

Health Savings Account (HSA): This is a medical savings account that is available for taxpayers enrolled in a high-deductible health plan. At the time of deposit, funds contributed to the account are not subject to federal income tax. The aforementioned funds must be used to pay for qualified medical expenses, but if HSA funds are not spent during the year, they are rolled over to the next year.

Alex wanted a Health Savings Account because he was looking to save for future medical costs.

Hospice Care: Refers to care provided on an inpatient basis or in the home of someone who is terminally ill. It is also known as supportive care and focuses on managing pain and discomfort while also providing patients and their families with emotional support.

The patient wanted hospice care in the home because she wanted access to her loved ones as often as possible.


Individual Health Insurance Policy: A policy for people who don’t have employment-based coverage. These policies are regulated according to the laws of the patient’s state.

As Lisa was not part of any work-related plan, she decided to buy an individual health insurance policy to give her the protection she needed.

Inpatient: Describes an individual who has been admitted to a hospital for a minimum of 24 hours. It also refers to the care received in a hospital once the duration of the stay exceeds 24 hours.

The nature of the condition meant Bill had to use inpatient services.


Job-Based Health Plan: Health insurance offered to an employee by his employer. This insurance normally covers the policyholder’s dependants as well.

Karen was happy to have the security of a job-based health plan for her and her family.


Lifetime Limit: A cap on the amount of lifetime benefits a policyholder may receive from their health insurance provider. For example, an insurer may set this limit at $2 million or look at specific benefit limits, such as a $250,000 cap on organ transplants. Once this lifetime limit is reached, the insurance plan no longer covers the specified services.

The patient was happy that the total expenses incurred left her a long way short of her lifetime limit.


Medicaid: A health program that is administered by the state and benefits disabled people, low-income families, and a select group of other eligible individuals.

Barbara and her family were in the low-income bracket and were eligible for Medicaid.

Medically Necessary: Health care services or supplies that are deemed necessary in order to successfully diagnose or treat a medical condition, illness, or injury. These practices or supplies must meet accepted medical standards.

The doctor decided the procedure was medically necessary to help treat the patient’s illness.

Medicare: A federally administered health insurance program that is available nationwide and was implemented in 1965. It covers the cost of hospitalization, medical care, and related medical services for individuals either over the age of 65 or those with certain disabilities who have not yet turned 65.

Richard was eligible for Medicare, as it was his 65th birthday last week.

Minimum Value: A health plan meets the minimum value standard if it is designed to cover no less than 60 percent of the total cost of medical services for the general population. From 2014, those who are offered an affordable employer-sponsored health plan that provides minimum value will be ineligible for premium tax credits.

The customer was angry because his health plan appeared to fall short of minimum value.


Network Plan: This is a variation of a PPO plan. A network plan requires policyholders to get their medical care from physicians and doctors within the insurer’s network if they wish to receive the highest amount of money from their claims. Services provided by medical care experts or hospitals outside the network may not be covered.

The customer decided that the network plan was too inconvenient and rejected it.

Non-Preferred Provider: Refers to a provider of medical services who doesn’t have a contract with the patient’s insurer. It will be necessary to pay more money to see a non-preferred provider.

The patient was not happy with the approved medical care provider, so she chose a non-preferred provider instead.


Office Visit: An outpatient visit to a physician or dentist for medical care. Also refers to the amount paid for this treatment. For those who have a 30 percent deductible on their policy and an office visit costs $100, they pay $30 and the insurer pays the rest.

Keith chose a higher office visit deductible so he would pay a lower annual premium.

Open Enrollment Period: During this timeframe, eligible individuals may decide to opt into a group health insurance plan. Normally, applicants don’t have to provide evidence of eligibility during this period of time.

The open enrollment period was the opportunity Aaron needed to get affordable health insurance under a group policy.


Point of Service (POS) Plan: A POS plan ensures that a policyholder pays less if they use health care providers and medical facilities that are part of the provider’s network. These plans require referrals from a primary care physician for those who wish to see a specialist.

The POS plan made sense for the patient, as he was happy to use the approved physicians and medical center outlined by the insurer.

PPACA: Acronym that stands for Patient Protection and Affordable Care Act. It was signed into law on March 23, 2010, and requires all Americans to have minimum essential coverage starting in 2014. Insurers are no longer able to refuse an applicant for a policy due to a pre-existing condition.

The PPACA means all Americans must purchase health insurance, and they are guaranteed a minimum level of coverage from the insurance company.

Pre-Existing Condition: A health problem that existed or was treated before health insurance coverage began. The majority of insurers have a list of pre-existing conditions that cannot be covered by the policy.

As Dave had a pre-existing condition, he would have to pay for all treatment related to it despite recently purchasing an insurance policy.


Qualifying Event: An event in a person’s life that triggers a group insurance member’s protection under COBRA. Such events include loss of employment or a divorce.

As George was recently divorced, he knew this constituted a qualifying event in his policy.


Rate Review: This process enables state insurance departments to review any rate increases added by insurance companies before the insurer can add the extra cost to its policies.

During the rate review process, the state department found it to be an excessive increase and did not allow it to be added to the cost of policies.

Risk Adjustment: This is a statistical undertaking that takes the underlying health status and spending on health of those who enroll in an insurance plan into account.

The risk adjustment process helped the insurer discover that a policyholder’s insurance premium should be increased based on their findings.


Service Area: Relates to a geographic area where a health insurance plan will accept members; this occurs when the plan decides to limit enrollees based on where they live. If the plan also limits the doctors and hospitals that may be used, the service area will be where individuals can receive non-emergency services. If a person moves out of their plan’s service area, they may no longer be eligible for it.

Sharon moved home and found that she was now outside the service area of her health insurance plan.

Skilled Nursing Care: Refers to services provided by nurses either in a home or in a nursing home. The patient receives skilled nursing care from therapists and technicians.

The patient was very sick and needed round-the-clock skilled nursing care.

Specialist: A medical care provider who offers secondary services, as he/she specializes in a particular field. A primary care provider may refer patients to a specialist if he/she is unable to properly diagnose them.

The doctor decided to refer the patient to a sports injury specialist.


TRICARE: A special health care program for uniformed service members and their families. It is available to active-duty and retired uniformed forces personnel.

As Phil had been in the Army, he was eligible for TRICARE.

Tertiary Care: Describes services provided by specialists such as neurosurgeons, intensive care units, and thoracic surgeons. These services typically require sophisticated and state-of-the-art facilities and equipment.

The patient was referred to tertiary care because the illness was deemed to be severe.


Uncompensated Care: Refers to health care services provided by physicians and hospitals that will not be reimbursed. This kind of care normally occurs when the patient doesn’t have health care insurance and is unable to afford the cost of treatment.

The hospital agreed to offer uncompensated care because the uninsured patient was very ill and couldn’t pay the bill.

Urgent Care: Refers to the kind of care required by an individual for a relatively serious condition, illness, or injury. Although it is a problem that needs medical attention, it is not so serious as to require emergency treatment.

The patient was deemed to be suffering from a condition that required urgent care, but it was not serious enough to require the use of an emergency room.


Vision Coverage: This is normally a group insurance plan that covers normal eye exams and may cover all or a portion of the cost of eyeglasses or contact lenses.

The patient decided to purchase added vision coverage because it was not part of his current insurance plan.


Waiting Period: Refers to a period of time, beginning with the effective date, when an insurance plan will not provide coverage for policyholders with pre-existing condition benefits. It is normally 12 months long but can be waived or reduced depending on the health care coverage they had prior to applying for the new health insurance plan.

The waiting period on the health insurance plan was a frustrating time for Steven, and he was anxious for it to end.

Health Insurance is Expensive, Here’s How Health Plan One Helps You Save

Posted on : October 8, 2014 | By : HealthPlanOne | In : Health Insurance

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A Low Price Guarantee in All 50 States & More Reasons to Compare with Us

Policy-PiggyBankNo country on Earth spends more money on health care than the United States. During the last 50 years, real per capita spending on health care has increased by 100 percent every 17 years. As the U.S. government funds just less than 50 percent of this spending, it has been suggested that price regulation could keep the cost of care under control.

Don’t Pay More

As things stand, the price of private health insurance plans is fixed in every state, which is why Health Plan One is able to offer a lowest-price guarantee. We are licensed in all 50 states and focus on a wide range of insurance plans, including Medicare Advantage Plans, Medicare Supplement Plans, and various individual and family health insurance plans. As well as ensuring you never pay more than you need for your individualized health plan, here are a few more reasons to choose Health Plan One:

  • Reputable Carriers: We carefully screen all health insurance carriers and only align ourselves with the very best. This is why we are an Anthem “Premier Partner”, a “Strategic Alliance Partner” with Humana and also work closely with reputable organizations such as Oxford, Cigna, Celtic, and dozens more.
  • Variety: We offer over 7,000 plans from more than 80 carriers! Simply put, there is no individual, family, or group that we can’t cater to.
  • Experience and Scale: We possess one of the most experienced teams in the insurance industry and have the staff to deal with the huge number of customers we speak with every day. For example, we helped more than 40,000 retirees meet their health insurance needs in 2013, so we will always be ready, willing, and able to help you.
  • Affordability and Customization: The sheer number and variety of our plans ensure that we can tailor coverage to suit your specific needs. Due to our ties with the nation’s top insurance carriers, we are able to find you the best coverage for the lowest price.
  • Simplicity: We strive to continually provide readers with easy-to-understand yet vital information and advice relating to health insurance. Our easy application process, coupled with the simple-to-use claim service, means you can rest easy knowing your future is in safe hands. There are also fixed-rate options and the opportunity to guarantee your premium rate for a set period of time. This is great news for those who like to plan out their budget.
  • Knowledgeable: Our expert team can help you make informed decisions about your health care. If you want to learn how to find a PCP, where to get the best drug prescription plan, or anything else relating to health insurance, contact us or read the wide range of information freely available on our site.

Finding high-quality, low-cost, tailored health insurance has never been easier. Use Health Plan One to compare and contrast coverage from different states and locate the plan you need. We are your one-stop shop for health insurance coverage, so make the most of what we have to offer!

Changing Health Insurance Plans? A List of Things to Consider

Posted on : October 2, 2014 | By : HealthPlanOne | In : Health Insurance

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Moving Health Insurance? Handle the Change with Care

ChoicesFor millions of Americans, the thought of changing health insurance plans is one that fills them with dread. It is believed to be a complicated process, and if you get it wrong, you may end up either uninsured or paying way more than you should on your new premiums. Fortunately, Health Plan One offers extensive resources and expert advice to guide you through the maze of options. As you think through making a change, either through necessity or desire, here are a few things to consider.

Double Coverage

While you need to be insured, sometimes it is possible to go overboard. For example, a couple may have the chance to be covered by one another’s insurance, but double coverage causes you to pay two premiums and can sometimes lead to confusion when it comes to who should be paying out. As some employers pay you not to use your insurance, you could be smart and end up receiving money for using your spouse’s insurance!

Changing Needs

Perhaps you have found a new health insurance plan that seems to provide the same level of coverage as your last insurer for less money. Yet there is also a chance that your needs of those of your family have changed, so what constituted adequate coverage before may now not be enough. Employers are also shifting more costs to employees, so bear this in mind if you are thinking of renewing a workplace insurance policy. The health care landscape outside of your family has also seen dramatic changes, so consult with an industry expert at Health Plan One to find a solution that best fits your current reality.

New Policy Exclusions

There will be certain exclusions no matter what health insurance plan you choose, and as they can be different from one insurer to the next, you have to be wary when switching health insurance. Aside from pre-existing conditions, other exclusions you need to watch out for include general outpatient medical services and alternative medicine, or treatments such as Traditional Chinese Medicine (TCM). You may be shocked to find exclusions on your new policy that didn’t exist on the old one. An experienced consultant can identify those pitfalls and help you sift out the ones that won’t fit for you.

Waiting Periods

When you have had a health insurance plan for a period of time, you may have taken your coverage and benefits for granted. This can change dramatically once you switch insurers or policies. For example, you need to look out for the waiting periods at the start of some policies when you will not receive benefits. Our team of licensed advisors can help you pick the right plans and manage your upcoming transition.

Switching From Group to Family Health Insurance

With employer-sponsored coverage, you’re used to having:

  • A choice of plans.
  • Some of the monthly premium paid.
  • A convenient method of payment.
  • Your plan documents given to you.
  • Access to expert advice.

With an individual or family plan, there are likely more choices than you know what to do with, and you’ll be in control of your monthly premium. This can seem like a big transition, but with Health Plan One, you have the help you need to navigate the vast array of options, you have the powerful search capability to get just what you need and not what you don’t, and the price tag is likely to look a lot more attractive.

Take advantage of the expert resources available to you at Health Plan One and have your “free look” period to fall back on, which should be 14 days. During this time, if you spot anything that doesn’t suit you, contact the insurer immediately and give them a notice of cancellation without losing the money invested in your first premium.

Health Insurance Simplified

Posted on : September 22, 2014 | By : HealthPlanOne | In : Health Insurance

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The news that Wal-Mart is breaking into the health insurance industry by having agents available to answer queries at their stores leads us neatly to the question: Should you look for health insurance via an instant price comparison tool or is it better to purchase from an agent?

Agent Quotations

Those who promote the use of agents, especially for first-time buyers, point out that the health insurance market is a complex one. An agent is supposed to save you time and money in the search for the best insurance for your needs. “Captive” agents, however, are best avoided because they work for one insurer and are usually employees of that company. As a result, you end up receiving health insurance that is likely to be nowhere near the cheapest, and it probably won’t be tailored to suit all your needs.

Independent agents, on the other hand, have access to various insurers from whom they receive a flat fee or a percentage of the sale. This sounds like an ideal scenario until you realize the level of effort required on your part to even find a suitable agent.

How to Find a Reputable Agent

First and foremost, you have to find a professional with a positive reputation in the industry, which means looking for reviews and feedback on the agent(s) in question. You also have to check references, licenses, and registrations. In order to find out more about an agent’s disciplinary record, it is necessary to phone the hotline of your state insurance commissioner. You should ask the commissioner if the agent has ever been sued by a client.

Once you have found a suitable agent, you need to learn more about the services offered. Agents usually specialize in the sale of certain health products and may not be knowledgeable about the services you require. At this stage, you will need to ask for examples of previous work relating to the services you need. Employers seeking insurance for their employees also need to ask if there is a dedicated account manager, and you’ll have to ask about the way referrals are handled too.

What’s the Alternative?

All of the above seems like a lot of work for a quote, mainly because it is! If this was the only way to find the most tailored health insurance quote for you, it would be acceptable, but there is a much easier and faster way! Using the Health Plan One search tool is about as easy as making a cup of coffee and takes about as long.

Simply choose whether you want individual, family, small business, or Medicare health insurance, and enter your ZIP code. Then you just input some personal details, and your quotes will appear within seconds. The information we ask for helps us to find individualized quotes, and you can review the best choices.

We are licensed in every state and the District of Columbia and work with all major health insurance carriers in the United States. With a lowest-price guarantee, you can find affordable insurance that is perfect for you in a fraction of the time it would take to complete the process with an agent.

Health Care Costs Explained: Premiums, Deductibles, Coinsurance & Co-Payment

Posted on : September 18, 2014 | By : HealthPlanOne | In : Health Insurance

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CostsHealth Insurance Costs Revealed

Healthy individuals may save money each month by opting for a health care plan with a low monthly premium and higher deductibles.

The cost of health care continues to rise at a rate higher than inflation. Up-front payments in the form of deductibles, co-payments, and coinsurance sometimes get a bad reputation, but they can actually be extremely beneficial to you in the long run. This is especially true if you are a healthy individual with little or no history of illness in your family. Below, we briefly explain the various health care costs.

  • Premium: The amount of money charged by an insurance company for the health plan you’ve chosen. Typically, it is paid monthly, and you must pay this fee to maintain active coverage regardless of whether you use it or not. An individual earning less than $85,000 a year, for example, will pay $104.90 in monthly premiums for Medicare Part B.
  • Deductible: A set amount you pay towards your medical bills annually. Once this limit has been reached, your insurance company steps in and foots the remaining bill. For example, if you pay a $500 deductible and a treatment costs $1,200, you pay the first $500 and the insurer pays the remaining $700. The insurance company then covers any remaining medical bills you have for the rest of the year. Higher deductibles can lower your monthly premiums.
  • Coinsurance: The percentage of a medical bill you agree to share with the insurer after the deductible has been paid. It is normal to pay a coinsurance rate of 20 percent, which is known as an 80/20 plan.
  • Co-payment: A flat fee you pay every time you go to the doctor or fill a prescription. For example, you may choose a $20 co-payment, which means you pay the first $20 of any doctor’s office visit or prescription drug you receive.

These Payments in Action – Real Life Examples

Deductibles and coinsurance tend to go hand in hand. If you have a $500 deductible and an ER visit costs $2,100, the remaining balance is $1,600. With a 20 percent coinsurance payment, you pay $320 of the remaining cost. If you have to go to the hospital again, you would pay no deductible and would only be liable for the coinsurance payment.

If you go to a doctor and are charged $100 after agreeing to a $20 co-payment, $80 is covered by your insurance company and you only have to pay the $20.

Cost Considerations, Healthy or Not

Young, fit, and healthy individuals are encouraged to commit to higher deductibles, co-payments, and coinsurance because the savings on their monthly premiums can be very impressive. If you don’t get ill for several years, skipping these “extras” will result in you paying higher premiums you shouldn’t really be paying.

What you end up saving in these premiums is immediate cash that could go towards a mortgage payment, family vacation, or student loan repayment. When you choose a higher deductible, you are increasing the likelihood of having extra disposable income. Even if you do have a bad injury or serious illness, you are still covered by health insurance and will only be paying an amount you know you can afford. Obviously, you should only look to pay “extra” toward a deductible when you know the spare cash is available.

Health Insurance: Pre-Existing Conditions Defined & Things to Watch Out For

Posted on : September 14, 2014 | By : HealthPlanOne | In : Health Insurance

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Got a Pre-Existing Condition? Read These Tips Before Getting Insurance

pre-existing-conditionsHealth insurance is a necessity, as it bears the brunt of costs associated with medical treatment. Insurance companies can provide coverage, but obviously they need to avoid risk as much as possible to remain profitable. Individuals with pre-existing conditions or people who are in generally poor health are deemed to be high-risk and getting insurance is tricky. Even if they can get a policy, their premiums are likely to be extremely expensive.

Pre-Existing Conditions

The definition of a pre-existing condition is a medical problem that existed before obtaining health insurance. Yet this definition can vary among insurers and types of health plans. Clearly, people with pre-existing conditions can cost an insurance company a lot of money, so they do what they can to either exclude these individuals or avoid paying out on a claim.

You will usually not be able to submit a claim for treatment of a pre-existing condition, and there is normally a nine- to 12-month waiting period for this kind of coverage when it is applicable. This means that when you are offered a policy, the insurer will not provide coverage on a specified condition for a certain period of time. It is also common for insurers to attach a “rider” to your policy that includes a pre-existing condition waiting period or states exclusions of coverage on particular body parts or medical conditions.

Things to Watch Out For

You may be so relieved to find an insurer that you fail to see problems ahead. For example, your insurer may impose stipulations such as prior authorizations or referrals on providers before they are able to give you a diagnostic test, recommend hospitalization, or prescribe medicine. This could delay the receipt of health care, and this can be very dangerous.

It can be frustrating for providers who are experts on health care and know when a patient is in need of help. Instead of getting to do their job, physicians may have to fill out a lot of paperwork, and this further delays the treatment process. Here are some stipulations to watch out for:

  • Referrals: You must be referred to the professional you need to see. You may need surgery to deal with a hernia, but you won’t be allowed to see a surgeon unless you are referred by a doctor. This means you need to pay to see the doctor, and this costs money in terms of deductibles and co-payments.
  • Prior Authorization: Your claim could be denied if it wasn’t pre-authorized by your insurer. Without it, you will be forced to pay the bill. While this often happens with major surgeries, it is now happening for minor procedures as well.
  • Statute of Limitations: This is when a time limit is placed on your claim. Fail to claim within this timeframe, and it will be rejected. If your doctor’s office doesn’t file the claim or misplaces the paperwork, you are the one who has to pay.

When you have a pre-existing condition, you need to be even more wary than usual when it comes to health insurance. Keep your eyes open and don’t be forced to pay more for your coverage than you should. 

Finding the Right Individual Health Insurance

Posted on : September 12, 2014 | By : HealthPlanOne | In : Health Insurance

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More Americans than ever before are purchasing their own individual health insurance plans, and thanks to the Health Plan One comparison service, a lot of the time and effort to research and contact agents about various plans has been eliminated. When you utilize our tool, you can quickly find the best insurance plans for your specific needs at a price you can afford. Users of the tool report savings of hundreds of dollars per year, and it only takes a few minutes of your time.

Nonetheless, you need to make an informed choice to ensure you know what you’re buying. As a result, we have outlined some important considerations to make before finalizing the purchase.


One possible issue with the individual market is that insurers can reject you due to pre-existing medical conditions or lapses in health insurance. Watch out for those clauses, and if you are losing health coverage because you have been laid off from work, consider continuing to purchase coverage via the COBRA program. Once this coverage runs out, federal law requires insurers to sell you another policy, but there is no price guarantee.


After using the Health Plan One comparison tool, please note the plan with the lowest premium is not always the cheapest. If you are paying a low monthly premium, you are probably subject to increased copays and deductibles. Then there is the matter of co-insurance. These extra costs can really add up if you end up receiving medical treatment during the course of the year, so make sure you understand the possible extra costs before committing to a plan.

High Deductibles for Good Health

The idea of paying a lot of money up front for medical treatment may be frightening, but if you are in excellent health, a high-deductible plan could be ideal. Policies with high deductibles allow you to become eligible for a health savings account (HSA), which helps you save money for health care and reduce your income tax too; this cash can then be used tax-free to pay for out-of-pocket medical expenses. Any unused cash in your HSA can be withdrawn without penalty once you reach the age of 65.

What Is Covered?

There is a chance your current doctor is not covered under your new health plan, so be sure to check and see if your primary care provider is approved by your insurer. Additionally, your new plan may not cover additional benefits such as prescription drugs. So-called “extras” like chiropractic care may not be covered either, so the best practice is to make a list of the prescription drugs you currently take, along with essential health services, and see if they are included.

Use Our One-Stop Search Tool

Health Plan One offers one of the best one-stop, state-specific health insurance comparison tools on the market. Benefit from the following:

  • Compare thousands of providers in all 50 states and the District of Columbia.
  • Choose between reputable providers, such as Aetna, Unicare, Oxford, Cigna, and many more.
  • Our lowest-price guarantee means you won’t find cheaper insurance anywhere else.
  • Learn more about state-specific rules and restrictions to further narrow down your choice.
  • Find plans tailored to your individual needs.

Instead of wasting time and money, use our comparison tool today and make sure you have the security and peace of mind that the right health insurance plan brings.