The highest total score in the three performance categories for any New Jersey health plan: 12. Cigna HealthCare of New Jersey and Aetna Health (New Jersey)-Southern New Jersey received “above average” in all three categories. The two are private health plans.
With regard to the three performance categories, “treatment” reflects how well a plan cares for common conditions, such as heart disease. “Prevention” covers services like cancer care. “Consumer satisfaction” considers satisfaction with a plan’s doctors and services.
The rankings were of 830 private, Medicare, and Medicaid plans.
In an HMO, you must consult a provider in the HMO’s network. A primary-care physician will refer you to specialists and coordinate your care. You may have to pay full cost for care outside the network.
With a PPO, you can use any in-network specialist without a referral. You can also consult someone outside the network, but you’ll pay more.