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AmeriHealth was founded in 1995 as Delaware Valley HMO, and originally served a small portion of Pennsylvania. They expanded over the next few years into New Jersey. Today they operate as a subsidiary of Independence Blue Cross.
The company offers individual and group health insurance with both HMO and PPO plans. The family of companies also includes AmeriHealth Caritas for Medicare and Medicaid managed care, and AmeriHealth Casualty, which writes worker’s compensation insurance for businesses. Caritas programs are available in several states, although not nationwide.
The company’s headquarters are located in Cranbury, New Jersey, although they have offices across the coverage area. Health insurance plans are sold through brokers and independent agents.
AmeriHealth New Jersey and AmeriHealth Pennsylvania offer a selection of health insurance plans for individuals, as well as group health plans. Managed care for Medicare and Medicaid and worker’s compensation are sold through separate companies.
In order to find information on the health plans offered by AmeriHealth, we had to visit the broker page, as the member’s page is aimed at those who already have coverage.
AmeriHealth offers many plans, with EPO and HMO options at the bronze, silver, and gold levels. There is also a Catastrophic Simple Saver plan that is available to provide a high deductible, low cost option for those who do not expect to require a lot of regular care.
At the Bronze level, there are three EPO choices: AmeriHealth Advantage, Tier 1 Advantage, and the Local Value/Regional Preferred network choice, which is also offered with an HSA. Co pays with these plans are $25 for primary/$50 specialist, and $50/$75, respectively. The Catastrophic Simple Saver plan has a $30 co pay for primary visits, while all others are subject to the deductible.
The Silver Level is the most comprehensive, with six plans to choose from. These include several EPO networks, three with an HSA, and one HMO option. Co pays start at $15/35 for the EPO Advantage plan, with a variety of other co pay and coinsurance options across the other plans. The one HMO option has a $50 primary and $75 specialist co pay.
The Gold plan options include three EPOs and one HMO. Co pays for these plans are as low as $10 for primary care and $20 for specialists. The HMO option has $15/$30 co pays for primary/specialist. The Gold plans feature the lowest deductibles, as low as $1000 individual.
Due to the large selection of plan options available, choosing the right plan based on combination of cost and benefits is best done with the assistance of a broker. The range of plans appears to provide an option to meet most budgets and needs.
Dental and Vision
AmeriHealth offers two dental plans. One is a pediatric dental only, and the other is pediatric dental with the addition of adult preventative care.
There are three vision plans offered. The three levels of adult vision care cover eye exams at 100%, and offer differing levels of coverage for other services and for eyeglasses and contacts.
AmeriHealth Caritas writes Medicare and Medicaid managed plans that include Medicare Advantage.
Plans vary from state to state as well as based on eligibility. Among the options are specific plans for those with special needs as well as for those qualified for both Medicare and Medicaid.
The AmeriHealth Casualty program offers a range of services for businesses including medical management, loss prevention, and worker’s compensation.
AmeriHealth has an easy to read chart for health insurance rates, listing costs for each of the various plans based on age. The chart starts with one rate for ages 0-20, and then goes by age yearly from there.
We were unable to find specific family rates, however, there is a system for calculating it; the chart instructs the reader to add up the rate for each person up to three children. After three, no additional premium is charged for adding more children to the plan.
Although rates are readily available, the wide variety of plans and difference by age, family composition, and even location makes it difficult to provide any sort of comparison to other insurance companies. It is nice to see that anyone can calculate their rate without having to make contact with an agent or enter personal information.
Since AmeriHealth is a health care company, there is little to review in terms of how claims are handled. In most cases, providers will bill directly for services and the insured will then receive a bill for any co insurance that is due, or any amount not covered.
Ratings and Consumer Reviews
AmeriHealth has a dismal rating of F on the Better Business Bureau (BBB) which is very unusual to see. Although the complaint volume is actually low – only 14 in the past three years – the BBB has given the lowest available rating due to the failure of AmeriHealth to respond to any of those 14 complaints.
AmeriHealth has 87 ratings on Consumer Affairs, the vast majority of which are negative. Many of the complaints regard failure to pay claims and a lot of run-around from customer service. There are a few scattered positive reviews, but of 87 star ratings, 81 are only one star.
While the overall number of complaints is low, it can be discouraging to see a company that fails to respond to complaints, particularly those filed with the BBB, which are usually dealt with swiftly.
The Bottom Line
AmeriHealth has a good selection of health plans available to those in New Jersey and Pennsylvania. The failure to respond to complaints with the BBB, however, gives us pause regarding this company’s reputation. They may be worth further investigation, but we would like to see them handle their current complaint volume before we can recommend them.
For a list of companies that we recommend, visit our Best Insurance Companies page.