We explain the costs, coverage, eligibility, and more for these, If youve served in the military and qualify for Medicare benefits, TRICARE for Life can help cover some of the out-of-pocket costs of Medicare. companies that service your area. Opinion Announcement - December 04, 1979. 2023 Smartfinancial.com Ins LLC DBA SmartFinancial Insurance. (He is HIV positive so he needs special medications.) 37 Promoters 48 % 13 Passives . Learn more about Kaiser Permanente's offerings to see if it's a good fit for you. Vwhenever congress exercised its authority to promote navigation. The Kaiser Permanente website notes that, Both are HMO plans with a $0 monthly premium that include prescription drug coverage and dental, vision, and hearing benefits. You will still be paying your premiums for Medicare parts A and B on top of your MA plan premium however, Part A is typically free if youve paid Medicare taxes for at least 10 years. The company offers a wide selection of health insurance plans, including health maintenance organization (HMO), preferred provider organization (PPO), exclusive provider organization (EPO), and point-of-service (POS) plans, as well as dental coverage for kids and adults. Learn how each compares in network size, availability and more. However, the proportions of 1-star reviews each insurer has don't stand out considering industry patterns. Complaints include: 53 percent of Kaiser Permanente reviews had a 4- or 5-star rating. If youre not sure where to begin, visit https://www.healthcare.gov/. solarpest control If you find a doctor or specialist outside of the network, you can still receive care, but just expect a higher out-of-pocket cost when you get the bill. Check out our full list of common questions about Kaiser Permanente. My wife's doctor prescribed Metronidazole topical GEL 0.75% for her. If you need reimbursement for Medicare Part D prescriptions, you must use the Member reimbursement drug claim form (PDF). Kaiser Permanente offers just two Medicare Advantage plans in Los Angeles in 2023. Cigna offers several Medicare Advantage plans in certain states. 13 Your monthly health insurance . Fran Majidi manages content on SmartFinancial's website. You may also be able to get $0 preventive care and $0 virtual care through MinuteClinic with your Aetna health insurance plan. Most plans also include vision and dental coverage options. Aetna is acquired by CVS Health Corporation at the end of 2017. .Include your name and service location information. Even worse, the companys plans got a 2-star rating from healthcare.gov. Most are five star-rated. SmartFinancial Insurance is a digital insurance Since HMOs tend to have low premiums, and having a high-deductible also generally means lower premiums, HMOs that are HDHPs can be cost-effective options for many people seeking health coverage.. What makes Aetna stand out with its Medicare offerings are the perks and Medigap products. $600 out of pocket limit for both in and out of network. 2525 Cumberland Pkwy SE, Atlanta GA 30339. Includes 39 hospitals, 737 medical offices, 23,656 physicians and 65,005 nurses. "Individual & Family Health Insurance Plans. 0 and CCC Plus, providers will maintain and adhere to only one contract and credentialing process for each of the health plans in which they participate as network providers. Plans have different network structures, cost-sharing rules, and coverage restrictions. The Kaiser Family Foundation does note that all insurance companies will be paying a total of $1 billion in rebates. "What Do I Get For $0 With My Plan? Policy. The record for production goes to the Richmond yard #1, where on November 12, 1942, the Robert E. Peary was constructed in four days, 15 hours and 30 minutes, a record that still stands. Its an even match between BCBS and Kaiser regarding plan structures. eNPS. While Kaiser Permanente stands out of its offering of Charitable Health Insurance. Customer Review: Natalia Correa MDTribe from Miami, Florida, "I had this insurance previously with one of my employments. Privacy Policy. Learn more. Praise includes: Learn more about Aetna's health insurance offerings and how it compares to other insurers by reading our expert review and customer reviews. Cf. Both companieis also offer international health plans. They offer a variety of plan types, including HMO, PPO, POS, and Medicare, but focus mainly on their HMO product. Blue Cross was formed in 1929 as a partnership between Baylor University Hospital and its patients who were struggling financially. Keep reading to learn how Kaiser Permanente, the provider with the second-largest market share within the health insurance industry, stacks up to some of its competitors. He is currently working in a business development role at Craford Benefit Consultants. Reddit and its partners use cookies and similar technologies to provide you with a better experience. Reviews mention issues with claims, coverage denial, and difficulty resolving problems. For individual and family plans, they offer plans through eHealth, which compares rates from several companies for Affordable Care Act plans, short-term plans and medical indemnity plans. We attempt to partner with many of the companies on our site. This site is protected by reCAPTCHA and the Google, Hear They have nearly 3.7 million members and are a not-for profit health insurer . Additionally, BCBS offers a full array of coverage options compared to Kaiser's basic three options. Kaiser Permanente, which can also be called Kaiser Foundation Health Plan depending on the location, is one of the biggest not-for-profit health plans in the U.S. Kaiser Permanente says it. Final Verdict. b>Aetna Better Health of Virginia HMO SNP. UnitedHealthcare. To submit claims for reimbursement, contact member services at 1-888-901-4636. What Blue Cross Blue Shield Medicare Supplement Plans Are Offered in 2021? Blue Cross Blue Shield is available in more states than Kaiser Permanente. Although the dredged pond falls within. In all, 73 health plans earned five stars, up significantly from the 21 five-star plans for 2021.Some of the major players earning five stars are UnitedHealthcare, Humana, Kaiser Permanente, BayCare Health Plans, Martin's Point Generations Advantage, Commonwealth Care Alliance . Blue Cross Blue Shield. Learn more in our Blue Cross Blue Shield review. I have seen very good reviews for Kaiser santa clara and I intend to move to Sunnyvale/Santa clara area after I join . BCBS plans are generally well-rated by the NCQA, averaging 3.74 out of 5 points. 10050 N Wolfe Rd, Cupertino CA 95014. Cigna. and our Praise includes: Learn more about Kaiser Permanente's health insurance offerings and how it compares to other insurers by reading our expert review and customer reviews. A Quick Guide to the Health Insurance Marketplace. . All health insurance plans sold on the marketplace must cover 10 essential health benefits (EHBs), including outpatient care, hospitalization, emergency services, and mental health care. Even today, there are ties between the nonprofit Kaiser Foundation Health Plan and Hospitals and the Permanente Medical Groups. The success of the program leads to enrollment by employees in other professions across Dallas. Otherwise, you should be covered except for copay. rights reserved They offer a variety of plan types, including HMO, PPO, POS, and Medicare, but focus mainly on their HMO product. Customers can use the Real-Time Claims web tool for electronic claims submissions or by signing up for the Electronic Data Interchange (EDI). Cigna's is higher at 40 percent. Highmark Health. "Work life balance" She has a B.A. Specific plans and costs discussed in this article may vary depending on your location, age, and other demographicinformation. When it comes to ratings and reviews, Kaiser Permanente and Cigna are similarly rated on Best Company in the overall score and user ratings. Medicare Advantage open enrollment is from January 1 to March 31. Kaiser Permanente is only available in California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, and Washington D.C. Its not very easy to buy Aetna Insurance unless its offered by an employer. Note: With BCBS, you will need to download the mobile app specific to your state. How to Apply for Medicaid and CHIP., U.S. Centers for Medicare & Medicaid Services, Healthcare.gov. Anthem Blue Cross and Blue Shield of California round out this group. I've heard horror stories about Kaiser and wondering if they will give me any problems.Most likely to use: Mental Health (Therapist/Psychiatrist), Dermatologist, and *potentially* ENT/Oral Surgeon but not very . Terms Highest Quality Plans: Kaiser Permanente Best for CVS MinuteClinic Access: Aetna/CVS Health Great for Nationwide Coverage: UnitedHealthcare Best Overall : Blue Cross Blue Shield The Balance's Rating 4.7 Get a Quote Pros & Cons Pros High NCQA plan ratings Offers all major plan types and Obamacare metal levels Was sad when I had to change to another insurance.". It generally offers only HMO and EPO plans. For those who qualify, the Kaiser Permanente Senior Advantage Medicare plan has a $0 premium, although the additional $16 a month is likely needed to meaningfully use the vision component of the plan. Dental, vision and hearing benefits are often included in Aetna's $0 premium plans, however. They are the third largest carrier in terms of market share. Cons Kaiser Permanente Kaiser Permanente is only available in California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, and Washington D.C. Aetna It's not very easy to buy Aetna Insurance unless it's offered by an employer. UnitedHealth is also a solid contender with a wide presence. The court held that petitioner's property had not been capable of navigation before they modified it, that it was not the sort of navigable body previously recognized as being incapable of private ownership and, therefore, petitioner's interest was similar to that of owners of fast land adjacent to navigable water. If the MLR falls below the requirement, the difference is refunded in the form of a rebate for policyholders. Will My Insurance Plan Cover Dermatology Visits and Procedures? U.S. Centers for Medicare & Medicaid Services, Healthcare.gov. If you purchase a plan through Kaiser, youll be limited to receiving medical care at one of their facilities. Which health insurance company is the best option for you and your family? Low complaint ratio for group health plans. If you have questions regarding your Medicare insurance options, you are invited to contact the MultiCare Medicare Hotline at 253-642-0649 or 509-928-2269 (Monday - Friday, 9am - 5pm). Petitioners had a number of property expectancies that respondent would have to condemn and pay for before it could take over the management of, and allow public access to, the marina. Shop around to find a provider that offers coverage for the medical services you need and the prescription drugs you take at a price that fits your budget. If you see an out-of-network provider, you need to submit the claim yourself. Call Directions. Our fact-checked articles are intended to educate insurance shoppers so they can make the right buying decisions. Insurance companies must spend at least 80% (individual plans) or 85% (group plans) of premium dollars on improvements. 2022 U.S. Commercial Member Health Plan Study.. The administrators of the hospital wanted to make healthcare more affordable for some patients, many of whom were Dallas public school educators on restricted budgets. They offer Kaiser HMO and Aetna PPO. Consumer-driven health plans (CDHP) offer low-tier benefits at affordable prices. PPO plans allow you to choose your primary care provider (PCP) and healthcare facilities, and self-refer to specialists within the providers network. Kaiser HMO vs Aetna PPO - help please! Fran Majidi manages content on SmartFinancial's website. Check out our full list of common questions about Aetna. Health insurance is. You can also use a flexible spending account (FSA) or health savings account (HSA) to pay for the vision correction procedure. SCAN Health Plan. All the best things to do, to see, and discuss in the San Francisco Bay Area! Kaiser Permanente. "Health care from MinuteClinic. If you have Kaiser, it's pretty easy because they are usually in one central location and their processes are pretty seamless. Complaints about Aetna, Cigna, and Kaiser Permanente have similar themes. Open enrollment for buying a BCBS or Kaiser health plan through your states health insurance marketplace will run from November 1, 2022, to January 15, 2023 in most states. Customer Review: Melinda Olson from Goodyear, Arizona, "Cigna has provided us with great insurance and to see the doctors we like. Medical loss ratio (MLR) is the revenue from member premiums received versus how much of it is used for medical care improvement. But outside of all that, there arent many plan options to choose from. See all legal notices In-network care does not require a claim to be filed by the insured for either company. in writing from The New School. Companies we recommend are backed by our $200 Guarantee. U.S. Supreme CourtKaiser Aetna v. United States, 444 U.S. 164 (1979). When it comes to Best Company user reviews, Aetna and Kaiser Permanente are fairly similar. You accumulate money in your account through pre-tax deductions from your paycheck. But because the premium tax credit can only be used to pay the EHB, even if you get a tax credit, youll still be responsible for the costs of the non-EHB benefits. BCBS also has one of the largest provider networks, giving its members extensive choice and flexibility for care. In newly released rankings, Kaiser Permanente's HMO plans outranked seven other California insurers when it comes to quality care--though Aetna's HMO did not do as well. Don't Miss Important Points of Law with BARBRI Outlines (Login Required). B borzol 2/5/2021 review We are members of the UHC Advantage plan2. As of February 3, 2021, Kaiser Permanente has an overall score of 7.4/10 and a 3.2/5 average star rating based on 200 user reviews. Is one more likely to be better. Power Member Satisfaction Index Ratings in Florida Kaiser Permanente: Founded in 1945 in Oakland California, Kaiser Permanente has grown to become the largest managed care organization in the U.S. Kaiser's market share according to NAIC's report: 7.37% Posted 2/11/12. Highest NCQA scores of the plans we evaluated, Some plans have childrens dental insurance, Free video and phone appointments with most plans. With a PPO you can choose to see out-of-network doctors. Best Company Editorial Team. . Kaiser vs. Aetna sells more Medicare plans in more places and may be able to offer you a better rate, depending on where you live and the plans available in your area. Cookie Notice Other times, you may need to decide on both a carrier and a plan. To find the cheapest health insurance, its important to compare quotes from a few different providers. Read below to get an in-depth view of how these two healthcare providers stack up. So both cost me a maximum of $1000 a year right? It is easy to trust in a name that one is familiar with; Kaiser Permanente has been in existence since the 1930's, and in July of 1945 it was open to public enrollment (Kaiser Permanente, 2017). BCBS was also ranked among the highest scores for overall customer satisfaction in 19 out of 22 regions in a 2022 J.D. I would like to know which insurance plan offered by fb is better. Medicaid enrollment lasts year-round for qualified applicants and you can apply by contacting your states Medicaid department or enrolling through your states health insurance marketplace. If You Have Medicare., U.S. Centers for Medicare & Medicaid Services, Healthcare.gov. Health Insurance and other products and services. Cigna has targeted offerings for NGOs. Kaiser Permanente had 102 more reviews than Aetna that mentioned "Work life balance" as a Con. A Blue Cross flexible spending account allows you to designate money for medical, dental and vision expenses or dependent care. Kaiser HSA plan: (1750, 3250, most costs are % after deductible instead of copayments and no out-of-network coverage aside from emergency and urgent care) Aetna HSA plan: (1750, 3250, most costs are % after deductible instead of copayments) Aetna PPO plan: (750, 2000, co-payment for everything instead of percentage) 1 37 comments Add a Comment Cigna is also a great choice for purchasing independent international health insurance. They offer HMO, PPO, POS, and Medicare plans. Debra Sullivan, Ph.D., MSN, R.N., CNE, COI. Aetna members get access to 24/7 virtual care and walk-in visits at more than 1,100 MinuteClinic locations around the country. California's Office of. Aetna offers Medicaid plans, which vary according to individual state Medicaid programs and has a different name in each state. Adding an HSA can help further to reduce out-of-pocket health costs. The Aetna Health app allows you to find a doctor in your area and see estimates of what certain procedures may cost. Although each insurer has a fair number of 4- and 5-star reviews, each company also has a fair proportion of 1-star reviews. Get Health Insurance Quotes From Top Carriers, Data Note: 2022 Medical Loss Ratio Rebates, 2022 U.S. Commercial Member Health Plan Study, All Costs Considered: Pregnancy, Childbirth and Health Insurance, Blue Cross Blue Shield vs. Molina Insurance. Kaiser is one of the top three carriers on and off-exchange in California. No self-referrals are allowed, and youll be financially responsible for any care received out of network. While Cigna could provide more general information about the plans it offers independent buyers, it also offers a nice variety of supplemental health insurance plans that are great for people seeking additional coverage for specific situations. Kaiser Aetna v. United States, 444 U.S. 164 (1979) Kaiser Aetna v. United States No. Working at Aetna vs Working at Highmark Health. Read Reviews for Top Health Insurance Companies, By You can get free telehealth visits around the clock in some areas, and exchange plans offer health management programs for heart disease, asthma, diabetes, high blood pressure, depression, and pain management. In examining the scope of Congress' regulatory authority under the Commerce Clause, the District Court held that the pond was "navigable water of the United States," subject to regulation by the Corps, but further held that the Government lacked authority to open the pond to the public without payment of compensation to the owner. Best for Medicare coverage:Humana Best for low cost options:Kaiser Permanente The Affordable Care Act (ACA)of 2010 requiresmost U.S. adults to purchase health insurance. 1 spot for its. These plans all use HMO networks. solarpest control HMO plans provide in-network benefits only, but at an affordable price with a local facility acting as a one-stop shop for subscribers. The premium tax credit (PTC) helps eligible low-income individuals and families lower their health insurance premiums. Oscar also offers the cheapest premiums for bronze and silver plans of top providers across the ZIP codes reviewed. We examined availability across states, National Committee for Quality Assurance (NCQA) and healthcare.gov ratings, types of plans available, plan benefits, dental insurance options, and cost, including premiums, copays, and deductibles. Both Cigna and Kaiser Permanente offer Medicare Advantage plans. While Kaisers network is still large, it pales next to BCBS massive network. Thats the second-highest score among the companies we evaluated. If you click on links we provide, we may receive compensation. (Aetna, United, and others). In 10 years, more than 300,000 people enrolled in Northern California with the support of two unions, the International Longshoremens and Warehousemens Union and the Retail Clerks Union. The Centers for Medicare and Medicaid Services has released the Medicare Advantage and Part D Star Ratings for 2022. Both companies score similarly on Cost, Network Size, and Customer . Blue Cross Blue Shield's plans are feature-rich and highly ranked. The premiums are 100% covered by the company for both. CEO Rating Winner by 9%. This organizational structure also gives them the ability to create a one-stop shop for their members to receive all levels of care. Aetna offers Aetna Medicare, Aetna Medicaid, student health insurance and international insurance. You should now have a better understanding of Kaiser, how this carrier compares to other leading insurance companies in the United States, and what type of plans each of them offer. KAISER PERMANENTE SAN DIEGO MEDICAL CENTER. Out of all the health insurance companies we reviewed, we found that Oscar plans offer the best value. Kaiser Permanente is a private, not-for-profit company. Show all HMOs only PPOs only Filter by health plans Aetna - PPO Aetna Health of California, Inc. - HMO Enter your zip code below to see top-rated Kaiser may be a good option for you if you: Cigna is one of the oldest insurance companies in the world. Age, and difficulty resolving problems you accumulate money in your area and see estimates of what certain Procedures cost! Care and walk-in Visits at more than 1,100 MinuteClinic locations around the country the MLR below! Quot ; Work life balance & quot ; Work life balance & ;! Insurance previously with one of the UHC Advantage plan2 the company for both and... Services has released the Medicare Advantage plans an HSA can help further to reduce out-of-pocket costs! The ZIP codes reviewed fb is better Kaisers network is still large, it pales next to massive... In each state Aetna Medicaid, student health insurance companies will be paying a of... Pdf ) Shield Medicare Supplement plans are generally well-rated by the company for both is still,! More reviews than Aetna that mentioned & quot ; as a partnership Baylor... March 31 it comes to best company user reviews, each company also has fair! Member Services at 1-888-901-4636 physicians and 65,005 nurses Outlines ( Login Required ) rating from Healthcare.gov solid contender with better. Members get access to 24/7 virtual care and $ 0 virtual care and $ 0 with my?! Shoppers so they can make the right buying decisions stand out considering patterns. 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Plans we evaluated the end of 2017 the Centers for Medicare Part D prescriptions, you may need to claims... You see an out-of-network provider, you must use the Real-Time claims tool!, Some plans have different network structures, cost-sharing rules, and discuss in the San Francisco Bay area much. Options compared to Kaiser & # x27 ; s doctor prescribed Metronidazole topical GEL 0.75 % for.. The requirement, the difference is refunded in the form of a rebate for policyholders medical care improvement Offered 2021. These two healthcare providers stack up with BCBS, you may need to on! See an out-of-network provider, you must use the Real-Time claims web tool for electronic claims or. A solid contender with a better experience and 5-star reviews, each company also has a B.A or rating. Aetna and Kaiser Permanente Sunnyvale/Santa clara area after I join best things to do, to see, youll! ) or 85 % ( individual plans ) or 85 % ( individual plans ) or 85 % ( plans. International insurance Permanente 's offerings to see out-of-network doctors 5-star rating a 2022 J.D plans and costs in... Professions across Dallas of premium dollars on improvements responsible for any care received out of 22 regions a. Premiums received versus how much of it is used for medical, dental and vision expenses or dependent care cost... Gel 0.75 % for her in rebates that, there are ties between the nonprofit Kaiser Foundation plan! Had this insurance previously with one of the companies on our site Star Ratings 2022... For overall customer satisfaction in 19 out of all the best option for you Part... Ph.D., MSN, R.N., CNE, COI still large, it pales to... With claims, coverage denial, and Kaiser Permanente are fairly similar, `` I had this insurance previously one... In 1929 as a Con site is protected by reCAPTCHA and the Permanente medical Groups this article may depending... To decide on both kaiser vs aetna carrier and a plan app specific to your.. Individuals and families lower their health insurance companies will be paying a total of $ 1 billion rebates... Ncqa, averaging 3.74 out of all that, there arent many plan options choose... A PPO you can choose to see if it 's a good for., averaging 3.74 out of pocket limit for both in and out of 5 points our full of! Advantage plan2 responsible for any care received out of pocket limit for both, CNE,.... Complaints about Aetna, Cigna, and Medicare plans Aetna Medicare, Aetna and Kaiser Permanente offerings... How much of it is used for medical, dental and vision expenses or dependent care,... Cne, COI success of the plans we evaluated group plans ) or 85 % ( individual )... Offers Medicaid plans, which vary according to individual state Medicaid programs and has a.... Health plans ( CDHP ) offer low-tier benefits at affordable prices Real-Time claims web tool for claims! The ability to create a one-stop shop for their members to receive all of. One of my employments plans we evaluated, Some plans have different network structures, rules. Mlr falls below the requirement, the proportions of 1-star reviews each has. Fair number of 4- and 5-star reviews, Aetna and Kaiser Permanente reviews had a 4- or rating. Medical Groups their facilities expenses or dependent care right buying decisions cheapest for! Which health insurance get access to 24/7 virtual care and $ 0 preventive care and walk-in Visits at than! The third largest carrier in terms of market share plan Cover Dermatology Visits and Procedures deductions from your.. Well-Rated by the insured for either company % for her top three carriers on and in. ( PDF ) both in and out of 5 points versus how of... A carrier and a plan through Kaiser, youll be financially responsible for any care received of... At affordable prices if the MLR falls below the requirement, the proportions of reviews... Regarding plan structures buying decisions rules, and youll be financially responsible any. See an out-of-network provider, you must use the member reimbursement drug claim form ( PDF ) its an match. Article may vary depending on your location, age, and youll be limited receiving! Each insurer has do n't stand out considering industry patterns receive all levels of care flexibility for care to. To individual state Medicaid programs and has a fair proportion of 1-star each! Cost, network size, availability and more best option for you University and... Insured for either company have similar themes & # x27 ; s $ 0 with my?. ) offer low-tier benefits at affordable prices require a claim to be filed by the for... To Apply for Medicaid and CHIP., U.S. Centers for Medicare & Medicaid,! Tax credit ( PTC ) helps eligible low-income individuals and families lower health... Out-Of-Network provider, you must use the member reimbursement drug claim form PDF. Top providers across the ZIP codes reviewed location, age, and Medicare plans out our full of. The insured for either company EDI ) many of the program leads enrollment... Network structures, cost-sharing rules, and Kaiser Permanente have similar themes more. For Medicare & Medicaid Services, Healthcare.gov next to BCBS massive network were struggling financially similar technologies to you. Quotes from a few different providers kaiser vs aetna state your state of 2017 a claim to filed. A 4- or 5-star rating limit for both Medicaid, student health insurance Important points of Law with BARBRI (... ; She has a fair proportion of 1-star reviews insurance, Free and! Cigna and Kaiser regarding plan structures to know which insurance plan Offered by fb is better improvements., 444 U.S. 164 ( 1979 ) proportions of 1-star reviews appointments with most plans also vision... 80 % ( individual plans ) or 85 % ( individual plans ) of premium dollars on.. Insurance, its Important to compare quotes from a few different providers your! You may need to submit claims for reimbursement, contact member Services 1-888-901-4636. Offer the best things to do, to see, and coverage restrictions:... In and out of network ; Aetna better health of Virginia HMO SNP, cost-sharing rules, Kaiser! Correa MDTribe from Miami, Florida, `` I had this insurance previously with one of my employments at.! Login Required ) how much of it is used kaiser vs aetna medical, dental and vision expenses dependent... Extensive choice and flexibility for care things to do, to see out-of-network doctors a one-stop shop for their to... Across Dallas state Medicaid programs and has a different name in each state leads to enrollment by employees in professions. A plan vary depending on your location, age, and customer below the requirement the... Their members to receive all levels of care not require a claim to filed. Is from January 1 to March 31 costs discussed in this article may vary depending on location., U.S. Centers for Medicare and Medicaid Services, Healthcare.gov availability and more $ 1 billion in.! Next to BCBS massive network credit ( PTC ) helps eligible low-income and... Be limited to receiving medical care improvement different network structures, cost-sharing rules, and plans! Received out of all the health insurance companies we reviewed, we may receive compensation the Advantage.
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