Celtic, North Carolina
CeltiCare II Select PPO 80/20 $5,000

Vimo Editorial: Health Plan Profile

CeltiCare's Select PPO plan offers a cash-back incentive for participating in a "Healthy Lifestyle" program. That means that 25 percent of charges for eligible programs, like hospital sponsored accredited smoking cessation, weight loss and even exercise programs, are returned to you -- up to $300 a year. It's an interesting incentive, and one that other health plans should offer. Like many high-deductible PPO plans, this one features coinsurance after you burn through the deductible -- and a high out-of-pocket-maximum. In other words, once you spend your deductible, you're responsible for a large percentage of your medical bill until you've reached your OOPM. The plan features an unusually high lifetime maximum payout of $7 million. For an additional premium, CeltiCare offers a generic prescription drug program: Generic drugs are available for a small copay and no deductible.

BEST FOR: Someone looking for a health plan with a sky high lifetime maximum benefit. $7 million can cover a lot of health care. Hopefully, it's a maximum that won't need to be used by the holder.

PROS: The A.M. Best Company – the leading provider of insurer ratings of a company’s strength and ability to meet its obligations to policyholders – has given Celtic an "A-" (Excellent) rating. A.M. Best assigned this rating after a thorough quantitative and qualitative evaluation of a company’s financial condition and operating performance. For more than 10 years, Celtic has earned a rating of Excellent for consistently demonstrating profitable operating results, high-quality investment portfolio and favorable capital position. Celtic holds no junk bonds, real estate or direct mortgage loans and maintains no outstanding debt.

CONS: Like any high deductible health plan, this one requires you to spend a substantial amount of money before the plan kicks in and pays for 100 percent of covered services.