Innovation Health Insurance Review & Complaints (2024)

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Innovation Health insurance company offerings include Leap Catastrophic, Leap Bronze, and the Innovation Health Leap Silver Basic plan. Innovation Health quotes for a 30-year-old in Virginia brought back Innovation Health insurance rates ranging from $181.06 to $351.96 for the Gold Diabetes Plan.

Innovation Health was created through a partnership between health insurance giant Aetna and local health care provider Inova to provide better care with a comprehensive healthcare system of physicians for Virginia members. The system’s health goals were designed to reduce health care costs on all sides, and it is the first of its kind to service the nation.

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What is Innovation Health?

Innovation Health is a partnership between Inova, a large health care system in northern Virginia, and Aetna, Inc., one of the largest health insurance companies in the U.S. This healthcare system was launched in 2012 in the hopes of creating a connection between the insurance company and the healthcare providers to keep medical costs down on all sides.

The Inova health system traces its roots back to the 1950s when a community hospital was opened in Fairfax Falls, VA. The hospital grew into a health care system comprising several facilities under the name Fairfax Hospital Association. The Association officially changed its name to Inova Hospitals in 1991.

Aetna is a hundred years older than Inova, going back to the 1850s when it was founded as a life insurance company. In the 1990s, Aetna began to shift towards health insurance, buying out several large companies. Today, Aetna Health is one of the largest healthcare companies in the nation, and a Fortune 500 company ranked at number 43 for 2017.

Innovation Health offers a wide variety of insurance health plans including individual and family plans, group plans, and Medicare.

Innovation Health was launched in 2012. It is a system that offers incentives to the insurance company as well as the provider to ensure a lower cost and for members to get affordable insurance options with access to the Inova provider network.

Plans are not quite HMO but are strongly focused on obtaining in network care from the Inova providers. The company has a selection of plans available for individuals and for groups.

What Innovation Health insurance plans are available?

The Innovation Health website does not provide detailed plan information without going through the quoting process. Since it was not open enrollment time when this review was prepared, the website also required that we enter a qualifying life event to apply for insurance out of the enrollment period.

For the purpose of accessing plan information and rates, we entered “loss of employer coverage” as a qualified event, and then requested information based on a 30-year-old in Fairfax County, Virginia.

The results returned seven plans, two of which are intended specifically for members with diabetes. One plan is specifically designed for those in the population with mental health conditions. Plans come at all levels: catastrophic, bronze, silver, and gold.

Read more: Best Life Insurance Policies When You Have Diabetes

The Leap Catastrophic plan has a $7,150 individual deductible and $14,300 family deductible in-network. These deductibles are also the out-of-pocket maximum so that in-network services are covered in full after they are met. Primary care visits have a $20 copay for the first four visits, and $0 after that, and do not require that the deductible be met first.

All out-of-network patient health care is covered at 50% after the $20,000 individual and $40,000 family out-of-network deductible is met. Prescription drugs are also covered at 100% after the deductible is met.

The Leap Bronze plan is very similar to the catastrophic health care plan. The deductibles are slightly lower at $7,050 individual and $14,100 family for in-network care, and again, deductibles are also the out-of-pocket maximum.

Out-of-network the deductible is $20,000 individual and $40,000 family – in fact, this is true across the board on the Leap plans. Under this plan, nearly all services are paid out of pocket until the deductible is met, including all office visits. The prescription coverage offers a $5 copay for generic drugs, with all others covered at 100% after the deductible.

The Leap Silver Basic plan brings the in-network deductible down a little, to $6,075 individual and $12,150 family, which like the rest is also the out-of-pocket maximum. The out-of-network is the same as the other plans previously mentioned. Primary care visits have a $10 copay, specialist visits $0 after the deductible is met. Prescriptions are covered with the same copay as the Bronze plan.

The Leap Silver Diabetes plan is designed for those needing ongoing diabetes care. Deductibles are $6,300 individual and $12,600 family and are also the out-of-pocket maximum. Copays are $5 for primary care and $100 for specialist visits. Prescription coverage on this plan has lower costs to assist with diabetes treatment needs. Tier 1 prescriptions have a $5 copay, Tier 2 a $50 copay, while the remaining Tiers are covered at 100% after the deductible.

Leap Silver Plus has in-network deductibles of $5,050 individual and $10,100 family. Like all of the preceding plans, these are the out-of-pocket maximum for in-network care, and out-of-network is covered with the same deductibles and 50% coinsurance after the deductible that all the plans offer.

Copays are $5 for a primary care visit and $0 for specialists after the deductible. Prescriptions have the same coverage as the Silver Basic and Bronze plans.

Leap Silver Healthy Minds is a plan designed for those living with mental illness. Like the Diabetes plan, it offers better coverage for office visits and has the same copays as the Diabetes plan. Deductibles are a bit lower, however, at $5,600 individual and $11,200 family for in-network care.

Again, these are also the out-of-pocket limits for this plan, and out-of-network care is the same as all other plans. Prescription drug coverage is the same as the Silver Basic and Bronze plans.

Surprisingly, our search returned only one Gold plan, and it is the Leap Gold Diabetes plan. This Innovation health plan has the lowest deductibles at $2,835 individual and $5,670 family, however, unlike the other plans, that is not the out-of-pocket maximum for coverage. Out-of-network care is covered with the same deductibles and coinsurance as the other plans.

The primary care copay is $5, and the specialist visit copay is $100. Prescription drugs are covered with a $5 copay for Tier 1, a $50 co-pay for Tier 2, and $0 after deductible for Tier 3. There is a 50% coinsurance after deductible for specialty drugs.

What are Innovation Health rates?

Rates were returned along with the Innovation health plan descriptions when we ran our request for plan information. The plans start at $181.06 for the Catastrophic plan based on the sample member information we entered. They rise steadily from there, up to the Gold Diabetes plan, which came in at $351.96.

Since this is a local provider with a limited coverage area, we are unable to offer a comparison to the rate quotes we usually run. The rates seem reasonable, but not the low cost we would expect from a plan that promises to work to drive down healthcare costs, a reduction that should be passed on to consumers.

We are also surprised at the range of rates given the fact that, outside of the Gold plan, there is not a large drop in deductible amounts among all of the plans, and not a large difference in the copays, either. That begs the question of what members are really paying for with the pricier plans.

Claims Process at Innovation Health

Ease of Filing a Claim (Online, Over the Phone, Mobile Apps)

Innovation Health offers a streamlined claims process for its members. Policyholders can conveniently file claims through multiple channels, including online submission, over the phone, and through their mobile apps. This flexibility ensures that members can choose the method that suits them best, making it easy to initiate the claims process.

Average Claim Processing Time

The speed at which claims are processed is a crucial factor for policyholders. Innovation Health is committed to providing efficient service, and the average claim processing time is a key aspect of this commitment. Policyholders can expect their claims to be handled in a timely manner, reducing the waiting period for reimbursements.

Customer Feedback on Claim Resolutions and Payouts

Customer feedback is invaluable in assessing the quality of an insurance provider’s claims service. Innovation Health aims to meet the needs of its members by delivering fair and satisfactory claim resolutions and payouts. Understanding customer satisfaction with this aspect of the insurance experience can help potential policyholders make informed decisions about their coverage.

Explore Innovation Health’s Digital and Technological Features

Mobile App Features and Functionality

Innovation Health’s commitment to technological innovation extends to its mobile app. The mobile app offers a range of features and functionalities designed to enhance the user experience. Members can access their policy information, track claims, and even initiate the claims process directly from their mobile devices.

Exploring the app’s capabilities can provide valuable insights into the convenience and accessibility of Innovation Health’s services.

Online Account Management Capabilities

Managing insurance policies and claims online has become increasingly important in today’s digital age. Innovation Health recognizes this need and offers robust online account management capabilities. Policyholders can easily log in to their accounts, view policy details, make premium payments, and monitor the progress of their claims.

Assessing these online features can help individuals gauge the convenience of managing their insurance with Innovation Health.

Digital Tools and Resources

Innovation Health provides a range of digital tools and resources to empower its members in making informed decisions about their health insurance. These tools may include cost calculators, provider directories, and educational resources.

Exploring the available digital resources can shed light on the level of support and guidance that Innovation Health offers to its policyholders in managing their healthcare needs.

What are Innovation Health’s ratings and consumer reviews?

Innovation Health does not currently have its own Better Business Bureau (BBB) page, and it is rare to find reviews of the system directly. This is partially due to the fact that this is a new partnership, and partially due to it being a partnership at all.

Reviews may appear about either Aetna or Inova that relate to Innovation Health, but it would not create an accurate picture to count all Aetna complaints against Innovation, nor to count all Inova complaints in the same way.

Looking at the BBB records for Inova leads to further complexity, as each hospital and medical center has its own page. We did pull the BBB file for Aetna to create a general picture of the company’s reputation. The company has an A+ rating with 609 complaints in the past three years, 212 of which have been closed the past 12 months. For a company with 22 million members, this is not a high complaint volume.

You can read our full review of Aetna here.

We will likely see more information on Innovation Health over time when the system is better established.

What is the bottom line?

Innovation Health may be a good choice for those who do not mind a small network of providers and are ok with a plan that is heavy on paying towards the deductible rather than many different copays. The system is new and unique, and time will be needed to see if it really makes a difference in health care costs, particularly for members rather than just for the companies.

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