As Congress labors to give birth to a bill that will redefine healthcare for decades, millions of Americans just want to figure out by December 31 which health insurance plan to pick for the coming year from their on-the-job options. It's not always simple, and U.S. News and the National Committee for Quality Assurance, managed care's major accrediting and standards-setting body, want to help. So they have joined for the fifth year to rank commercial, Medicare, and Medicaid health plans.

NCQA looked at 730 health plans overall to create the 2009-10 "America's Best Health Insurance Plan" rankings. NCQA analyzed quality-related information supplied by most of the plans--dozens of measures covering three broad areas: member satisfaction (for example, how well doctors communicate), prevention (such as diligence in screening for various illnesses), and treatment (like success in controlling high blood pressure in members with heart disease).

Commercial plans were graded on 50 measures, Medicare plans on 44, and Medicaid plans on 41. Each plan got a score of 0 to 100 according to how well it performed compared with other commercial or Medicare or Medicaid plans. Member satisfaction made up 25 percent of the score, prevention and treatment together 60 percent, and NCQA accreditation 15 percent. Rank was determined by plan score.

The Honor Roll below consists of plans that got the highest scores--the 10 top-ranked commercial plans, five Medicare plans, and five Medicaid plans.

Click here to see the rest of the top plans.

How to Choose a Health Plan: 12 Helpful Tips

Choices, choices. Which health insurance plan would be best for the coming year? No problem: the one that offers the best balance of coverage and total cost. Thanks a lot, you say. How can anybody predict the coverage a family might need or what health expenses might be lurking out there? The future could hold routine checkups and a prescription or two-or weeks of testing and hospitalization--so picking a plan will always be something of a guess. But the following dozen tips should make it an educated one.

1. Survey the field. There are three basic flavors of health insurance plans, each providing a different degree of freedom in choosing caregivers. A health maintenance organization (HMO), which limits members to physicians in a defined network, may offer enough choice and coverage for someone young and healthy. A point-of-service (POS) plan or preferred provider organization (PPO), which provide unrestricted access to specialists, might be preferable if someone has a chronic illness such as diabetes.

2. Fill in the blanks. Most employers provide an online calculator to help make a rough estimate of the amount of coverage that families need, but only a small percentage of employees use them. Online plans for individuals also offer calculators.

3. Figure the cost. With your coverage needs in mind, see how each of the plan options might affect your budget. Remember that your costs will be more than the total of the monthly premiums. There is the deductible (how much you have to pay before coverage starts), cash out of pocket for copayments (fees charged by providers), and coinsurance (your share of the bill for hospitalization and prescription drugs). Someone young and healthy, who probably will need mostly preventive services, may save with a high-deductible plan, which won't start paying until $2,500 in charges, say, are run up. Warning: Make sure you can afford to pay the deductible yourself, plus a safety margin, should unexpected medical costs pile up.

4. Check for changes. Aside from a higher premium or deductible, the plan you had last year could have raised the out-of-pocket maximum, the total you pay before 100 percent of expenses are covered-from $1,000 to $1,500, say. As healthcare costs escalate, checking is especially important this year, says Randall Abbott, a senior healthcare consultant at Watson Wyatt.

5. Look for favorite docs. To continue seeing the same primary-care doctor and familiar specialists as before, make sure they are in your favored plan's provider network.

6. Don't bump the ceiling or fall through the floor. Plans often put annual caps on coverage for specific services--the number of visits for physical therapy following an injury, for one. And some coverage may be entirely absent--maternity, for example. But a law to take effect in 2010 will soften the once harsher limits on mental-health and substance-abuse coverage.

7. To save, start saving. One way to afford out-of-pocket costs is with an individual savings account created to cover ordinary healthcare expenses such as copays, prescriptions, and eyeglasses. A health savings account, offered by an increasing number of companies, has to be paired with a high-deductible plan. Anything left in the account at the end of the year rolls over to the next year. A flexible spending account is another option; it does not have to be linked to a high-deductible plan, but leftover amounts at year's end will be forfeited unless the employer adds a grace period of up to 2 ½ months (many do), as permitted by law. Contributions to either an HSA or FSA are subtracted from your pretax income.

8. Don't overpay for prescriptions. The plan's formulary shows the prescription medications that are covered. This year, you could see your copay for generic drugs dip. Those with chronic conditions may have the option to get meds for less or free in some cases. Opting to get them by mail can save even more.

9. Take advantage of wellness incentives. Plans often offer discounts for quitting smoking or keeping your diabetes in check. You could make $200 just by taking a health risk assessment, or receive a premium reduction to participate in wellness activities that 93 percent of large employers are now offering, according to a 2009 benefits survey by the Kaiser Family Foundation. "While employees are bearing a lot of the cost increases in premiums and out-of-pocket expenses, employers are giving them a carrot to help offset some of those costs," says Sara Taylor of benefits consultant Hewitt Associates.

10. See if your spouse has a better deal. If your spouse can get coverage through an employer, his or her options might be better suited for your family. Though group coverage through an employer is generally cheaper than buying a family plan in the individual market, it could pay to shop around as long as no one has an illness or condition for which coverage could be denied.

11. Protect yourself if your job looks shaky. If a layoff seems likely, you may want to consider a plan with a lower premium in case you have to pay the whole cost through COBRA, advises Samuel Gibbs, a senior vice president at eHealthInsurance.

12. Don't let the decision slide. Sixty percent of employees do nothing about their benefits during open enrollment season, Taylor says. That could drop you into a plan that doesn't work as well as your current one. Worse yet, some employers are terminating coverage for employees who do not make a choice.