Which are the best health insurance companies in the United States? It's hard to know how to even begin sorting through your multiple options when your employer offers a choice of health plans or you need to select a private health insurance policy.
We've done some of the legwork for you by examining which of the more than 900 companies that sell health insurance in the U.S. are ranked highest by objective criteria for such factors as prevention, treatment, and customer satisfaction. We selected nine recommended insurance companies that have a wide range of available products, along with a few highly-rated regional companies.
To find the best policies for you and your family, you can start by entering your zip code and then other information at the companies' websites. That will direct you to policies available in your area and for your circumstances, at which point you can compare local physician, hospital, and pharmacy choices. You can also find the combination of premium price, deductibles, and other out-of-pocket expenses that is the best option for you.
Best Health Insurance Companies
- Aetna: Best for Medicare Advantage
- Blue Cross/Blue Shield: Best for Nationwide Coverage
- Cigna Health Insurance: Best for Global Coverage
- Humana: Best for 360 Degree (Wrap-around) Coverage
- Kaiser Foundation Health Plans: Best for HMOs
- United Healthcare Services Inc.: Best for the Tech Forward
- HealthPartners: Best Midwest
- Harvard Pilgrim Health Care: Best New England
- Capital District Physicians' Health Plan (CDPHP, CDPHN): Best New York
Best for Medicare Advantage: Aetna
An impressive 43 Aetna Medicare Advantage plans sold in 37 states, plus the District of Columbia, received top NCQA ratings, with Connecticut and Maine being standouts. For 2020, Aetna Medicare Advantage is available in 264 new counties across the country, providing millions more Medicare beneficiaries access to an Aetna plan. The insurer also sells Medicare Supplemental and Prescription Drug Plans in all 50 states and D.C. as well as a combination dental, vision, and hearing product supplemental Medicare insurance in most states.
In the private arena, Aetna is a large provider of employer-based health insurance, and four Aetna plans serving four states made the top NCQA ranks. The company no longer sells individual insurance on healthcare.gov. Aetna plans in Utah and Pennsylvania were top scorers in NCQA, and Aetna was rated a J.D. Power regional "best for consumer satisfaction" in Delaware, Ohio, Virginia, West Virginia, and D.C. In addition, Aetna's pricing seems to be at a lower level than many competitors.
Aetna recently became part of CVS Health Company and synergies between the two are beginning to emerge. For example, Aetna medical plan subscribers with high blood pressure can get a free home monitor at CVS. Chronic disease monitoring may also be available at CVS stores.
Best for Nationwide Coverage: Blue Cross/Blue Shield
One out of three Americans have health coverage from Blue Cross/Blue Shield. The names on various state plans include Anthem, Independence, Hawaii Medical Service, Highmark, and Wellmark, but all of the 36 independent and locally operated Blue Cross Blue Shield companies open doors in all 50 states. Nationwide, more than 96% of hospitals and 95% of doctors and specialists contract with Blue Cross Blue Shield companies—more than any other insurer.
Thirty-one Blue Cross Blue Shield companies were highly rated by NCQA and 14 received good financial ratings, although quite a few were not rated in this area. Ten Anthem Plans—including some with lower overall ratings—scored impressively in the customer satisfaction area. Eleven of the Blue Cross/Blue Shield Medicare Advantage Plans were highly rated. The Blues offer employer insurance, individual policies on healthcare.gov, and a variety of Medicare plans (Medigap, Prescription Drugs Part D, and Medicare Advantage).
Best for Global Coverage: Cigna Health Insurance
It's not surprising that a company that sells a product called Expatriates Insurance would lead our list for international coverage. This global health service company has 170 million customers served by a global network of 1.5 million healthcare professionals and access to doctors in 200+ countries. Its more-than-70,000 employees provide services in 170+ languages. It recently merged with Express Scripts.
In the U.S., four private Cigna plans were top-rated in NCQA. Cigna is the top performer in customer satisfaction in New Jersey and East South Central region according to the J.D. Power survey. Cigna also has one of the lowest complaint rates in the industry, according to ACSI. Cigna sells medical plans in 10 states and dental plans in all 50, plus D.C. It sells individual plans on healthcare.gov and recently entered 19 new markets. Cigna also expanded its Medicare Advantage plans to 80 counties across 17 states.
Best for Umbrella Coverage: Humana
Health insurance policies don't usually cover such expenses as eyeglasses and contacts; dental exams, crowns, and appliances; or prescription drugs. Humana, a broad-based health and well-being company, sells private policies in all these areas, and the company has a range of plans for people living with chronic conditions that include transitions from a hospital stay to home care and meal delivery. It no longer offers health insurance on healthcare.gov. Humana is also among the companies that offer special needs policies for people with a severe or disabling chronic condition or living in an institution.
Four private Humana plans (Kansas/Missouri, Wisconsin, two in Illinois) and three Humana Medicare Advantage Plans (Florida, Illinois, Tennessee) were highly-rated by NCQA. Humana led the pack for customer satisfaction in 2019, according to recently released data from the ACSI survey, and consumers rated it highest for providing good access to primary and specialty care. Humana's policies for HMOs are relatively affordable.
Best for HMOs: Kaiser Foundation Health Plans
The nonprofit insurer won stellar ratings for private insurance, with one plan (Mid-Atlantic States) getting a top overall NCQA score of 5.0 and eight other plans, ranging from Georgia to California, winning 4.0 to 4.5 ratings. In the Medicare Advantage arena, Kaiser was also a winner with eight plans in the very top echelons. The company operates in eight states (California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, Washington) and Washington, D.C.
All of Kaiser's highly rated private and Medicare Advantage plans are HMOs. This is good news for those needing budget health insurance because HMO premiums are generally lower, there is often no deductible, and copays and prescription drug costs may also be lower. The rub in an HMO is the restriction that—except in emergencies—you must use only doctors, hospitals, and other services that are in the network. The plans do, however, deliver the essential goods. They score quite high on the percent of patients receiving screenings, immunizations, and other preventive services and on the treatment of chronic and acute health conditions. Kaiser's policies have relatively low premiums.
Best for the Tech Savvy: United Healthcare Services Inc.
Want to track your health on an Apple Watch? File claims, set up doctor appointments, and find doctors online? United Healthcare's latest annual survey found that almost 40% of consumers shop for healthcare on a computer or with mobile apps. The company is pushing "consumer-driven digital health care," including wearable technology for glucose management, smart baby monitors for high-risk infants, and activity trackers that allow fitness participants to win monetary awards.
Two private United plans (both in Rhode Island) scored an impressive 4.5. Thirteen plans in six states (Connecticut, Iowa, Massachusetts, New Hampshire, Nebraska, Wisconsin) scored 4.0 in overall NCQA ratings. Thirty-four of United's Medicare Advantage plans were highly rated, including many sold under the name Sierra Health and Life Insurance Company.
United offers the full spectrum of health benefit programs for individuals, employers, and Medicare and Medicaid beneficiaries, and contracts directly with more than 1.3 million physicians and care professionals as well as 6,500 hospitals and other care facilities nationwide. Both HMO and PPO plans are available with access to healthcare savings accounts (HSA) and flexible spending accounts (FSA). Its polices may cost a bit more than some of its competitors, but it may be worth it for the extra features.
Best New England: Harvard Pilgrim Health Care
This New England not-for-profit company has two 4.5 rated plans (Maine, Massachusetts), one of which also scored an impressive 4.5 on prevention, and one 4.0 (New Hampshire) plan. The Harvard Pilgrim Choice Plus and Options PPO plans are offered jointly by Harvard Pilgrim and UnitedHealthcare, allowing members access to a network of half a million doctors nationwide, thousands of hospitals, and flexible health benefits.
Best New York: Capital District Physicians' Health Plan (CDPHP, CDPHN)
This not-for-profit, physician-directed health plan has some of the highest rated plans. Two plans garnered a 5.0 in overall score from NCQA, and were among the five private plans nationally that scored 5.0 in consumer satisfaction. A third plan from this company came in near the top at 4.5. And the company's Medicare Advantage plan was also a high scorer. The plans are available in 26 of New York's 68 counties. The company notes that eight out of its 15 board members are practicing physicians.
What Does Health Insurance Cover?
You will find that health insurance coverage ranges pretty widely from one insurance provider to the next, and even between the individual plans offered. But while your exact options vary, there are some mandatory coverage standards that every health insurance policy must now provide.
Thanks to the Affordable Care Act, there are 10 categories of health services that all Marketplace insurance plans are required to cover, called Essential Health Benefits. These include pregnancy and childbirth services, prescription drug coverage, mental health services, outpatient hospital care, preventative care, emergency services, and more. Plans must also provide dental coverage to minors (adult dental coverage is optional).
The exact details and limits of this coverage may differ from one state to the next. Also, large companies that self-insure employees are not required to follow these same standards, though many still do. You’ll want to check with your employer’s plan to see exactly what is covered if you are offered health insurance through your job.
Is Health Insurance Required?
When the Affordable Care Act was first passed, it included a health insurance mandate; if you could afford adequate health insurance (“minimum essential coverage”) throughout the year but chose not to purchase it, you were required to pay a penalty fee. This fee was usually charged when it came time to file that year’s taxes and was imposed on everyone in your household who did not meet the minimum healthcare requirements.
Beginning with the 2019 plan year, however, this penalty—called the Shared Responsibility Payment—was reversed on a federal level. You are no longer responsible for this fee if you choose not to carry minimum coverage, and no exemption is necessary to avoid the penalty.
However, there are some states that still have their own health insurance coverage requirements. Be sure to check the laws in your state of residence to see what level of insurance you’re required to carry and what penalties, if any, apply for not meeting these minimum standards.
How to Determine the Best Health Insurance Plan?
Buying health insurance can be an arduous and confusing process, especially when there are so many options and costs to consider.
There are a few questions to ask yourself if you want to make the search a bit easier. They include:
- Does my employer offer coverage or will I need to shop the Healthcare Marketplace? A workplace plan, if offered, may be more affordable than buying a private plan.
- How often do I anticipate using my coverage? If you only see the doctor for routine/preventative care, you’ll need a very different plan than someone who has a chronic condition or a child with special needs.
- What sort of costs can I expect to encounter? You typically have two options to choose from: a high deductible or high(er) premiums. If you don’t expect to use your coverage much—and can afford the out-of-pocket cost if you do wind up needing serious care—a plan with a high deductible can save you money all year long. On the other hand, if you and your family are at the doctor’s office often, paying a bit more for premiums in exchange for a lower cost-share/deductible may be the less painful option.
- Will I be able to see my same doctor(s)? If you enjoy seeing your current providers, you’ll want to make sure that they accept your new plan before switching, or you’ll need to find new doctors.
- What if I need emergency care (especially when traveling)? Be sure to read the fine print and coverage options before picking a plan, particularly if you’re often in other states. Some plans have stricter guidelines than others when it comes to seeking care while away from home.
Depending on whether you are choosing an employer-based plan or shopping on the Marketplace, you may also want to compare PPO vs HMO options. You should also consider whether you need a plan that also provides dental and/or vision coverage.
How Much Does Health Insurance Cost?
As with any insurance product, there are countless personal factors that go into calculating your cost for coverage. When it comes to health insurance premiums, you also have to take into account the difference between employer-sponsored plans and those purchased on the marketplace, the difference between coverage for a single person and that for a family, and whether your income qualifies you for a tax credit on your marketplace plan premiums.
There are a few factors that go into calculating your health insurance cost across the board, though. These include your age, gender, location, personal and family health history, and whether or not you’re a smoker.
For instance, whether you’re buying an employer-sponsored plan or one on the ACA marketplace, you can expect your premiums to go up by as much as 50% if you smoke or vape. When you consider that annual healthcare premiums are already an average of about $6,896 for single folks and $19,616 for families, an extra 50% could feel significant.
How We Chose the Best Health Insurance Companies
We examined the 126 health insurance plans that were top-rated by NCQA, the National Committee for Quality Assurance, a nonprofit rating group, and aggregated them by the insurance company. We then narrowed the list to companies that had highly-rated plans available in multiple states. To make the best list, the company also had to have at least an A- financial rating by AM Best, Fitch, or Standard & Poors.
We then took a qualitative look at our nine highly-rated companies to identify special strengths that might appeal to the priorities of different types of consumers. We examined how the companies rated in NCQA subcategories, in the ACSI (American Customer Satisfaction Index) survey of roughly 300,000 consumers, and in the J.D. Power customer satisfaction survey of 28,809 commercial health plan members. We looked at company profiles and Top Ten Reviews to evaluate the depth and breadth of the company's coverage offerings and pricing for individual and employer-based insurance, Medicare Advantage, and other types of policies.
We also looked at availability—the number of doctors, hospitals, and medical systems that contract with (or accept) a particular insurance company’s coverage—and types of coverage offered. And we considered where these insurance companies operate and whether plans can be purchased on healthcare.gov.
Pricing was an important factor in our consideration, and lastly, we considered the number of plans offered and what sort of coverage limits consumers were able to choose from while shopping around for their health insurance.
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