The Best Affordable Health Insurance Companies

If you're looking for affordable private health insurance, which company should you choose? The best source of affordable coverage is often one of the plans available on the Health Insurance Marketplace through the Affordable Care Act. This is especially true if you qualify for a subsidy that lowers your monthly charges. And, depending on where you live and which level of plan you want, you may have a number of choices to consider.

For the first time, quality star ratings are now available for many of the 2020 health insurance plans sold through healthcare.gov. The five-star scales are based on three elements: surveys of member experience, clinical measures such as preventive screenings, and plan administration (including customer service).

While coverage and cost issues remain paramount when choosing a health insurance plan, the star ratings add an indication of the quality for the plans sold on the federal and state exchanges.

Overall, about 80% of the plans in the federal marketplace earned three stars or more, with only 1% earning five stars. However, eight states on the federal marketplace didn’t have any health plans that earned at least three stars: Iowa, Kansas, Missouri, Nebraska, Nevada, New Mexico, West Virginia, and Wyoming. Kaiser and Blue Cross Blue Shield were among the best-rated insurance companies.

Kaiser Foundation Health Plans were the only ones to win five-star ratings on the federal exchange, ranking highest for 24 of its plans in Virginia, 34 in Georgia, and 11 in Hawaii. Kaiser Permanente also earned five stars on the California state exchange. It garnered four stars on the Colorado and D.C. state exchanges, though the number of plans is not available.

Blue Cross Blue Shield plans, sold under many different “blue” names, had a number of four-star plans on the federal exchange: 24 in Florida; 25 in Michigan; 4 in Pennsylvania; and 4 in Virginia. And Harvard Pilgrim Health Care had 4 four-star plans in Maine and four in New Hampshire. The Blues also garnered five stars in Massachusetts and Vermont state exchanges, and four stars in D.C. and Vermont (again, the number of plans was not available). 

Overall star ratings have not been released from the other states that have their own Affordable Care Act exchanges—Connecticut, Idaho, Maryland, Minnesota, Mississippi, New Mexico, New York, Rhode Island, Utah, and Washington. But local star ratings can be obtained by residents who enter their zip code. 

The Affordable Care Act remains robust, despite court challenges and budget cuts for publicity. Overall sign-ups for 2020 dipped only slightly to 8.3 million from 8.4 the year before, and in some states enrollment has actually gone up. Florida, Texas, and North Carolina had the highest number of enrollees.

Rates for plans sold at healthcare.gov decreased by almost 3% for 2020. Average cost for a bronze plan, before tax credits, for a 40-year-old-man was $331 a month in 2020, compared to $340 a month in 2019; a 2020 silver plan premium averaged $442 a month, and the lowest-cost gold premium averaged $501 a month.

If your circumstance have changed, resulting in a loss of employer-provided health insurance, you may be eligible for a special enrollment period at healthcare.gov and not have to wait until the next open enrollment period in the fall. Under these circumstances, which include loss of job-based health insurance or COBRA expiration, a divorce or legal separation, or the addition of a child, you are allowed to purchase health insurance on the exchange outside the next open enrollment period.

Here are some additional tips for finding affordable health insurance coverage now.

The least expensive health insurance is likely to be Medicaid. States vary drastically in who qualifies for this insurance, but if you do, you may be able get free or very low-cost coverage. To get started, go to medicaid.gov, where qualifications are summarized and there are links to get you to the details of your state’s program. 

Subsidies under the Affordable Care Act can significantly reduce premium costs, and even families with substantial income, such as a family of four earning $100,000 a year, may qualify. Check it out with this simple calculator. 

Even if you don’t qualify for a subsidy, it’s a good idea to start looking for a plan at healthcare.gov. When comparing plans available in your zip code, pay attention to total annual costs, which includes premiums, copays, and deductibles. While the monthly premium of some plans may be very attractive, large copays (such as $1,000 for every day of hospitalization) may make the lowest premium plans a risky choice. 

With the lowest cost bronze plans the insurance company pays 60% of the costs and you pay 40%. At the other end, the highest priced platinum plans pay 90% of medical costs and you pay 10%. Bronze plans can be a good choice for those who anticipate needing very little medical care but need protection against worse-case medical scenarios. Those who are dealing with chronic medical conditions, however, may want to opt for a plan that covers more expenses. 

If you don’t qualify for a subsidy at healthcare.gov, it’s wise to shop there first and then get premium quotes directly from the insurance company you prefer. For certain plans you may actually pay less if you buy directly than if you shop at healthcare.gov or on the state exchanges.  

Short-term plans, not available in every state, are not guaranteed issue, meaning that you may be turned down or charged a premium based on your medical history. These plans often do not cover pre-existing conditions and are not required to cover the full range of benefits available on Affordable Care Act plans. Nonetheless, they are worth looking into as a last resort if you cannot buy coverage through a special enrollment. They will provide at least short-term coverage from unexpected and catastrophic healthcare emergencies, and serve as a bridge until you’re able to buy longer-term coverage.

There are two free sources of help for finding health insurance. Navigators for the Affordable Care Act are available in person and by phone. And private insurance brokers in your local area, paid through commissions by insurance companies, can guide you through the process of finding an Affordable Care Act or other policy.