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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.

Key Takeaways

  • Many 2020 health insurance plans sold on healthcare.gov now have star ratings that reflect member experience surveys, clinical measures, and plan administration.
  • Roughly 80% of the plans in the federal marketplace earned three stars or more, but eight states had no plans with at least three-star ratings.
  • Kaiser and Blue Cross Blue Shield were among the best-rated insurance companies.
  • If your circumstance have changed, resulting in a loss of health insurance, you may be eligible for a special enrollment period at healthcare.gov.
  • Other tips for finding affordable health insurance include considering Medicaid, seeing if you qualify for subsidies, getting quotes directly from insurers, and using a short-term plan as a bridge.

Which Plans Rated Best

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. 

Highest-Rated Companies on the Federal Exchange

STATE COMPANY Overall Star Rating
(1-5 stars/5 is highest rating)		 Number of High-Rated Plans
Arizona USAble Mutual
Insurance Company		                                        4                           7
Florida Blue Cross Blue
Shield of FL, Inc.		                                        4                          24
  Health First, Inc.                                        4                          44
Georgia Kaiser Foundation Health Plan of Georgia, Inc.                                        4                           34
Hawaii Kaiser Foundation Health Plan, Inc.                                        4                           11
Louisiana Louisiana Health Service & Indemnity Company                                        4                             5
  Vantage Health Plan                                        4                             6
Maine Harvard Pilgrim Health Care, Inc.                                        4                             9
Michigan Blue Care Network of Michigan                                        4                           16
  Blue Cross Blue Shield of Michigan Mutual Insurance Company                                        4                             9
  Physician Health Plan                                        4                           18
New Hampshire Harvard Pilgrim Health Care of NE                                        4                             9
  Celtic Insurance Company                                        4                             7
North Carolina Cigna                                        4                             5
North Dakota Sanford Health Plan                                        4                             8
Oregon Kaiser Foundation Health Plan of Northwest                                        4                           10
  Providence Health Plan                                        4                           11
Pennsylvania Geisinger Health Plan                                        4                           64
  Independence Blue Cross (QCC Ins. Co.)                                        4                             5
South Dakota Avera Health Plans, Inc.                                        4                             7
  Sanford Health Plan                                        4                           16
Texas SHA, LLC                                        4                             6
Virginia CareFirst BlueChoice                                        4                             5
  Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.                                        5                           23
  Optima Health                                        4                           15
Wisconsin Childrens Community Health Plan                                        4                             7
  Dean Health Plan                                        4                           40
  Group Health Cooperative of South Central Wisconsin                                        4                           27
  HealthPartners Insurance Company                                        4                             6
  Network Health Health Plan                                        4                           18
  Unity Health Plans Insurance Corporation                                        4                           57

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.

How to Find Affordable Health Insurance

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.

It's possible for someone to buy health insurance directly from an insurance company at any time.

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

Consider Medicaid

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. 

Check if you qualify for a subsidy

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. 

Compare total annual costs

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. 

Decide how much coverage you need

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. 

Get quotes directly from insurance companies

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.  

Use a short-term plan as a bridge

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.

Get free help in finding a plan 

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.