Who are the biggest, best, safest and most reliable health insurance carriers in the US? After extensive and exhaustive research, we think we know! Our 2018 ratings and reviews are available to help you choose a top-ranked company that provides affordable pricing and comprehensive on and off-Marketplace coverage. Typically, single, family, self-employed, Senior, and small-business options are offered. Non-subsidized and off-Exchange plans are also available. Our Top-10 list is shown below.
Some of the factors used in determining rankings include size, stability, ratings, promptness of paying claims, plan availability, competitiveness of prices, ease of customer service and broker assistance, online enrollment process, and size of local and national provider networks. In recent years, the number of available providers has dwindled, so having access to physicians, hospitals, and other medical facilities is more important than in past years. Also, many carriers, such as UnitedHealthcare, Humana, and Aetna, have substantially reduced the number of states where they write Exchange business. Under the Trump administration, they may return to many states in 2019. It's also possible that several insurers, such as Kaiser and Cigna, will offer plans in additional states.
When purchasing benefits during Open Enrollment, your pre-existing conditions are covered without paying a higher premium, or waiting for any benefits to begin. Your eligibility for a federal subsidy will determine how much your rate reduces and which cost-sharing features will apply. However, quality "off-Marketplace" plans are also available for persons that prefer as little government involvement as possible. Often larger provider-networks and streamlined enrollment are common with these options. Comprehensive and catastrophic options are offered. Senior Medigap plans are not eligible for federal subsidies and have a separate Open Enrollment period.
Part of the Blue Cross and Blue Shield Association, Anthem was created 15 years ago when it merged with Wellpoint Health Networks, and instantly became the largest US health insurer. Although it eventually lost that top spot to UnitedHealthcare, it is still the biggest for-profit managed care company in BCBS. Officially, the branded name reverted back to "Anthem" four years ago. Based in Indianapolis, several "customer segments" provide diversified coverage. These segments include Individual, Medicare, Medicaid, Blue Card, Federal Employee Program, National Accounts, Local, and Specialty Products.
Cigna and Anthem were previously in the process of merging their $54 billion of assets, although completing the transition never occurred. A federal judge also blocked the merger, after the US Justice Department filed suit in several states. Violation of antitrust laws was the main reason that the merger was denied. Humana may be a possible takeover target in the future. Both carriers offer competitively-priced Senior products in all states.
Based in the Midwest (Indianapolis), Wellpoint offers all types of health insurance, including, HMOs, PPOs, HSA Accounts, short-term plans, student medical coverage, and of course, Exchange/Marketplace contracts. In addition to medical plans, also available are specialty products such as life, disability, dental, vision, flexible spending accounts (FSAs), and long-term care. Anthem rates in Ohio, Indiana, and other Midwestern states were very competitive and usually were among the lowest prices available. Currently, they offer Marketplace plans in 14 states.
Because of the huge nationwide provider network, customers are often able to take advantage of services that are "repriced" due to contractual agreements. This often results in discounts up to 75% (especially for lab tests and diagnostic services) that save patients thousands of dollars in out-of-pocket expenses. Costs of MRIs, CT Scans, ER visits, and other expensive procedures are also helped by these agreements.
Senior services are heavily emphasized by Anthem Medicare Supplement and Medicare Advantage plans. Medigap coverage is available outside of standard Open Enrollment periods if you reach age 65. They recommend that older adults routinely receive the following screenings: BMI (Body Mass Index), diabetes, hypertension, cholesterol, fall prevention, osteoporosis, and colon cancer. Since preventative expenses are fully covered on Senior and under-65 plans, out-of-pocket expenses are typically extremely low or $0.
Some of its biggest brand name affiliated companies include Blue Cross, Blue Cross Blue Shield, Empire Blue Cross, Anthem, Amerigroup, UniCare and CareMore. Additional companies that offer related services include DeCare Dental, Golden West Dental, Resolution Health, Meridian Resource Company, and National Government Services. Anthem is also involved in low-income household coverage, including Medicaid and State Children's Health Insurance programs (CHIP). One of the most recent major acquisitions was Health Sun, an integrated Medicare Advantage Health Plan in Florida. Federal Employee Program (FEP) coverage is offered to US Government workers and dependents.
UnitedHealthcare is the insurance wing of UnitedHealth Group, the largest writer of coverage in the US. Currently, more than 70 million persons are covered and the provider network consists of more than 750,000 physicians, specialists and other related professionals. Also, almost 6,000 hospitals are "in-network" along with more than 80,000 dentists and eye wear-related providers. Either individual, group, or Senior products are offered in every state.
Plans are marketed to the single, family and small business marketplace. Previously, millions of grandfathered plans remained in-force, providing quality benefits at a reasonable rate. However, most of those contracts were updated or re-issued to comply with federal regulations. Typically, prices are among the most competitive of all companies in most urban and rural areas. "Short-term" policies remain very popular, and although these plans do not meet Affordable Care Act guidelines, they are very inexpensive and are usually issued within 24 hours. Different variations of temporary plans are available, including copay policies that cover pcp office visits.
After choosing to skip most state Exchanges in 2014 and 2015, in 2016, UHC made a robust effort to participate in many more states, and prices were typically very attractive. Copay plans were among the most popular, and are available in the Bronze, Silver, Gold and Platinum tiers. HSA and High-Deductible policies continue to offer quality low-cost coverage, while the over-65 market is well-served with many Medigap contract options. However, beginning in 2017, UHC began to drastically reduce the number of states that it offered personal plans. It's expected that by 2019, many additional states will be added again.
Seniors across the US use UHC for Medicare Advantage, Medicare Supplement, Prescription Drug (Part D) and Special Needs coverage. The most common Medigap (Supplement) options are Plans A, B, C, F, K, L, and N. Advantage plans, which allow the carrier to offer standard benefits, are popular in many areas because of their low cost. They compete very favorably with other companies. Their out-of-state provider network is very popular for consumers that live in border areas. AARP MedicareRX plans are offered to many persons age 65 and older.
The four Medicare Advantage options at UHC are HMO (most non-emergency services from a local network), PPO (outside of network services also provided), POS (limited outside of network services provided) and PFFS (approved Medicare physicians may be utilized if they agree to UHC's reimbursement options). Four Medicare Special Needs plans are also offered. They are: Chronic Condition, Institutional Equivalent, Institutional, and Dual Eligible.
Aetna, like UnitedHealthcare, is one of the nation's biggest carriers and also participated in many more State and Federal Marketplaces in 2015 and 2016, compared to 2014. A proposed merger with Humana was halted as the Justice Department filed antitrust lawsuits, and both carriers mutually agreed to cease negotiations. Also, several physician groups (American Medical Association is one of the largest) opposed the Aetna-Humana merger, along with the Cigna-Anthem merger. Access, cost, and quality of healthcare were their major concerns.
Although their subsidiary Coventry is also very active in many states, the brand name "Aetna" is one of the most recognizable names in the industry, with its home office in Hartford. In addition to medical coverage, dental, vision, small business and Medicare benefits are available. Senior Medicare Supplement and Advantage products have been given much more attention in recent years. Competitively-priced options include Advantra Silver, AdvantraOne, Aetna, Medicare Standard Plan, Advantra Silver Plus, and Advantra Gold.
For 2017, Marketplace plans are available in Virginia, Nebraska, Iowa, and Delaware. However, in many other states, "off-Exchange" contracts may be purchased, along with employer-sponsored, and Medigap options. Although prices are not different (occasionally, a slight difference), a broader network may be available when enrolling "off-Marketplace." Coventry is the brand name associated with Exchange plans in many states, including Pennsylvania and Ohio. Competitively-priced HSA plans are offered.
Previously, before the passage of "The Affordable Care Act," Aetna offered competitively-priced PPO and HMO plans in most states. Premiums were typically very attractive in many parts of the East and Midwest. In many areas of the country, Aetna's HMO contracts are the most competitive contract available. In future years, we anticipate an additional 5-10 states of Marketplace participation, including potential profitable areas in the Midwest, especially Ohio and Indiana.
Cigna is a global services company with more than $30 billion of annual revenues and 35,000 employees. Their pending merger with Anthem will create one of the largest healthcare companies. Individual medical, group, disability, dental, and life coverage are offered throughout the world. Here in the US, their single and family health insurance plans are available in most states. Both subsidized and unsubsidized contracts are offered. Cigna was previously created when INA and Connecticut General merged in 1982.
For Seniors, many Medigap and Medicare-related products and services are available. Cigna-HealthSpring offers Medicare Advantage plans while HealthSpring RX offers standalone prescription drug options for existing policyholders. Supplement contracts are also offered. Premiums are very competitive, and policies are guaranteed renewable. Whole Life coverage can also be added to cover funeral expenses, grandchildren's education, and spouse or children's needs. Rates are somewhat attractive, although choosing a major life carrier, such as MetLife, Prudential, Northwestern, or New York Life, will probably provide better choices.
For persons under age 65, Marketplace plans are offered in the following states: Arizona, California, Colorado, Connecticut, Florida, Georgia, Maryland, Missouri, North Carolina, South Carolina, Tennessee, and Texas. The HSA Bronze and HSA Silver plans are very popular for healthier households seeking low rates and an additional tax deduction. Flex Silver and Flex Gold plans provide lower deductibles and copays. Expatriate International policies are also offered in 12 countries. Benefits are offered from $1 million to "unlimited."
Like most carriers, group policies are offered through small and large employers, along with various ancillary products, such as dental, vision and disability. Online tools and resources are easily assessable for the policyholder, or for brokers and/or websites like ours to assist customers. Most importantly, there are several low-cost plans available in most areas including pharmacy management and voluntary products. Senior Part D prescription drug plans offered include Cigna-HealthSpring RX Secure ($400 deductible) and Cigna-HealthSpring RX Secure-Extra ($50 deductible) plans.
Kaiser is actually two separate large organizations. Kaiser Foundation Health Plan And Hospitals is a non-profit entity and works with Permanente Medical Groups. Although coverage is only offered in the District Of Columbia and eight additional states, about 10 million persons receive services and/or benefits. Currently, they are based in Oakland and are very active in the California Marketplace. Other states they currently write business include Georgia, Oregon, Colorado, Hawaii, Maryland, Virginia, and Washington, and the District of Columbia.
Created and founded in 1945, their stated goal is to keep their customers and clients healthy. And with a large emphasis on preventive benefits and management, their policyholders are among the healthiest in the US, when compared to other insurers. Dozens of Kaiser medical centers are located throughout the US, including Los Angeles, San Diego, and Richmond. Currently, Kaiser is not rated by A.M. Best Company Health Insurance Ratings. However, they are rated by several other companies. Customer satisfaction is generally very high, and most policyholders renew their plans after the first year.
Typically, Kaiser is ranked highly for quality and preventative care. The National Committee For Quality Assurance (NCQA) recently awarded their highest ratings for breast cancer and cervical cancer screening, adult BMI assessment, control of high blood pressure, Beta-Blocker treatment after a heart attack occurs, patient-monitoring when receiving regular medications, and nutrition for children. Other awards received have been for safety procedures and patient safety, supplier diversity, hypertension control, nursing anesthesia, adult heart surgery, clinical excellence, best hospital for obstetrics, military friendly, Medicare plan ratings, and for improvements in community health.
Kaiser Senior Advantage (HMO) plans are very popular (where available) for applicants that are Medicare-eligible. Monthly premiums in California are often $0 and primary-care physician and specialist office visit copays are as low as $5. Urgent-Care visits also may be subject to just a low $5 copay. Washington, and Virginia, for example, have higher rates, copays, and maximum out-of-pocket expenses. The policy received a 5-Star rating from Medicare, its highest possible score. Policies are re-rated each year and can always change.
Humana is one of the most widely-admired healthcare companies in the United States. Based in Louisville, they offer very competitively-priced plans both on and off the federal Marketplace. Originally created as a nursing home company, Humana has evolved over the years as leader in individual and family coverage for persons under age 65 and Seniors. Their Senior portfolio is as extensive as any other major carrier, with products offered in most states. Three prescription drug plans (Part D) are offered (Walmart Rx, Preferred Rx, and Enhanced), while wellness and fitness programs are often included in Medigap contracts. Popular Advantage plan options are Gold Plus (HMO), HumanaChoice (PPO), and Gold Choice (PFFS).
Private individual policies are available in 22 states including most Midwestern, Central plains and Western areas. However, in California and most of the Northwest (Washington, Oregon, Idaho, Montana and Wyoming), policies are not offered. As the third-largest health insurance company, they offer extensive support to the US Department of Defense and TriCare. Also, their coverage of active-duty and retired military personnel is very extensive, with more than 3 million persons covered. Individual plan options include Basic 7150, Bronze 6150, Bronze 6550, Silver 3550, and Gold 1250.
Two popular ancillary products that are frequently needed by individuals and families on a stand-alone basis are dental and vision. Humana offers one of the most consumer-friendly ways to apply online and easily enroll and obtain coverage. Typically, the process takes less than 15 minutes, and applicants are not required to be enrolled in other products to qualify. Many consumers choose their dental and vision products, while retaining group medical coverage through an employer.
Go365 is available, and provides a health assessment, along with a customized wellness and rewards program. Rewards are given to participants, that complete specific tasks, such as verified workouts, flu shots, immunizations, routine annual physical, eye and vision check-ups, and wellness screenings. Earned points (dollars) can be used for movie tickets, gift cards, charitable contributions, and several other options.
HCSC is perhaps the largest company in the US that nobody heard of! Health Care Service Corporation is owned by its customers and consists of several health insurance carriers and their subsidiary companies. The largest entities include Blue Cross and Blue Shield of Texas, Montana, Illinois, New Mexico and Oklahoma. And with more than 20,000 employees and about 15 million policyholders, this carrier is a "big player" in the industry. With policyholders owning the carrier instead of investors, patients become the sole priority with the absence of shareholders.
Originally created in 1936, HCSC offers more than medical insurance coverage. Dearborn National, a fully-owned subsidiary, offers dental, disability and life plans. Both stand-alone and attachment contracts are available. Other subsidiaries include Availity (Internet healthcare information), Dental Network of America (third-party administrator), Prime Therapeutics (Pharmacy benefit management), Medecision (Case and disease management), TMG (Business Process Outsourcing), Dearborn National (Group life, disability, and dental), HCSC Services (administers Medicare and Medicaid), and Triwest (Military family coverage).
Many innovative tools and programs are offered to customers to help maintain and manage health. Blue Care Advisors provide condition and care management, for persons that are currently in the hospital, or being treated for serious or chronic conditions. A Wellness initiative provides a 24/7 nurse hotline, a fitness program, lifestyle management assistance, and a "Special Beginnings" maternity program. Additional online tools allow customers to review claims statuses, locate physicians or hospitals, and receive directions, obtain duplicate identification cards, and utilize available tools to determine (in advance) cost of treatment.
Safety is not a concern since they have earned an "A" rating from the three major rating agencies (A.M. Best Co., Standard & Poors, and Moody's Investor Service). As a customer-owned carrier, there is no stock available for purchase, and thus, there are no shareholders. The first policy was written in 1937, and HCSC continues to be an independent licensee for Blue Cross and Blue Shield Association. Headquartered in Chicago, HCSC, like many other carriers, are increasing their focus on Senior products, as Marketplace participation continues to decline.
Based in Pittsburgh, Highmark provides benefits to more than 5 million persons countrywide. Their main products are health insurance, dental, and vision coverage, and its reinsurance operations. Most of the individual and group healthcare plans are provided in Pennsylvania, West Virginia, and Delaware. A few years ago, they merged with Northeastern Blue Cross of Pennsylvania (BCNEPA) and operate under "Highmark Blue Cross Blue Shield, which provides plan in 42 Pa counties. BCBS Delaware services the entire state of Delaware, and BCBS West Virginia services the entire state of West Virginia and one Ohio county (Washington).
Operating under the Blue Cross and Blue Shield name, they are one of the nation's largest BCBS carriers. Their rates are typically very competitive, especially in the home territory of Western Pennsylvania, where battles with current nemesis UPMC frequently take place in policy pricing, network availability, and the courts. In Allegheny and Westmoreland Counties, rates are extremely competitive for both individual and group products. Generally, the only other carriers in the area that provide strong competition (other than UPMC) are Aetna, and UnitedHealthcare. Affiliate United Concordia provides dental coverage while affiliates Visionworks Of America and Davis Vision underwrite vision plans.
One of the major contributions of Highmark was the establishment of their juvenile health insurance program designed for children. Many years later, the national CHIP program was created, based on the existing program that was created in Western Pennsylvania. Still today, the CHIP program has assisted hundreds of thousands of children obtain affordable medical coverage.
For Seniors, popular Medicare Supplement policy options are Plans F (High-Deductible), A, N, B, C, and F. Available Medicare Advantage contracts include Community Blue HMO Signature, Security Blue HMO Basic, Security Blue HMO ValueRx, Freedom Blue PPO Select, Community Blue Medicare HMO Prestige, Security Blue HMO Standard, Security HMO Deluxe, and Freedom Blue PPO Classic. Prescription drug plans (Part D) that are available, include Blue Rx PDP Plus and Blue Rx PDP Complete.
Blue Shield Of California
Blue Shield is a non-profit carrier offering coverage to California residents. Based in San Fransisco, they were founded in 1939 and currently have more than 4 million members covered. Revenue is more than $10 billion each year, and they receive "A" ratings from A.M. Best Company, Weiss, and Fitch. Their "Blue Ribbon" program recognizes physicians for their outstanding service in the state. They also were the first healthcare carrier to include benefits for heart transplants and general catastrophic coverage.
With more than 6,000 employees, they are NCQA- accredited (National Committee For Quality Assurance) and have more than 60,000 pharmacies in their Network. Life and disability products are offered through the life-insurance subsidiary, which is Blue Shield of California Life and Health Insurance Company. Extensive dental and vision products are also available at very competitive prices. Traveling outside of the US? No problem, since BlueCard coverage can be used in more than 200 countries.
As a non-profit entity, annual net income is capped at 2% of revenue. Any excess profits are given back to policyholders or the general community. So far, about $500 million has been given back. Holistic treatment is offered on many plans with emphasis on preventive benefits (always covered at 100%) and professional and personal case management with online access to nurses and other providers at any time. For Seniors, a full range of products is offered, including Medicare Supplement plans, Advantage plans, and prescription drug plans.
Popular private plans for persons under age 65 include Bronze 60, Bronze 60 HDHP, Bronze 5550, Silver 70, Silver 1850, and Gold 80. Medicare Supplement contract options offered are Plans A, C, D, F, F (HD), K, and N. Blue Shield Life underwrites each policy. Two Medicare prescription drug (Part D) options are available. The Blue Shield Medicare Basic plan has a lower premium and a $400 deductible (not applicable to Tier 1 drugs). The Blue Shield Medicare Enhanced plan has no deductible.
Independence Blue Cross
Independence Blue Cross (IBX or IBC) is Southeastern Pennsylvania's biggest provider of medical coverage for individuals and businesses. However, they aren't limited to covering persons in the Pa area (currently more than two million) since they insure more than eight million persons in 25 states. More than two million persons are covered in just the Philadelphia area (Philadelphia, Montgomery, Delaware, Chester, and Bucks Counties). Currently, they are the only carrier that offers Exchange options in Southeastern Pennsylvania, since Aetna has exited that market.
As an Independent licensee of the Blue Cross and Blue Shield Association, IBC offers Marketplace plans, off-Exchange contracts, and group coverage for small and large employers. CHIP and "Special Care" plans are also offered. In the Philadelphia area, along with Aetna, they are a very popular individual and group choice, and maintain a significant market share. Their network provider list extends to New Jersey, which makes IBX one of the best options in Philadelphia. Affiliated companies include AmeriHealth, AmeriHealth Casualty Services, AmeriHealth Caritas, NaviNet, and Tandigm Health.
Policy options for consumers under age 65 are Personal Choice Bronze Classic, Personal Choice PPO Bronze Reserve, Personal Choice PPO Bronze, Keystone HMO Silver Proactive, Keystone HMO Silver, Personal Choice PPO Silver, Keystone HMO Gold Proactive, Keystone HMO Gold, Personal Choice PPO Gold, Keystone HMO Platinum, and Personal Choice PPO Platinum. A "catastrophic" plan is not offered. Silver-tier plans are popular options for low-income households, since "cost-sharing" can substantially reduce deductibles, copays, and maximum out-of-pocket expenses.
Seniors can also obtain affordable coverage as Supplement (MedigapSecurity) contracts are available. Referrals and choosing a primary-care physician are not necessary. Plans A, B, C, F, and N are offered. Popular Medicare Advantage HMO plan options are the Keystone 65 Focus, Select, and Preferred. A Personal Choice PPO plan is also offered. All plans include SilverSneakers fitness benefits.
Centene is a diversified Fortune 500 Company that provides medical coverage through private individual plans, Medicaid, CHIP, Foster Care, and Special Needs Plans through Medicare. Temporary Assistance For Needy Families (TANF) and coverage for the aged, blind, and disabled (ABD) are additional Medicaid programs that are utilized. In 10 states, benefits are provided through Medicare Advantage Dual Eligible Special Needs Plans (D-SNPs).
They also contractually provide many additional services, including dental benefit and pharmacy benefits management, health and life management, correctional service, and home aid assistance.
Health Net provides health insurance to 11 million persons, and merged with Centene to create the biggest Medicare managed care company in the US. Plans are offered to about 6 million persons in all states. HMO, PPO, and POS products are available.
For persons under age 65, single and multi-person Marketplace plans are offered, with, and without a federal subsidy. Coverage is available in the following 10 states: Arkansas, Florida, Georgia, Illinois, Indiana, Massachusetts, Mississippi, New Hampshire, Ohio, Texas, Washington, and Wisconsin. Ambetter underwrites plans, and generally, rates are extremely competitive. Popular policies include Balanced Care 1, Balanced Care 2, and Balanced Care 10.
Several of the most prominent Centene companies are Cenpatico (Arizona), Sunshine Health (Florida), Peach State Health Plan (Georgia), Illinicare Health (Illinois), Sunflower Health Plan (Kansas), Centurion (Minnesota, Tennessee, Vermont, and New Mexico), Magnolia Health (Mississippi), Buckeye Health Plan (Ohio), Trillium (Oregon), Absolute Total Care (South Carolina), Superior HMO (Texas), Coordinated Care (Washington), and MHS Health Wisconsin (Wisconsin).