Best Health Insurance Companies
- Blue Cross and Blue Shield
- Kaiser Permanente
Centene: Best for Low-Income Individuals & Families
Centene is the largest Medicaid managed-care insurer in the U.S. It is ranked highly for price, claims, and customer service.
Individual healthcare plans are offered through the Ambetter brand. The plans are designed for lower-income individuals and families who may not qualify for Medicaid or other government coverage.
Blue Cross and Blue Shield: Best for In-Network Coverage
Blue Cross and Blue Shield are among the most significant health insurance companies with large provider networks nationwide. That often means members can access in-network providers outside of their state.
Blue Cross Blue Shield offers various plans, including HMOs, EPOs, and PPOs. Access to HSAs and FSAs is also available.
Cigna: Best for Supplementary Programs
Cigna offers a range of health insurance options and has a significant presence in the employer plan market.
Noteworthy member benefits include home delivery pharmacy, telehealth, and rewards programs.
Kaiser Permanente: Best for Budget-Friendly Plans
Kaiser Permanente is a nonprofit insurer known for budget-friendly options, and it ranks highly in terms of financial stability and customer service.
Their HMO plans feature low premiums, copays, and prescription costs. There's the option to add an HSA for high-deductible programs, which can help pay for qualifying healthcare expenses.
Humana: Best for Wellness Programs
Humana is touted for excellent primary and specialty care access, including plans for people with chronic health conditions or special needs. The insurer offers wellness programs that allow members to reduce their monthly premiums by exercising and eating better.
Unfortunately, Humana only offers group life insurance plans -- individual health insurance options are not available.
Rankings for the best health insurance companies were identified in partnership with Insure.com, which analyzed the 15 leading health insurance issuers and surveyed over 2,800 home, condo, and renters insurance customers. Each company was rated based on price, customer service, website, mobile app, and customer recommendation while also considering the ratings of A.M. Best. (A.M. Best financial ratings are assessed based on the insurer's ability to fulfill their financial obligations to policyholders.)
Compare Types of Health Insurance Plans
Learn about the different types of health insurance plans and how they work.
HMO (health maintenance organization)
With an HMO, you have to stay within the network for coverage (except in the case of emergencies), and visits to specialists will often require referrals from your primary doctor.
The upside is that it tends to be the most affordable, especially with lower out-of-pocket costs when you visit in-network healthcare providers.
PPO (preferred provider organization)
With a PPO, you don't have to stay in the network to get coverage, and visits to specialists do not require referrals. More freedom to choose your providers often means higher premiums and out-of-pocket costs.
The significant advantage is that you can go to any doctor without worrying about coverage. This is very useful:
- If you favor a particular provider
- If you have limited options in your area
- When you don't have much choice in times of emergency
EPO (exclusive provider organization)
An EPO requires you to stay within the network for coverage (except in the case of emergencies), but you don't need a referral to see a specialist.
EPO plans allow you to minimize costs if you use in-network providers.
POS plans require you to obtain referrals from your primary care doctor before seeing a specialist. But, you pay less out-of-pocket costs if you stick with providers in the plan's network.
It is similar to a PPO plan without the referral requirement.
How to Choose the Right Health Insurance Plan
For many people, choosing a healthcare plan is a bit of a chore because the process often entails some work and research. The decision is not as simple as picking the program with the lowest premiums.
1. Review your medical needs.
Your current and existing health conditions will likely determine the type of medical care required.
If you have no major health issues and need regular check-ups, you might go with a plan with low monthly premiums but high out-of-pocket costs -- because you'll rarely need to pay these costs.
On the other hand, if you visit a doctor frequently, require medication regularly, plan to have a baby, have a chronic condition, or expect surgeries, you'll prefer a plan that covers much of these costs (but it'll likely have high monthly premiums).
2. In-network research providers.
After you review your anticipated medical needs, it's time to look up providers in your area that are part of the health insurance company's network.
You may have a doctor you like or like the liberty of switching doctors quickly, and HMOs, for instance, would not be ideal as they may limit your options significantly.
Or, no healthcare providers nearby offer the medical services you require so you may be forced into a PPO plan.
Every health insurance company will have a directory of in-network providers. You can also ask providers whether they are in-network or not.
3. Compare out-of-pocket costs and premiums.
Once you've identified the potential plans that you'd consider, compare the out-of-pocket costs.
Every plan will have a summary of benefits listing how much you'd pay for services.
Key terms to know:
Returning to your medical needs, refer to the summary of benefits to see which services may require you to pay out-of-pocket costs.
Then, consider the premiums.
Usually, plans with lower premiums have higher out-of-pocket costs, while plans with higher premiums have lower out-of-pocket costs.
4. Pick the plan with the lowest long-term costs.
Finally, you want to account for the whole picture.
Based on your anticipated healthcare needs, you should aim to pick the health insurance plan that will cost you the least over the next 12 months.
If you are in good health, you may be okay with a plan with lower premiums and high out-of-pocket costs (i.e., HMO).
If you are highly selective about your doctors and hospitals or prefer flexibility with switching providers, then a PPO plan may be the best choice.
If you have existing conditions or anticipate certain medical services, looking at all the plans would be wise because you could save
more money with a higher-premium plan with lower out-of-pocket costs. Considerations for Family MembersAnother major factor that plays a role in choosing your health insurance provider will be how these plans cover your family members. The same concerns are in place when selecting the best plan for your family situation. For instance, if you've got several health conditions between yourself, your children, and your spouse, you might opt for a higher-premium plan to reduce your out-of-pocket costs. You may also consider adding a Flexible Spending Account (FSA) to the mix if you have additional medical expenses to cover due to your and your family members' health.
FSAs use pre-tax money to cover expenses such as copayments, qualified drugstore purchases, prescriptions, and many other health care costs—which can be helpful in a situation where your family uses medical services and products frequently.
Make sure that the people in your family can be added to your insurance as covered family members. Although requirements may vary across providers and employers, here are common standards for family members to qualify as a dependent on your health insurance plan:
- Biological children and stepchildren
- Legally adopted children and children placed with you or your covered spouse for adoption
- Children for whom you and your spouse have been appointed legal guardian
- Disabled dependent children older than age 26 who meet specific criteria
Key Health Insurance Terms
This is when you can change your job's benefits elections, such as health, vision, and dental insurance plans.
Typically, it occurs once a year, lasts a few days, and most often occurs sometime in the fourth quarter.
Unless there is a qualifying life event life (i.e., marriage, divorce, etc.), you cannot change your plan's elections until the next open enrollment period.
Special enrollment period
The open enrollment period is when you can change your job's benefits' elections outside of the open enrollment period due to a qualifying life event.
Although qualifying life events will vary from plan to plan and employer to employer, here are some common examples of qualifying life events:
- Divorced or legally separated and lost health insurance
- The death of the responsible party that previously covered you on their insurance plan
- Having a baby
- Adopting a child
- Turning 26
Typically, a maximum amount of time, i.e., 60 days, can pass after this event that qualifies you to make changes to your health insurance plan.
Your health insurance premium is the amount you pay monthly for your health insurance plan. If you get insurance coverage through your employer, your premium may be deducted directly from your paycheck with pre-tax money. Additionally, your employer may cover all or part of your premiums.
A copay is a fixed amount you pay for a health care service, usually when you receive the service. The amount depends on the type of service and can be set by your insurance provider. You should be able to log onto your plan's website or use the mobile app to see your plan's copays.
Coinsurance is your share of the costs for a particular healthcare service.
It's usually a percentage of the amount the provider charges for services. In most cases, you start paying coinsurance after you've paid your plan's deductible.
A deductible is a set amount you may be required to pay out of pocket before your health insurance plan begins to pay for covered costs.
An out-of-pocket maximum limits how much you must pay for covered healthcare services in a plan year.
If you have a severe illness or chronic health condition that requires frequent medical care, the out-of-pocket maximum can help you keep your healthcare costs to a minimum.
Health savings account (HSA)
Available exclusively to those with a qualifying high-deductible health plan, health savings accounts allow you to save pre-tax dollars for future qualified medical expenses.
Some people like this combination to decrease monthly healthcare insurance premiums.
Flexible spending account (FSA)
A Flexible Spending Account (also known as a flexible spending arrangement) allows you to put pre-tax money aside to pay for certain out-of-pocket healthcare costs.
You can contribute $3,050 per year per employer, and the funds must be used up by the end of each year.
Some employers allow a "grace period" of up to 2 ½ extra months and the ability to carry over $550 into the following year.
COBRA stands for Consolidated Omnibus Budget Reconciliation Act.
It's a federal law created in 1985 to give people who experience a job loss or other life-qualifying event the option to continue their current health insurance coverage for a set period.
Industry Ratings of the Top U.S. Health Insurance Companies
|A.M. Best Financial Strength Rating
|A.M. Best Issuer Credit Rating
|CVS Health (Aetna)