July 17, 2024

The Health

Your health, your choice

Best health insurance companies in April 2024

Finding the best health insurance companies has a major impact on how much you’ll pay and the type of coverage you’ll receive for medical issues you face. While many people receive health insurance through their job, more than 21 million people bought a plan through the Health Insurance Marketplace for 2024, according to the Centers for Medicare and Medicaid Services. We’ve examined those plans to find the best insurance for your needs.

Methodology



To identify the top health insurance companies, we looked at rates from 864 plans across the country and more than 200 additional data points related to customer service and plan options. From there, we scored seven companies across seven key categories, then chose winners based on our data and editorial judgment. Read our full methodology here.

Blue Cross Blue Shield

Blue Cross Blue Shield

Why we picked it

Blue Cross Blue Shield earned the top score in our study. It ranked well for plan types and availability, and average silver deductible. Additionally, it had the second-best score in our study for its quality of care and patient experience.
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One thing to watch for is expensive premiums. Blue Cross Blue Shield had the highest average premium across the entire group, averaging around 17% higher across those aged 30, 40, 50 and 60.

Pros

  • Average silver deductible was about $800 lower than the group average
  • Has the most plan types and metal tiers

Cons

  • Highest average Silver premium in group
  • Premiums for 50-year olds were considerably high

Who should use it

You want an insurer that offers multiple plan types and metal levels and has a good complaint record.

Oscar

Oscar

Why we picked it

Oscar was one of two insurers to offer three different plan types, allowing you to opt for an HMO plan or explore other options that make referrals easier to obtain. The company also provides three metal levels, which means you should have a good number of options to fit your monthly budget.
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However, Oscar has its drawbacks. It had the second-lowest rating in the group for quality of care and patient experience.

Pros

  • Three plan types offered
  • Three metal tiers offered
  • Competitive average premiums

Cons

  • Second-lowest rating in group for quality of care and patient experience
  • Average Silver deductible was over $900 higher than group

Who should use it

You want to have multiple options for plan type and metal tier but want to avoid Blue Cross Blue Shield’s high premiums and Kaiser isn’t available in your state.

Kaiser Permanente

Lowest average deductible

Kaiser Permanente

Why we picked it

Kaiser had the lowest average deductible among the companies considered for this category. Its $3,733 average was over $800 lower than the group average. The insurer’s average premium was lower than the group average, too, by around $60.
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While Kaiser’s average deductible led the group, its complaint rate was higher than expected, and it offered only two plan types while other top companies offered three.

Pros

  • Lowest average deductible
  • Highest NCQA ratings in the group

Cons

  • Complaint rate was higher than expected for a company of its size
  • Limited plan types

Who should use it

You expect to have multiple visits to the doctor and at least one procedure done, so you need a plan with a low deductible.

Cigna

Cigna

Why we picked it

Cigna was one of the top companies in the group for value, which measures how well the company scored for its average deductible and premium. Value is an important metric because a low premium with a high deductible can result in high medical bills, while a high premium and low deductible might push your monthly budget to the limit and leave you with limited savings to pay for a medical emergency.
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While Cigna scored well for value, its deductible was slightly higher than the group average and its customer service score was the lowest in the group.

Pros

  • Among the best combined score for average deductible and premium
  • Better-than-average premiums

Cons

  • Deductible was slightly above average
  • More complaints than expected

Who should use it

You want to find a good balance between an affordable premium and a manageable deductible.

Aetna

Aetna

Why we picked it

Aetna’s policies had the lowest average premium among all seven insurers we analyzed. The monthly cost for a plan averages just $639, compared to $705 overall. That’s a monthly savings of $66, or $792 per year.
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While you’re likely to save on your monthly premium with Aetna, it’s in exchange for a higher deductible. In fact, the insurer’s average deductible was over $3,800 above the group’s average.

Pros

  • Lowest average premium
  • Above-average customer service score compared to the group

Cons

  • Many more complaints than expected
  • Average deductible was around $3,800 above group average

Who should use it

You don’t have preexisting conditions, are generally healthy, want to save some money on your monthly premium and have some extra money in savings to cover unanticipated out-of-pocket expenses.

What is health insurance?

Health insurance is a contract between an individual and an insurance company. By paying a premium, you get some or all of your medical costs covered by the insurer. The policy can cover an individual or members of a family. You can get health insurance through an employer or pick a private policy from the federal or your state’s Health Insurance Marketplace.

What does health insurance cover?

All Marketplace plans must cover the following 10 essential benefits:

  • Prescription drugs
  • Lab tests
  • Mental health treatment
  • Outpatient care
  • Emergency care
  • Hospitalization
  • Maternity care
  • Rehabilitative and habilitative services
  • Pediatric care
  • Preventative care (such as vaccinations and yearly checkups)

Short-term health insurance plans are not required to have the 10 essential services listed above.

What does health insurance not cover?

The following treatments are not covered under most health insurance plans:

  • Adult dental care
  • Vision
  • Cosmetic surgery
  • LASIK
  • Fertility treatment
  • Hearing aids
  • Private nurses
  • Alternative health treatments such as acupuncture
  • Weight loss treatment programs and surgeries
  • Vaccinations for travel

If you have any questions or concerns about whether something is covered, read through your policy’s benefits or call your insurer.

Types of health insurance

The type of health insurance you choose will determine not only your policy cost but who you can see and how much your out-of-pocket costs will be:

  • Health maintenance organization (HMO): An HMO allows you to visit in-network doctors, which are doctors and specialists it contracts or works directly with within a specific coverage area near your home or work. You typically have to get a referral from your primary care doctor (PCP) to see a specialist within the network. There is no out-of-network coverage, except in emergencies.
  • Preferred provider organization (PPO): You can see any doctor or go to any hospital when you have a PPO, but you pay less when you see an in-network doctor. You also don’t need a referral to see a specialist.
  • Exclusive provider organization (EPO): Only doctors, hospitals and specialists within the plan’s network are covered by an EPO, except for emergencies.
  • Point of service (POS): Like a PPO, but you must get a referral from your PCP to see a specialist. 
  • Short-term: A health plan that offers coverage for a short time to fill in a gap when you don’t have a long-term health plan in place. You may have missed open enrollment, are waiting for your plan to start, are waiting to become eligible for Medicare or between jobs.

What are the typical health insurance costs?

Most health insurance plans include the following components that contribute to your costs:

  • Premium: The premium is your monthly payment for your health insurance plan. You may qualify for a premium tax credit that can cover some or all of your Marketplace plan premium.
  • Deductible: Generally speaking, this is the amount you have to pay out of pocket for covered services before your insurer pays its share of your expenses per your policy’s coinsurance rate and copays.
  • Copay: The copayment is the fixed amount you pay for health care, such as a $25 copay for a primary care visit or $100 copay for an urgent care visit. Copays usually apply after your deductible has been met.
  • Coinsurance: This is the percentage of health care costs you pay after your deductible has been met. For example, you pay 30% of your covered expenses if you have a silver-level Marketplace plan.

Ways to get health insurance

You have multiple options when searching for a health insurance plan:

  • Marketplace exchange: You can view plans and policy costs online in the Health Insurance Marketplace at HealthCare.gov. Eighteen states and Washington, D.C. have their own state-level Marketplace where you can purchase plans. 
  • Medicaid: Eligible families with low incomes and people who meet other criteria, which vary by state, can get low-cost or free health insurance through Medicaid. In some states, adults and children are eligible for Medicaid if an adult earns less than 133% of the federal poverty level, which is $41,496 for a household of four in 2024.
  • Employer: Many employers offer group health insurance to employees, which is often cheaper than insurance through the Marketplace because employers typically pay for part of your premium. There is usually only one health insurance company to choose from, though there are typically multiple plan options to consider.
  • Short-term: If Marketplace, Medicaid or employer insurance isn’t an option for you, short-term health insurance is an option. Most plans are for 12 months or less and several states won’t let you have the same plan for more than one coverage period. Additionally, short-term plans usually don’t cover pre-existing conditions.

How to pick the best health insurance

Compare all of the costs associated with a health insurance plan, including short-term costs like your premium and longer-term costs like your deductible and coinsurance. Also, consider the doctors and health care facilities included in the network to make sure you like your options. You may find it’s not worth it to pay a low premium if your choice of doctors is limited and your deductible is high.

How to get health insurance

You can apply for health insurance through HealthCare.gov (“the Marketplace”) or your state’s Marketplace exchange (18 states and Washington, D.C. have one). You’ll need to create an online account if it’s your first time, preview plans and prices and also see if you’re eligible for a premium tax credit to lower your costs.

Another way to apply is through an insurance company or online health site certified to enroll people in Marketplace plans, over the phone or with a paper application sent in the mail.

If you aren’t eligible for Marketplace plans, you can purchase short-term health insurance plans. However, these plans tend to offer substandard coverage that, while affordable, aren’t required to cover preexisting conditions and could leave you paying out of pocket for many of your expenses throughout the year.

Methodology

Our research encompassed hundreds of data points and thousands of quotes for Bronze, Silver, Gold and Platinum Marketplace plans. We scored the companies in the following seven key categories:

Average Silver deductible (20%)

Deductibles play an important role in health insurance. The lower the deductible, the less you have to pay out of pocket before your coverage benefits kick in and vice versa. Because deductibles have such a big impact on what you pay out of pocket, we gave it the most weight in our scoring. Companies with a lower average deductible received a higher score.

Average premium (20%)

A premium is how much you pay every month for your health insurance coverage. In our research, we looked at premiums for all metal levels offered in a state. Our data is for “unsubsidized” premiums, which is a technical way of saying “your premium before you use any available premium tax credits to lower what you pay.” We calculated average premiums based on 27 different combinations of ages and family sizes in 33 states that offer Marketplace plans. Companies with lower premiums earned higher scores.

Plan types (15%)

Marketplace insurers offer plans that typically fall into at least one of the following health insurance plan types: HMO, PPO, EPO, and POS. HMO, PPO and EPO plans require you to use in-network doctors to get the most savings. Each plan has different rules for which doctors you can see, what you have to pay out of pocket for, if you need to designate a primary care physician and get a referral to see a specialist. Insurers that offered more plan types received higher scores.

Metal tier offerings (15%)

Marketplace plans are classified based on how you and your insurer split up the cost of your medical expenses. Each tier is given a metal: Bronze (you’re responsible for 40% of your expenses), Silver (you’re responsible for 30%), Gold (you’re responsible for 20%) and Platinum (you’re responsible for 10%). Insurers that offered more metal tiers earned a high score because more tiers means you have more options to choose from.

Quality of care and patient experience (15%)

The National Committee for Quality Assurance (NCQA) releases yearly ratings of health insurance plans based on two main factors: quality of care and patient experience. NCQA ratings are widely accepted as a benchmark for health insurance plans. Our scoring takes into account an insurer’s average Marketplace plan ratings across multiple states and plan types.

Customer service (10%)

Our customer service score is based on the average score an insurer receives from J.D. Power, a research firm that provides yearly scores of insurance companies in several industries. J.D. Power’s health insurance score includes customer feedback in six areas: billing and payment; cost; coverage and benefits; customer service; information and communication; and provider choice. J.D. Power conducts scoring on a state and regional level, so our overall score for a company’s customer service is based on an average of its J.D. Power scores across states and regions. Companies with a higher J.D. Power score received a higher grade.

Complaint rate (5%)

Our complaint-rate data is based on insurers’ National Association of Insurance Commissioners (NAIC) index. The NAIC index is a database of complaints that consumers filed about an insurance company to their state insurance department. The index is the result of a calculation that divides the insurer’s share of complaints in the market by its share of premiums. An index of 1.00 means the insurer receives as many complaints as expected for a company of its size. Insurers with indexes above one receive more complaints than expected and vice versa. Companies with lower complaint indexes received higher scores.

What didn’t make the cut

Of the seven companies we analyzed, two did not meet our minimum scoring threshold of three stars: UnitedHealthcare and Molina Healthcare. Both companies scored well in certain areas. For example, United Healthcare had the best complaint rate in the group, while Molina had the lowest average deductible. However, the two companies stumbled in key areas. UnitedHealthcare offered only two plan types and had a below-average J.D. Power score. Molina’s complaint index was the highest in the group, and it only offered one plan type.

Frequently asked questions (FAQs)

A deductible for your health insurance is the amount of medical bills you must pay for each year before coverage kicks in. So if your deductible is $2,000, you must pay that much for health care services before your policy’s copays and coinsurance activate. In a family plan, there is a deductible per person as well as a collective family deductible.

Health insurance costs include your premium, deductible, copays and coinsurance. Plans come with an annual out-of-pocket maximum, which is the most you have to spend in a single year. Then, your health plan covers the rest.

If you don’t have access to health insurance through an employer, you can still apply for insurance through the Marketplace. Savings from the premium tax credit are determined by income and household size. Other options include Medicaid and the Children’s Health Insurance Program (CHIP), provided you meet certain income requirements. You can buy short-term health insurance, too, but this option might come with high out-of-pocket costs.

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