Health Insurance Companies (2025)

A health insurance company offers medical insurance in the form of a contract in which you pay premiums in exchange for coverage of eligible medical expenses.

But the insurer you choose to work with can significantly affect your healthcare costs and experience. Different insurers offer unique provider networks and wide gaps in member satisfaction.

As you explore the health insurance landscape, here’s what you should know about the top health insurance companies in the country and how to choose the best fit.

Health insurance companies with the most market share

Most health insurance companies don’t operate everywhere. Instead, each chooses to sell coverage where it makes sense. For example, it’s common for insurers to operate in one state or in a single region, like the Midwest or Northeast. Many large insurers operate multiple subsidiaries, which may compete within a single state.

The following table highlights the six largest insurers by market share, based on 2023 American Medical Association (AMA) data.^[1]

You’ll also find their customer satisfaction scores, digital experience ratings from J.D. Power, financial strength ratings from AM Best, and state-level availability.

Insurance Company	National Market Share	Customer Satisfaction vs. Industry Avg. of 562*	Digital Satisfaction vs. Industry Avg. of 656*	Financial Strength	Availability
UnitedHealth Group	15%	532	663	Excellent	All 50 states and Washington, D.C.
Elevance Health (formerly Anthem)	12%	560	651	Good	CA, DO, CT, GA, IN, KY, ME, MO, NH, NV, NY, OH, VA, WI
Aetna	12%	564	658	Excellent	All 50 states and Washington, D.C.
Cigna	11%	542	683	Good	All 50 states and Washington, D.C.
Blue Cross/Blue Shield (BCBS)	7%	570	645	Good	All 50 states and Washington, D.C.
Kaiser Permanente	7%	617	680	NR	CA, CO, DC, GA, HI, MD, OR, VA, WA

Sources: National market share data from the American Medical Association, customer and digital satisfaction from J.D. Power studies, financial strength data from AM Best, and availability from the National Association of Insurance Commissioners. *Scores averaged from J.D. Power ranking/scores across all markets where the insurer operates.

UnitedHealth Group

Elevance Health

Aetna

Cigna

Blue Cross/Blue Shield (BCBS)

Kaiser Permanente

Types of health insurance plans and networks

With so many health plan options, it’s easy to get confused. Before you purchase your next health insurance plan, it’s important to understand the plan types so you can pick one that best suits your needs:^[2]

• HMO (health maintenance organization): An HMO often requires you to choose a primary care physician who can provide referrals to see specialists. You’ll often need to stay in-network for care.

• PPO (preferred provider organization): A PPO allows you to see both in-network and out-of-network providers without a referral. While out-of-network care may cost more, you won’t need a referral to see a specialist.

• EPO (exclusive provider organization): Like a PPO, EPOs don’t require you to get a referral to see a provider. But you’ll need to stick with in-network doctors.

• POS (point of service): POS plans typically require you to have a primary care doctor who provides referrals for specialist visits. But unlike an HMO, you can often get out-of-network care if you need it.

• HDHP (high-deductible health plan): HDHPs come with lower monthly premiums and higher deductibles. You can often pair an HDHP with a health savings account (HSA), which allows you to save money tax-free for medical expenses.^[3]

Factors that affect your health insurance premium

Health insurance premiums can vary widely across insurers. Some of the factors that affect your costs include:

• 

  Age

  Older people typically pay more for health insurance than younger people.

• 

  Tobacco use

  If you use tobacco, insurers will likely charge you higher premiums.

• 

  Location

  Where you live can have a big influence on your costs, with expenses varying widely across state lines.

• 

  Policy type

  The type of plan you choose will reflect different levels of coverage, which can lead to different price points.

• 

  How you get coverage

  You’ll typically face a lower out-of-pocket premium through an employer-sponsored plan, sometimes called group health insurance, as opposed to going through the health insurance marketplace.

• 

  Individual or family enrollment

  Individual plans tend to cost less than family coverage.

While insurance companies can take many factors into account when determining health insurance premiums, some details are off-limits. For example, federal laws prohibit insurers from considering your gender, health status, or medical history when determining premiums.^[4]

How to choose a health insurance company that’s right for you

Selecting the right health insurance company for your needs can involve some legwork. Here are some things you can do to make sure the process goes as efficiently as possible:

1. Estimate your annual healthcare usage and prescription costs.

2. If you’re buying on the marketplace, get multiple quotes for health insurance, or compare your employer’s group health insurance options.

3. Check the size of the provider network and find out if your doctor is on the list of in-network providers. Additionally, confirm that the types of services you want are covered. For example, you can confirm a plan covers mental health, telehealth, or preventive care services before signing up for it.

4. Compare the total cost of the plan. Look beyond the premium to factor in out-of-pocket costs, like copays and co-insurance.

5. Check National Committee for Quality Assurance (NCQA) and NAIC scores to see how an insurance company stacks up.

6. Consider the provider’s digital tools, claims process, customer service options, and any healthcare perks it offers.

7. Complete your enrollment.

Typically, you’ll need to make any changes to your health insurance plan during a designated open enrollment period. For employer-sponsored health plans, open enrollment is usually in the fall. If you’re buying through the open marketplace, open enrollment runs from Nov. 1 to Jan. 15 each year.^[5]

To buy health insurance or make changes to your plan outside of the open enrollment period, you’ll need to have a qualifying life event. Such events include getting married, having a baby, and losing your job.

How to save on health insurance costs

Paying for healthcare expenses can add up quickly. But you can lower your costs using the strategies below:

• Use HSA or FSA funds. If you have a health savings account (HSA) or a flexible spending account (FSA) available, making tax-free contributions and using the funds to cover qualified health expenses can help stretch your budget.

• Opt for generic medications. Even if you have prescription drug coverage, paying for medication can get expensive. If approved by your doctor, consider purchasing generic medications over name brands to save significantly.

• Consider what’s covered. When choosing a health insurance plan, see what preventive care services or wellness programs it covers. For example, plan benefits might include an annual physical and gym membership.

• Consider the costs. The premium is just the beginning of the costs you’ll face. It’s also helpful to understand what you’ll face in copays or co-insurance costs before getting a medical bill.

• Shop around for coverage. Take the time to shop around for policies across multiple insurers. You may find more affordable coverage options, especially if you don’t have access to an employer-sponsored plan.

• Explore Medicare and Medicaid options. If you qualify for Medicare or Medicaid, seek out insurance policies that meet the program requirements. For many people, this could lead to big savings.

• Consider tax deductions. When you have a year in which your household’s medical expenses exceed 7.5% of your adjusted gross income, you might qualify for a tax deduction.^[6]

Health insurance companies FAQs