Healthcare expenses are rising faster than medical inflation, making it essential to have health insurance coverage. It helps save emergency funds and lifetime savings in case of medical emergencies. Investing in a health insurance policy early in life offers advantages like better coverage, lower premium rates, and no medical tests. This guide can help explain what health insurance companies are the best companies to invest in in 2023.
What Is Health Insurance?
Health insurance is a contract between a company and a consumer, where the company pays healthcare costs for specific expenses related to illness, injury, pregnancy, or preventative care.
Note that:
- In exchange for a monthly premium payment, health insurance covers the majority of the insured person’s medical, surgical, and preventative care costs.
- In general, the insured has lower out-of-pocket expenses and a higher monthly premium.
- There are deductibles and copays in almost all insurance plans, but these out-of-pocket costs are now limited by federal law.
- Since 2010, the Affordable Care Act has made it illegal for insurance providers to refuse to cover patients with preexisting conditions, and it also permits kids to stay on their parent’s insurance plan until they are 26 years old.
- Older, disabled, and low-income people are covered by Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP).
What Are Health Insurance Companies?
A health insurance company is a corporation that has been permitted by its charter to carry out business that involves paying out money or something else of significance in the case of a loss brought on by a disability brought on by illness or infirmity.
How Does Health Insurance Work?
Health insurance in the US is challenging due to its regional and national competitors, with coverage, pricing, and availability varying across states and counties. About half of Americans have health insurance coverage as an employment benefit, with employer premiums partially covered. Tax-deductible employer costs are tax-free for employees, while self-employed individuals, freelancers, and gig workers can buy insurance directly.
Furthermore, the Affordable Care Act of 2010 mandated the creation of HealthCare.gov, a national database for finding standard plans from private insurers. Coverage costs are subsidized for taxpayers below the federal poverty threshold.
Finally, Retirees receive federally-subsidized care through Medicare, and families in the lowest income bracket are eligible for subsidized Medicaid coverage.
What Are The 3 Types Of Health Insurance In The Us?
#1. Exclusive Provider Organizations (EPOs):
EPOs give you access to a network of participating providers from which to choose. Except for emergencies, the majority of EPO plans do not cover care received outside of the network. As a result, you will probably be responsible for paying for the entire cost of services if you go to a provider or facility that is not part of the plan’s local network.
Additionally, you might or might not need to pick a Primary Care provider (PCP), depending on the plan. You don’t require a PCP referral to see a specialist in your network.
#2. Preferred Provider Organizations (PPOs):
PPOs typically provide you with a sizable network of participating providers, giving you a wide selection of hospitals, clinics, and other healthcare facilities and professionals. Choosing to see a provider who is not in the network of the plan will result in higher out-of-pocket costs.
Additionally, with these kinds of health plans, selecting a Primary Care Provider (PCP) is not necessary, and you can see specialists without a referral.
#3. Health Maintenance Organizations (HMOs):
HMOs offer a local network of participating doctors, hospitals, and healthcare professionals, with a Primary Care Provider (PCP) as the home base. PCPs coordinate care and provide referrals to in-network specialists.
Additionally, HMO plans typically have lower costs, such as copays and coinsurance, as long as participants stay in-network.
What Are The Top Health Insurance Companies?
#1. UnitedHealth:
UnitedHealth Group, a diversified health and well-being company, has over $170 billion in direct written premiums and a 14% market share. Additionally, it offers healthcare coverage and benefits services through the UnitedHealthcare and Optum platforms, investing over $4 billion in technology and innovation.
#2. Kaiser Foundation:
Kaiser Foundation Health Plan, Inc. is a non-profit healthcare organization with $104.2 billion in direct written premiums and an 8.3% market share. They offer various services in the US, including allergy, audiology, cardiology, dermatology, oncology, hospice, laboratory, nephrology, occupational therapy, pain management, pediatric rehabilitation, and pharmacy.
#3. Anthem, Inc.
Anthem, Inc. is a health benefits company with $76.9 billion in direct written premiums and a 6.2% market share. Serving over 100 million people, Anthem offers various health plans, including HMOs, PPOs, network-based dental products, hybrids, and specialty products. The company combines consumer-friendly attributes with cost-effective services.
Additionally, they offer basic and comprehensive plans, as well as specialty products and services like flexible spending accounts and COBRA administration.
#4. Centene Corp.:
Centene Corporation is a Fortune 500 healthcare company with a $75 billion market share and 6% direct written premiums. It focuses on uninsured and underinsured individuals and operates in 50 states and three international markets.
Furthermore, the company offers local health plans, health insurance solutions, and contracts with other organizations for specialty services like behavioral health, dental benefits, life and health, pharmacy benefits management, care management software, correctional healthcare, in-home health services, managed vision, specialty pharmacy, and telehealth services.
#5. Humana:
Humana offers personalized, simplified healthcare experiences for individuals, families, and communities, with a $73.9 billion market share and 5.9% direct written premiums. Its innovative solutions help people live healthier lives on their terms, recognizing evolving healthcare needs.
#6. Aetna:
Aetna, acquired by CVS Health Corp. in 2018, offers low-cost insurance plans for individual, dental, Medicare Advantage, Medicare Part D, Medicaid, and group plans. Founded in 1853, it is the third-largest provider of health insurance and services by membership. In 2022, Aetna limited plans on the ACA marketplace but expanded to individual and family plans in 12 states in 2023.
#7. Cigna:
Cigna, the fourth-largest major medical insurance company in the US, offers health insurance and services to companies worldwide. It provides corporate health insurance, dental, behavioral health, vision, supplemental health, and Medicare/Medicaid benefits.
Additionally, Cigna offers individual health insurance in 16 states and Medicare Advantage plans in over half of the country.
#8. CVS:
CVS Health is a healthcare innovation company with $69 billion in direct written premiums and a 5.5% market share. With over 9,000 retail locations, 1,000 walk-in medical clinics, a pharmacy benefits manager, 23 million medical members, a senior pharmacy care business, specialty pharmacy services, and a Medicare Part D prescription drug plan, CVS aims to help people improve their health.
#9. HCSC:
Healthcare Service Corporation (HCSC) is the largest customer-owned healthcare insurance company in the US, serving over 16 million members across five states. Additionally, with $42 billion in direct written premiums and a 3.4% market share, HCSC offers various life and health insurance products and services through affiliates and subsidiaries.
#10. Molina Healthcare, Inc.:
Missouri Healthcare, a Fortune 500 company, focuses on government-sponsored healthcare programs for qualified individuals and families. With over $21 billion in direct written premiums and a market share of 1.7%, the company contracts with state governments and offers quality services in various states.
Additionally, Missouri offers a Medicare product and participates in dual demonstration projects for Medicaid and Medicare eligibility.
#11. Independence Health Group:
Independence Health Group, based in Philadelphia, serves 10 million clients in 27 states and the District of Columbia. With a market share of 1.6%, the insurer offers commercial, Medicare, Medicaid, pharmacy benefits management, workers’ compensation, and third-party benefits administration. It is an independent licensee of the Blue Cross and Blue Shield Association.
Who Is The #1 Provider Of Health Insurance In The U.S.?
The largest health insurance provider in terms of membership is UnitedHealthcare, which is part of UnitedHealth Group. The range of products offered by UnitedHealthcare includes everything from full employer-employee benefits for some of the largest companies to individual health insurance.
What Is The Most Popular Health Insurance Plan?
PPO plans are the most popular health insurance plans in the US, offering a network of healthcare providers and greater flexibility in doctor and hospital selection. They also cover out-of-network providers at a higher cost. Popularity depends on location, employer offerings, and individual preferences.
Who Is The Largest Payer In Healthcare?
The federal government is the largest payer in healthcare, with Medicare and Medicaid spending accounting for over one-third of all spending. Private health insurance companies, including employer-sponsored plans and individual plans, are the second-largest payer, with over $1 trillion in 2020.
Other payers include out-of-pocket spending, public programs like CHIP, and the VA. However, healthcare spending distribution varies based on factors like age, income, and health status, and can change over time due to policy or market dynamics.
What Are The Top 5 Health Insurance Companies In California?
#1. L.A. Care Health Plan
L.A. Care Health Plan offers affordable Silver 70 HMO rates for Los Angeles County residents. Monthly rates range from $283.50 for 21-year-olds to $769.41 for 60-year-olds. Annual deductibles vary between $75 and $7,900 for individuals and $150 and $15,800 for family plans. The plan aims to provide quality care for vulnerable communities and support the safety net.
#2. Molina Healthcare
Molina Healthcare allows San Diego County residents to enjoy affordable Silver rates with the Silver 70 HMO plan, offering monthly rates for 21-year-olds, 40-year-olds, and 60-year-olds. Deductibles range from $75 to $7,350 for individual plans and $150 to $14,700 for family plans. Molina provides health and wellness resources for conditions like asthma, diabetes, and senior health.
#3. HealthNet
Orange County residents can afford the cheapest rates with HealthNet’s Silver 70 Community Care Plan. Monthly rates range from $318.18 for 21-year-olds to $863.55 for 60-year-olds. Additionally, plans include nurse advice, health coaching, disease management, and free in-home health assessments.
#4. Blue Shield of California
Riverside County residents can access Blue Shield’s Silver 70 Trio HMO with monthly premiums ranging from $292.79 for 21-year-olds to $794.62 for 60-year-olds. Benefits include a 24/7 nurse helpline, care programs, gym discounts, and individual and family plans through Covered California.
#5. UnitedHealthcare:
UnitedHealthcare, with a market share of more than 7%, is a subsidiary of UnitedHealth Group and the fifth-largest health insurance provider in California. PPOs, HMOs, and Medicare Advantage plans are just a few of the different types of health insurance that UnitedHealthcare provides.
Top Health Insurance Companies in Florida
#1. Blue Cross Blue Shield:
Blue Cross Blue Shield is the top overall health insurance company in Florida, offering comprehensive plans, satisfied customers, and low premiums. It offers plans in each metal level and has the lowest premiums on its bronze and silver plans, which are suitable for those who don’t expect to use their policy for more than preventive care.
However, BCBS Gold plans offer better value, with reasonable premiums and low deductibles, making them a better value than other major insurers in Florida.
#2. Oscar Health Insurance:
Oscar Health Insurance offers a good balance of coverage and affordability, offering small business plans, child dental coverage, and a wide range of health management programs. It offers the cheapest silver plans across all age groups and is best for CVS MINUTECLINICS. However, its Florida plans are not yet rated by the NCQA or Healthcare.gov.
#3. Aetna:
Aetna’s affiliation with CVS MinuteClinic offers free same-day prescription services and a 100% tax credit reduction on premiums. It ranks third in customer satisfaction in the state but has mixed results in customer satisfaction. However, the NCQA rates its commercial health plans in the state 3.0 stars.
Top Health Insurance Companies in Texas
#1. Blue Cross Blue Shield:
Blue Cross Blue Shield of Texas is the largest health insurance provider in Texas, offering well-rated plans with 3-star Healthcare.gov ratings. Its gold plans have low deductibles and low annual costs. However, affordability may be better served by other companies, and customer satisfaction is slightly below average.
#2. Aetna:
Aetna offers affordable premium bronze plans with no virtual care, no low-cost MinuteClinic visits, and the second-highest J.D. Power rating for Texas in 2022. It offers the lowest estimated annual cost plans for low health needs and free virtual care 24/7.
Aetna’s plans are eligible for the maximum premium tax credit, making them a top choice for self-employed individuals. However, the company’s gold plans may not provide the best value for frequent doctor or hospital visits.
#3. Ambetter:
Ambetter offers exchange plans with adult dental and vision coverage, EPO plans without a specialist referral, and free virtual urgent care. These plans are limited to in-network doctors and offer 24/7 virtual care.
However, the estimated annual cost of Ambetter’s silver and bronze plans is high for low and medium medical needs. Opting for Aetna’s plans and private dental coverage separately may be more cost-effective.
Top Health Insurance Companies in New Jersey
#1. AmeriHealth:
AmeriHealth is a top health insurance provider in New Jersey, offering individual and family plans on the ACA Marketplace. They offer essential benefits and discounts on dental plans, with four individual plans and sub-plans. AmeriHealth offers HMO, POS, EPO, and PPO plans, as well as health savings accounts, and dental, and vision insurance.
Additionally, members can manage claims and benefits through AmeriHealth’s website or mobile app, choosing their network of doctors to balance personalized care and low premium costs.
#2. Horizon Blue Cross Blue Shield:
Horizon Blue Cross Blue Shield is New Jersey’s top independent health insurance provider, offering paperless online account management for plan holders. With a vast network of doctors, hospitals, and specialists, Horizon offers nationwide coverage.
Additionally, as an independent licensee of the Blue Cross Blue Shield Association, Horizon offers insurance policies on the healthcare exchange. Additionally, the platform makes it easy to find providers for any health issue, and prices cover a wide range of budgets.
#3. Oscar Health:
Oscar Health offers affordable plans with lower monthly premiums, including ACA-compliant plans starting at $300 per month and higher-cost options starting at $2,300. The company offers low copays for doctor’s visits and prescriptions and provides access to telehealth services with in-network healthcare providers.
Oscar also offers free preventive care and virtual visits with 24/7 accessibility. The company’s low copays help trim costs, and it offers 24/7 telehealth conferences with in-network doctors.
Top Health Insurance Companies in New York
#1. Fidelis Care
Fidelis Care offers affordable health insurance coverage for those who qualify for both Medicare and Medicaid. Their Dual Advantage plan bridges gaps between Medicare and Medicaid with minimal out-of-pocket costs, making it an excellent choice for those with disabilities or fixed incomes.
Additionally, it is designed for fixed-income individuals and is easier to maintain over time. However, it may not be helpful for those without Medicare or Medicaid eligibility.
#2. Univera Healthcare:
Univera Healthcare offers affordable health insurance plans for individuals and families in New York. Their Essentials plan offers low premiums as low as $0 per month and discounts on deductibles for low-income families. With multiple providers in the area, Univera offers free preventive care and Medicare plans. However, not all premiums are extremely low.
#3. Empire BlueCross:
Empire BlueCross offers comprehensive catastrophic insurance plans for young, healthy individuals. The website provides information on preventive treatments and care schedules, with plans starting at $49 per visit. This resource is ideal for families concerned about overpaying for coverage and can help manage health conditions.
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