Best Health Insurance Companies Of September 2024 (2024)

Kaiser Permanente and Blue Cross Blue Shield are the best health insurance companies that offer Affordable Care Act (ACA) plans. Both companies top the ratings in our analysis of quality ratings, complaints, deductibles and plans offered.

Even so, it pays to look at different health insurance providers in your area. This includes smaller insurers on the ACA marketplace.

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• Summary: The Best Health Insurance Companies
• The Best Health Insurance Companies
• What Is Health Insurance?
• What Does Health Insurance Cover?
• What Does Health Insurance Not Cover?
• How Much Does Health Insurance Cost?
• Health Insurance Complaints by Company
• What Are the Types of Health Insurance Plans?
• Ways to Get Health Insurance
• Methodology
• Other Health Insurance Companies We Rated
• Best Health Insurance Frequently Asked Questions (FAQs)

Health insurance pays for healthcare expenses for treatments, medicine and services as determined by the coverage features defined in your specific policy. You pay a health insurance premium for the coverage, whether or not you seek medical care.

When you use services covered by your plan, the health insurer pays a portion of your healthcare costs. Depending on the plan type and services used, you may have to pay a share of the bill, as part of the plan’s health insurance deductible (a fixed amount before any coverage begins), copayment (a fixed amount per services) and/or coinsurance (a percentage of the service cost).

Some health plans require that you stay within the provider network if you want the plan to pay for services, while others allow you to seek care out-of-network, usually at a higher cost-sharing percentage for your portion.

Health insurance covers doctor visits, hospital visits, outpatient care, preventive care and prescription drugs.

The Affordable Care Act, sometimes called Obamacare, requires health insurance companies in the ACA marketplace at HealthCare.gov to cover:

1. Ambulatory patient services, also called outpatient services.
2. Emergency services.
3. Hospitalizations.
4. Lab services.
5. Mental health and substance use disorder services.
6. Pediatric services, including vision and dental care.
7. Pregnancy, maternity and newborn care.
8. Prescription drugs.
9. Preventive and wellness services, as well as chronic disease management.
10. Rehab and habilitative services and devices.

Congress has added other requirements for health insurers beyond the ACA mandate, including birth control coverage and breastfeeding benefits.

Health insurers don’t have to offer dental or vision coverage for adults or medical management programs like weight management, but some insurance companies offer this expanded coverage.

Health insurance doesn’t cover everything. Services that are often excluded include:

• Alternative treatments, which may include acupuncture.
• Care outside of the U.S.
• Cosmetic surgery.
• Dental care.
• Experimental treatments and drugs.
• Fertility care.
• Hearing aids.
• LASIK surgery.
• Out-of-network care.
• Some prescription drugs.
• Sterilization reversal.
• Vaccines that you need to travel.
• Vision care, though it may cover annual eye exams.
• Weight loss programs and surgery.

The services that health insurance will not cover (or will only partially cover) depend on the health insurance company and plan type. For instance, a health maintenance organization (HMO) or exclusive provider organization (EPO) plan won’t pay for care outside your provider network, while a preferred provider organization (PPO) plan will cover out-of-network care.

The average cost for a silver plan for a 30-year-old is $488 a month.

• A 40-year-old pays an average of $549 a month.
• A 50-year-old pays an average of $767 a month.
• A 60-year-old pays an average of $1,164 a month.

Health insurance costs vary based on multiple factors, including the metal tier and your age. Bronze and silver plans have cheaper premiums but higher out-of-pocket costs than gold plans.

Bronze Plans: Average Monthly Health Insurance Costs

Silver Plans: Average Monthly Health Insurance Costs

Gold Plans: Average Monthly Health Insurance Costs

We didn’t include platinum plan costs because those plans are fairly rare. The ACA marketplace doesn’t have enough platinum plans for us to calculate an accurate average.

UnitedHealthcare was the only health insurance company in our analysis with a complaint level that’s below the industry average.

Health insurance companies offer multiple types of benefit designs, which affect where you can get care, how much you’ll pay and whether you need a referral to see a specialist.

The four most common types of health insurance plans are:

• Preferred Provider Organization (PPO): Preferred provider organization (PPO) plans offer the most flexibility, but that typically comes with higher premiums than other plan types. A PPO allows you to get out-of-network care (but at a higher cost than in-network care). You also don’t need a primary care provider referral to see specialists.
• Health Maintenance Organization (HMO): Health maintenance organization (HMO) plans are generally cheaper than PPOs, but those lower premiums have more restrictions than a PPO. You typically must name a primary care provider, who oversees your healthcare. Referrals are required to see specialists. An HMO only pays for in-network care.
• Exclusive Provider Organization (EPO): Exclusive provider organization (EPO) plans are similar to HMOs and generally cost about the same. They don’t reimburse for out-of-network care, so you should stay in your provider network. EPOs are different from an HMO in that you don’t need a referral to see a specialist.
• Point of Service (POS): Point of service (POS) plans, which are the least common health plan type, combine elements of an HMO and PPO. A POS may cover out-of-network care, just like a PPO, but you generally need to name a primary care provider and they must write a referral for you to see specialists, which is similar to an HMO.

Here are common ways to get health insurance.

We analyzed 84 data points about coverage and quality for seven large health insurance companies to determine the best health insurance companies. Our ratings are based on:

• Complaints made to state insurance departments (30% of score): We used complaint data from the National Association of Insurance Commissioners.
• Plan ratings from the National Committee for Quality Assurance (30% of score): The National Committee for Quality Assurance (NCQA) is an independent, nonprofit organization that accredits health plans and produces ratings based on specific metrics, including patient experience, prevention, treatment, overall rating of the health plan and rating of care. We collected ratings for each company’s rated plans and devised an average for the company.
• Average silver plan deductible (20% of score): The deductible is how much you have to pay for healthcare in a year before the health plan begins picking up a portion of the costs. Companies with health plans that had low deductibles got more points. Source: HealthCare.gov.
• Breadth of health plans (10% of score): Health insurance companies may offer up to four types of plan benefit designs (PPO, HMO, EPO and POS). We gave companies that offered more types of plans more points. Source: HealthCare.gov.
• Metal tier offerings (10% of score): The ACA marketplace has four metal tier levels. We gave points to companies that offered more tier plan options. Source: HealthCare.gov.

Read more: How Forbes Advisor rates health insurance companies

Here are other health insurance companies we analyzed as part of our research.

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