The Best Health Insurance Companies
Health insurance is a necessary tool for ensuring you have the resources to look after yourself and your loved ones in the case of an accident or illness.
The health insurance market is booming, and there are thousands of options on the table. So how do you know which health insurance company is best?
To help you make that decision, we have put together a list of top health insurance companies in the US, all of which offer reliable services.
We have also put together a complete guide explaining how health insurance works, what it covers, and how to choose the right services for you.
This will help you determine both which of our recommended providers is best for you and which of their plans is likely to offer the right level of return on your investment.
Best Health Insurance Companies
All of the health insurance companies we have chosen have an A financial strength rating from A.M. Best, offering a firm underpinning for their various plans.
Why Do You Need Health Insurance?
Monthly health insurance premiums can be expensive, and that’s why many people are tempted to go without, especially when they are young, healthy, and “never get sick.”
But the whole point is that accidents and illnesses can strike unexpectedly, and you can suddenly find yourself facing very large bills and even the possibility of not being able to get the care you need due to a lack of funds.
People have been bankrupted by unexpected medical fees. Breaking a bone while playing football or having an unexpected fall at home can cost you thousands of dollars you don’t have. Things can be even more challenging if you find yourself with a chronic illness requiring rehabilitation or medication in the long term.
Depending on the type of injury or illness, you might also find yourself unable to work while you are struggling to pay your medical bills, which will just exacerbate the problem.
Moreover, often those who do not have coverage avoid getting treatment for minor issues. But minor issues ignored can quickly become major issues that not only cost you, but can seriously compromise your quality of life.
So, the fact is, it is not worth the risk of skipping health insurance to save a few dollars.
What Health Insurance Should Cover?
No two medical insurance packages are exactly the same, but it is a highly regulated market, so there is a minimum number of things you can expect any health insurance policy to cover. This includes:
- Ambulatory patient services (outpatient care)
- Emergency services
- Hospitalization for surgery and overnight stays
- Pregnancy, maternity, and new baby care
- Mental health and substance use disorder services
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventative care (e.g., shots and screening tests, usually even without deductible) and wellness services including for chronic diseases
- Pediatric services including vision and dental services for children (these are not included in standard plans for adults)
What is included in preventative services is wide-ranging and includes things such as vaccinations, blood tests, and diabetes screenings. You can see a full list of the standard preventative services covered by most insurance providers here. Moreover, unlike most services, these preventative services are usually covered without a deductible.
There are a few things you should not expect to see covered by your insurance. These include:
- Durable medical equipment such as wheelchairs and ventilators
- Cosmetic procedures
- Fertility treatments
- Off-label prescription drugs
- New/experimental technologies and treatments
Insurance will not usually cover 100% of your medical costs. The vast majority of plans will have an amount you need to pay, known as a deductible, before your insurance kicks in. For example, you may need to pay $500 toward your emergency care before your insurance covers the rest of your expenses.
Once your insurance kicks in, it still may cover only a percentage of your incurred expenses, for example, 80 or 90% of the allowable charges. As the insured, you will be responsible for the remaining amount due to the provider, known as coinsurance.
While deductibles work on an individual treatment basis, there is also an annual cap, called an out-of-pocket maximum, after which you will not need to pay any further coinsurance.
Certain services will also have copayment arrangements. A common example of this is prescription medications, for which you are required to pay a small part of your prescription fee and your insurer will pay the rest.
Have you recently lost your job-related health insurance? Read: What do I do if I lose my job-based health insurance?
Types Of Health Insurance?
There is a wide range of health insurance types, but there are a few key categories to be aware of.
On And Off-Exchange Health Insurance
First, there is public versus private insurance. The former includes services such as Medicaid, Medicare, and CHIP, but we aren’t really dealing with those today.
There are also two main types of private insurance.
On-Exchange Private Health Insurance
This type of health insurance is sold on government-run exchanges and is highly regulated. They will need to cover the key benefits we have listed above, plus they will need to meet a number of other state-mandated regulations.
The various plans offered by these providers must also be graded based on a “metal” tier system, which we’ll talk about next.
Off-Exchange Private Health Insurance
This is health insurance that is not sold on government exchanges, and while it must cover the same basic benefits, it is otherwise less regulated. They do not need to use the metal tier system, but often offer plans on a very similar basis.
The main difference between these two types of insurance is that the former is tax-deductible, while the latter is not. However, if you are not eligible for tax deductions, you can often find cheaper plans off-exchange.
As already mentioned, On-Exchange Health Insurance providers grade their plans based on metal tiers. While Off-Exchange insurance does not need to use these tiers, they often do or use very similar tiers with alternative naming.
The tiers are bronze, silver, gold, and platinum.
At the lower end, you will pay lower premiums but will have higher deductibles and greater out-of-pocket expenses. For example, on a Bronze plan, you might expect to pay out $5,000 before your insurance kicks in.
Taking into account deductibles and copayments (such as for prescriptions), you can basically expect their various tiers to cover the following percentages of your medical expenses:
- Bronze – 60%
- Silver – 70%
- Gold – 80%
- Platinum – 90%
Services You Can Access
Different insurance companies will also have different rules on how you can go about accessing medical treatment.
Most insurance companies have relationships with medical providers and will push you to use providers on their specific network.
There are generally four ways this works.
HMO: Health Maintenance Organization
On this plan, you will need a primary care physician (PCP). These are actually required on all plans, but with an HMO plan you will need a referral from your PCP to access other services, such as specialists. Moreover, all the specialists you see need to be from within the network. This is generally the cheapest option.
EPO: Exclusive Provider Organization
This is very similar to an HMO plan, except that you are not required to obtain a referral from your PCP to access other services. But all the services you access do need to be provided by the specialist network.
POS: Point Of Service
Again, this is very similar to an HMO plan, except that your PCP can refer you to further services both within and outside your network.
PPO: Preferred Provider Organization
This is the most flexible, and therefore the most expensive, option. It allows you to access services both within and beyond your provider network.
Cost Of Health Insurance
The cost of your health insurance will depend on how you combine these three factors as well as four other factors.
- Where you live – market competition means that prices vary significantly across the country
- Age – premiums tend to be much higher for older people
- Smoking – smokers are required to pay higher premiums due to anticipated additional needs
- Who is covered – you can get discounts for family or couple coverage
While costs vary dramatically, in 2018 the average cost of health insurance in the United States for an individual was just under $5,000 per year.
However: Here are four reasons why your health insurance will go up in 2021.
How To Choose The Right Health Insurance?
In order to determine which health insurance is right for you, you should ask yourself several key questions.
- Am I eligible for a tax deduction? This will indicate whether you should be looking on- or off-exchange for your insurance.
- How much are the premiums? You should be looking at your budget and how much you can actually afford to pay for health insurance each month.
- How much are the deductibles? Consider whether you will realistically be able to cover the required deductible in the case of a medical emergency.
- How at risk am I? If you are relatively healthy and rarely visit the doctor, you can probably seek out less comprehensive coverage. If you suffer from regular or chronic problems, you can get greater benefit from higher-level plans.
- What kind of medical facilities do I have access to? Look at what medical facilities are within the network covered by your insurer. Do you have easy access to these services and are they likely to cover your needs, or will they require significant travel when you are unwell? Do you travel a lot, and will that make accessing your PCP difficult? You need to consider how much flexibility you need in actually getting treatment.
Cheap Is Not Always The Best Option
Often when making the final decision on health insurance, it comes down to whether you can afford to pay the premiums. But be cautious about choosing a policy with low premiums if the payoff is a very high deductible. You won’t be able to access your policy until you pay your deductable. So, if you won’t realistically be able to accord a $5,000 deductible in the event of a medical emergency, those low premiums won’t benefit you.
Benefits Of Health Insurance
If you are still on the fence about investing in health insurance, here is a reminder of the main benefits of having health insurance.
- Secure Finances – The cost of healthcare can be unpredictable, but the cost of health insurannce isn’t. You know your premiums and your deductibles, so it is something you can plan and budget for.
- Ease of Mind – You don’t need to worry about “how will I pay for… if I or a member of my family is in an accident or becomes seriously ill?” You know that your health insurance will cover you if disaster strikes.
- Better Health – Health insurance often enables you to get better access to check ups and preventative care, which means better health overall.
While health insurance is a necessity, finding the right health insurance plan is a challenge. There are thousands of health insurance companies, each offering a range of plans. How do you know which companies you can trust and which plan is right for you?
Hopefully, our comprehensive guide has helped to answer these questions. We have put together a list of great health insurance companies you can trust and that offer the best health insurance plans. We have also gone through all the things you should consider when choosing the best health insurance plan for your specific needs.
Your choice needs to balance what you can afford and the kind of coverage your age, health, and lifestyle requires.
Whatever you choose, just remember that the answer is never to go without health insurance.
How Do I Get Cheap Health Insurance?
When considering the cost of health insurance, you need to think about both what it will cost you in monthly premiums and what it will cost if you are required to pay for medical care. The cheapest plan for you will balance what you can afford to pay monthly with how much you might be able to pay out as a lump sum deductible in the event of an accident or unexpected illness.
How Much Does Health Insurance Typically Cost Per Month?
The average cost for individual health insurance per month in 2018 was $574 for an individual and $1,634 for family coverage.
How Much Does One Night In Hospital Cost?
The average cost of spending one night in an ICU bed is $1,107. It is estimated that the average hospital stay costs around $10,000.