Fortunly’s Guide
Advertiser Disclosure

Best Health Insurance Companies

Written By
G. Dautovic
Updated
December 01,2024
Some or all of the products/services listed on this page are from our affiliate partners from which we receive commissions. This, however, does not influence the evaluations in our reviews. Learn more by reading our Advertiser Disclosure.

Few things in life are as valuable as personal health - except perhaps the well-being of our loved ones. Since none of us can predict when we might require medical assistance, purchasing a health insurance policy is essential. Regardless of your present state of health, knowing that you have something to fall back on will help you sleep better at night.

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Best Health Insurance Companies in December 2024

Kaiser Permanente Health Insurance Logo

Kaiser Permanente Health Insurance

Our Rating

Fortunly's Rating: Our editorial team determines the rating based on a set of evaluation criteria developed for each product and service category.

5 stars
Overview

Kaiser Permanente is a nonprofit company that easily ranks among the leading insurers today. With high consumer satisfaction, a variety of plans and a top-of-the-line platform, it is an especially good choice for senior citizens. Read more

A.M. Best: A+
J.D. Power: 782/1000
BBB: A+
In-network providers: over 23,600 physicians and 65,000 nurses

Average monthly costs:

$464 (California)

Get a Quote
Blue Cross Blue Shield Health Insurance Logo

Blue Cross Blue Shield Health Insurance

Our Rating

Fortunly's Rating: Our editorial team determines the rating based on a set of evaluation criteria developed for each product and service category.

4.9 stars
Overview

Blue Cross Blue Shield has a great reputation among customers as a company that provides a wide range of plan options, benefits and add-ons which anyone can use to build coverage that suits their personal needs. Read more

A.M. Best: A+
J.D. Power: 716/1000
BBB: A+
In-network providers: 1.7 million

Average monthly costs:

$389 (Illinois)

Get a Quote
Aetna Health Insurance Logo

Aetna Health Insurance

Our Rating

Fortunly's Rating: Our editorial team determines the rating based on a set of evaluation criteria developed for each product and service category.

4.5 stars
Overview

Aetna is one of the largest insurance companies in the United States. With nationwide coverage and vast experience, it provides a great variety of plans that come with relatively low fees. Read more

A.M. Best: A
J.D. Power: 730/1000
BBB: A+
In-network providers: 1.2 million

Average monthly costs:

$0 – $33 (for HMO-POS plans)

Get a Quote
United Healthcare Health Insurance Logo

United Healthcare Health Insurance

Our Rating

Fortunly's Rating: Our editorial team determines the rating based on a set of evaluation criteria developed for each product and service category.

4.5 stars
Overview

United Healthcare is the largest health insurance company in the world. With a wealth of plan types, excellent discounts, and the widest selection of tools and optional features on the market, it provides an all-around stellar service for customers of all ages and income levels. Read more

A.M. Best: A+
J.D. Power: 731/1000
BBB: A+
In-network providers: over 1.3 million

Average monthly costs:

$483 (New York)

Get a Quote
Cigna Health Insurance Logo

Cigna Health Insurance

Our Rating

Fortunly's Rating: Our editorial team determines the rating based on a set of evaluation criteria developed for each product and service category.

4 stars
Overview

Cigna is a global insurance leader, with one of the largest provider networks and a fantastic platform that provides world-class service and a variety of plans across twelve states. While the company’s insurance coverage in the US is limited, dental plans are available nationwide. Read more

A.M. Best: A
J.D. Power: 736/1000
BBB: A+
In-network providers: 1.5 million

Average monthly costs:

$344 (age 40, Illinois)

Get a Quote
Humana Health Insurance Logo

Humana Health Insurance

Our Rating

Fortunly's Rating: Our editorial team determines the rating based on a set of evaluation criteria developed for each product and service category.

4 stars
Overview

Praised for its flawless services and mail-order pharmacy support, Humana provides a wide range of excellent and affordable healthcare plans. The insurer has versatile plans and services, yet it falls short regarding individual policies. If you choose this provider, you may rest assured that you’ll enjoy top-notch healthcare services for a reasonable price. Read more

A.M. Best: A-
J.D. Power: 741/1000
BBB: A+
In-network providers: over 1 million

Average monthly costs:

starting from $0 + copayments and deductibles

Get a Quote
Quick Breakdown

Top 5 Health Insurance Companies of 2024 - Our Picks:

  • Kaiser Permanente - Best for HMO plans
  • Blue Cross Blue Shield - Best for nationwide coverage
  • Aetna - Best for Medicare plans
  • UnitedHealthcare - Best for mobile and online care
  • Cigna - Best for healthcare tools
Evaluation Criteria

How We Evaluate Health Insurance Companies

Our website was built around a few key principles, including transparency. We give a great deal of importance to helping readers understand precisely why and how we rate companies and what factors determine their overall rating. The review process here is based on four different categories that determine the quality of service.

Financial Strength

All reputable companies need to be able to fulfill their obligations toward customers, which is why a company’s ability to pay claims is at the top of our list.

Pricing

Even though health insurance quotes vary depending on your geographical location and requirements, there is plenty of data available to determine the average premiums for each of the companies we reviewed.

Our goal is to direct you to the highest quality of service and the most customer-friendly insurer. This is why companies with lower-than-average premiums will be viewed more favorably, especially when pricing is the only thing separating two great firms.

Product Quality

This section is the core of every review and focuses on the overall quality of the service provided. Every detail, from the number of plans to the size of the network and coverage options, and even the special platform features and tools that aren’t found among the competition, is measured against the best that the industry has to offer.

The carriers that emerge with the most extensive reach, the widest variety of insurance plans, and the best online resources will rate higher than others.

Customer Satisfaction

Last but not least is the category that has a great deal of influence on the overall company rating and has everything to do with customer satisfaction.

From dedication to quality user experience and the helpfulness of the support staff, our reviews are meant to bring you closer to those firms that best treat their customers.

These features and user ratings play a substantial role in our methodology and can often be the deciding factor that pushes a company up or down the list.

Detailed Reviews Of Health Insurance Companies

Kaiser Permanente

Kaiser Permanente Logo Get a Quote

On Official Website

Number of healthcare members:
12.5 million
Available States:
California, Colorado, the District of Columbia, Georgia, Hawaii, Maryland, Oregon, Virginia, and Washington
Average monthly costs:
$464 (California)
  • Superior mobile platform
  • Affordable option for older customers
  • Great customer support

Kaiser Permanente is a nonprofit insurance company headquartered in Oakland, California. Founded in 1945, it only serves a limited number of states but still has over 12 million healthcare members. Kaiser is now ranked among the top carriers regarding customer satisfaction and the range of services.

Financial strength: A+

Kaiser Permanente has a superior financial strength rating, meaning that it is considered a safe choice. Both A.M. Best Rating Services and BBB give it the highest possible score of A+.

Pricing

The rates at Kaiser are generally below the industry average, especially for non-smokers and people 55 or older. If you are living in one of the states that the company services and falls within the right age group, it might very well be the best option available right now.

There are, of course, plenty of other factors that influence the cost of your policy, but overall you should expect to pay less than with some of the other providers. 

For customers who are dedicated to a healthy lifestyle, Kaiser Permanente offers a ChooseHealthy program that provides you with hundreds of discounts on various fitness, wellness, and entertainment activities. This allows you to save a lot of money on gym membership, snowboarding lift tickets, live theater, and weight loss programs.

Product Quality

Kaiser Permanente operates in just eight states plus the District of Columbia, which is one of the biggest downsides for any insurance firm. In the covered regions, however, the company has 39 hospitals, 734 medical offices and outpatient facilities, and well over 23,656 Kaiser doctors within its network.

But if you choose to use Kaiser, you will have to stay within those borders. Kaiser Permanente does not cover outside specialists or refer you outside of its network, which can pose difficulties even for people within the states that are covered.

For instance, if your family subscribed to one of the Kaiser plans, but your child is working or studying in a state that is not covered, Kaiser may not cover their medical care there. 

When it comes to the available plans, Keiser insurance offers HMO, PPO, Medicare, Medicaid, and even dental and vision insurance plans. You can easily access all the plans that are available for your region by inputting your ZIP code on the company’s website. The other option is to take advantage of an excellent, feature-heavy mobile app. 

The whole process is straightforward and quick, especially since the Kaiser online platform has a great deal of resources that customers can use. For instance, the member portal tracks prescriptions 24/7, and you gain access to a dedicated customer support line.

You can also access your medical records, make appointments, order medication or educate yourself by either going through the tips and information on the website or by attending live classes at Kaiser facilities. All in all, it is one of the premier platforms if you and your family are eligible to take every advantage being offered.

Customer Satisfaction

Kaiser Permanente is among the few firms with perfect health insurance ratings on J.D. Power’s list, and it has been holding that 5-star rating for six years in a row.

Customers on Consumer Affairs have given the company a 3.1 rating, mostly praising its customer service quality and the speed of claims processing.

Final Words

With stellar products and a limited area of coverage, Kaiser Permanente is a great choice if you can make use of its services. This is a rare company that is both nonprofit and manages to remain strong in a for-profit industry. Kaiser manages this by providing a variety of solid plans, a world-class platform, and an even better mobile app.

It is also one of the top choices that we can recommend for persons 55 and older. So if you are living, working, or already planning a retirement in one of the states covered, Kaiser Permanente should definitely be a company to consider.

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Blue Cross Blue Shield

Blue Cross Blue Shield Logo Get a Quote

On Official Website

Number of healthcare members:
107 million
Available States:
all 50 states + District of Columbia and Puerto Rico
Average monthly costs:
$389 (Illinois)
  • World-class mobile app
  • Great source of health insurance information
  • Variety of insurance plans

Blue Cross Blue Shield (BCBS) is one of the US's largest and most prominent insurance companies. Founded in 1982 when two industry veterans, Blue Shield and Blue Cross merged, this carrier now serves over 107 million Americans across all 50 states.

Financial Strength: A

It is no surprise that BCBS is considered one of the safest choices regarding financial stability. The company holds an A+ rating with A.M. Best Rating Services and a superior A+ rating from Fitch. Therefore, Blue Cross Blue Shield is a safe choice for anyone looking for a stable, nationwide insurance carrier.

Pricing

BCBS generally has slightly higher than average rates, but quotes do vary depending on a number of standard variables, such as your chosen state and level of insurance. For example, in Illinois, premiums range from $389 to $565, but in Michigan, you can get insurance for as low as $273 per month.

The great thing about the BCBS platform is that it offers a side-by-side analysis where you can compare plans, either on a desktop device or a dedicated mobile app. The whole process of getting quotes is very quick and after answering a few simple questions you will be provided a list of different options. 

Product Quality

Blue Cross Blue Shield provides individual, family, and group plans as well as Medicare coverage, employee coverage, and short-term insurance. 

The HMO plans are the right choice for saving money in exchange for a limited choice of doctors, while the numerous PPO plans offer more flexibility and a much broader selection of doctors.

With all the BCBS plans, you also get access to a health savings account and a flexible spending account to manage your premiums and deductibles better. Finally, the company offers free fitness, health and wellness programs as well as optional dental and vision coverage.

The BCBS platform itself works flawlessly on mobile and desktop devices and has a number of useful features like online help and the find-a-doctor option. Members can track prescriptions 24/7 and download most of the paperwork directly from the website. They can also get access to a dedicated customer support line.

Aside from being able to contact the support staff, customers can also turn to the company website that offers a section filled to the brim with useful information on the BCBS’s plans and services.  

Customer Satisfaction

The Consumer Affairs rating is 3.8, which is higher than many other insurers. Customers expressed special praise for the online help section of the website, which often answers all of their questions. The online quotation process and the claims process also received notably positive reviews.

The National Association of Insurance Commissioners (NAIC) complaints are below average.

Final Words    

Blue Cross Blue Shield provides a wide range of plans with multiple benefits and optional add-ons so anyone can tailor their coverage around their personal needs. This is not only one of the largest insurance companies globally but also one of the very few carriers to provide this level of quality to customers.

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Aetna

Aetna Logo Get a Quote

On Official Website

Number of healthcare members:
22.1 Million
Available States:
50 states + Washington, D.C.
Average monthly costs:
$0 – $33 (for HMO-POS plans)
  • Customer service quality
  • Numerous insurance plans
  • Financial stability

Aetna is one of the oldest and most recognizable brands in the insurance industry. The company was founded way back in 1853 and has since expanded to cover all 50 states.

One of the more obvious things about an established giant like Aetna is its financial muscle, which has allowed this nationwide insurer to stay on top for 150 years. Both A.M. Best and Fitch awarded it with an A. BBB rates the company with an A+, while its NAIC complaint index is just 0.29 - far lower than most competition. 

Pricing

When it comes to pricing, it varies depending on several factors, including age and state of residency. There are also different pricing options, depending on whether you want a PPO or an HMO plan. One minor annoyance with this provider is that the quote process is not as streamlined as with other companies offering similar services. 

Product Quality

Aetna offers range from individual, family, employer to Medicare plans. The number of options here is fantastic and facilitates building a personalized plan tailored to your financial capabilities and the amount of money you can spend on doctor visits each month. 

You also have the option of opening up a health savings account to increase your power over the plan customization and save tax-free money to help meet your deductible. 

Short-term plans are the only feature lacking at Aetna, so if you are between jobs and want to stay covered, this is not an option for you.

For customers who can take advantage of the service, Aetna has a great platform rich in features and resources. The website is a one-stop shop for finding plans and doctors, checking out education programs and deductible levels, and monitoring your care history and health information in real-time.

The same high level of functionality and ease-of-use is available on the mobile app while offering the option to get medical advice from a nurse  24/7. 

Customer Satisfaction

Aetna is consistently recognized for its outstanding customer service experience. It scored a 4 out of 5 rating on Insure.com, with 84% of current policyholders planning to renew their coverage. 

As for the Consumer Affairs reviews, the company received a 3.7 rating based on 503 customer reviews in the past year. Aetna has A+ on BBB, but it is not accredited there. 

Final Words

With an unparalleled degree of experience and a rich offering of health insurance plans, Aetna boasts impressive nationwide insurance coverage, plenty of options to save money, and a stellar mobile app.

The only caveat is the absence of short-term options among Aetna’s insurance plans. Still, for anyone who isn’t affected by that, this company represents one of the best choices available.

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UnitedHealthcare

UnitedHealthcare Logo Get a Quote

On Official Website

Number of healthcare members:
26.5 million
Available States:
50 states + Washington, D.C.
Average monthly costs:
$483 (New York)
  • Tons of handy tools available
  • One of the best mobile apps
  • High customer satisfaction levels

UnitedHealthcare (UHC) is the largest healthcare insurer in the world, with a revenue of over $285 billion and 26.5 million customers across the globe. UHC is part of the United HealthGroup, which includes over 100 subsidiary companies and specializes in providing plans for the elderly and underprivileged members of the community.

Financial Strength: A

UHC is among the strongest companies in terms of finances. A.M. Best gave it an A+ rating, BBB rates the company with an A+, and Fitch rates it AA-. The ratings confirm that UnitedHealthcare is viewed as a safe choice by industry professionals across the board.  

Pricing

UHC has slightly above-average premiums, but it is not the priciest option available. Still, there are dramatic variances in quotes depending on a number of factors like geographic location and customer requirements.

For example, average monthly premiums in New York can range between $483 and $1,618 depending on the size of your deductible and other factors such as the age and health bill of those insured.

Thankfully, getting a quote is the easiest and most straightforward process out of all major carriers and requires nothing more than sharing some personal information with the company.

Product Quality 

UnitedHealthcare justifies the high cost of premiums through the quality of service and the vast amount of products it has to offer. UHC also has one of the largest networks of healthcare professionals, with 1.3 million physicians across the US.

This is hugely beneficial to customers, allowing them to choose a strictly in-network plan and feel safe regardless of their location or that of their families. 

The company provides a number of member discounts on items such as Lasik treatments and hearing aids and also has numerous well-being and fitness programs that you can get access to. 

UHC truly shines when it comes to its online platform and member portal, which is among the very best we’ve seen in the industry. There is a wealth of information, downloadable forms, and tools that you can use to find a healthcare professional or track your claims in real-time. 

MyEasyBook feature allows you to set up appointments online, and before you commit to a procedure, you can even use a tool to estimate the costs. UHC also has a mobile app that is easily among the best available and represents one of the most significant steps in the pivot toward virtual healthcare.

Customer Satisfaction

UHC customer ratings differ depending on the region, but the feedback is generally very positive for a company of this size. UnitedHealthcare’s plans and customer service received particular praise, and J.D. Power ranks the company among the most reputable insurance carriers. 

The same above-average score is found on Consumer Affairs, where the company holds a 3.4  rating from 496 customer ratings in the past twelve months. Users are mostly impressed with the website and the new and improved mobile app while praising company employees they interacted with. 

Final Words

Even with slightly expensive premiums, UnitedHealthcare is a company worth your attention. It provides several plans, has lots of optional features, and offers more tools than any other competing platform. There’s also a fantastic mobile app and a wealth of plans, discounts, and well-being programs. As a package, it’s truly hard to beat.

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Cigna

Cigna Logo Get a Quote

On Official Website

Number of healthcare members:
17 million
Available States:
12 states (dental plans in all 50 states)
Average monthly costs:
$344 (age 40, Illinois)
  • Competitive prices
  • Numerous useful online tools
  • Highly-respected customer service

Cigna was formed in 1982, but its roots as a global provider of health services go further back in time. The corporation is the product of a merger between two of the oldest private health insurance companies, INA and CG, which have been operational since 1792 and 1865, respectively.

Today, Cigna employs over 70,000 people around the globe and has a massive annual revenue of more than $160 billion, putting all those invaluable centuries of experience to good use.

Financial Strength: A

Cigna is highly rated regarding financial strength and security. A.M. Best Ratings gives the company an “Excellent” A rating. It is currently unrated at BBB but used to have an A+ rating.

Pricing

The quotes offered at Cigna fall somewhere in the lower-to-average range but will still vary a fair bit depending on your location and other factors.

For example, a 21-year old on the Cigna Connect 7150 plan in Illinois will pay only $268 a month, but someone who is 60 or older and wants a higher-tier Cigna Connect 1000 plan will have to fork out as much as $968 for insurance premiums each month.

Getting a quote from Cigna is relatively quick and easy, requiring only a zip code and other basic information.

Product Quality

The biggest downside to Cigna is that it currently has medical plans for only 12 states, Arizona, Colorado, Connecticut, Florida, Georgia, Maryland, Missouri, North Carolina, South Carolina, Tennessee, and Texas. 

The lack of coverage not only excludes the majority of the population but also makes it harder for people with family members working or studying in one of the many states not covered by Cigna coverage. For those that can take advantage of the service, however, the company represents one of the finest options available.

Cigna’s coverage options are widely accepted at hospitals and clinics within the available regions. Plans range from PPO to HMO, and HSA (Health Savings Accounts) are also available to further control your premiums and deductibles.

You also have access to a stellar comparison tool that helps you compare all of the company’s packages. It also allows you to search for specific drugs covered by your plan. 

You can pay your bills online and monitor your claims in real-time, whether using the desktop platform or the mobile app. The only thing lacking is short-term health care plans, so you should probably avoid Cigna if you are in between jobs.  

Customer Satisfaction

The support staff is available 24/7 nationwide and has gotten J.D. Power’s highest ranking for years. When looking at customer reviews on Consumer Affairs, Cigna has 3.8 out of 5 stars. The ranking, based on 351 reviews in the past year, is pretty good for such a large company.

Final Words

Born out of a merger between two of the oldest names in the industry, Cigna has grown into a global insurance leader that continues to provide fantastic service in its home country.

With a world-class platform and customer service, and a variety of options to build and compare your insurance plans, it is easily among the companies with the most well-rounded offers.

The only downside is that these services are currently limited to 12 states, but if you live in the areas covered by Cigna, you should consider it when choosing your plan.

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Humana

Humana Logo Get a Quote

On Official Website

Number of healthcare members:
8.6 million
Available States:
all 50 states + Washington, D.C. and Puerto Rico
Average monthly costs:
starting from $0 + copayments and deductibles
  • Affordable monthly premiums
  • Medicare coverage
  • A great option for seniors

Founded in 1961, Humana offers its services in all 50 states and has a network of over one million physicians. Moreover, the insurer is well-known for its pharmacy service that allows fast and secure mail-order prescriptions.

The main advantage of this insurer is the Medicare coverage and very affordable starting plans. Humana’s plans are generally much more affordable than most of its competitors on our list. Hundreds of positive reviews and countless happy consumers speak volumes, but let’s dive deeper and see why this company is so well-regarded.

Financial Strength: A

Like other similar providers we listed, Humana is a reputable and safe place for getting health insurance. The A.M. Best rating is A-, while BBB rates the company’s service with an A+. Humana wouldn’t be on our list if it wasn’t a stable company. Revenue of over $106 billion in 2023 speaks for itself, though -  you have nothing to worry about here.

Pricing

Humana offers below-average premiums. It is probably one of the most affordable insurers in the US. Of course, the amount of money you have to pay depends on various factors, including your area and the type of coverage you have need. The insurer offers HMO, PPO, and PFFS plans. 

To get the quote, you’ll have to visit Humana’s website and click on the Explore plans button to get a quote. To start the search, you need to type in your zip code. Humana will ask you a few questions before they send you a quote.

For starters, you’ll need to choose the type of coverage you want - Medicare Advantage, Medicare Supplement, or Prescription Only. 

Monthly premiums at Humana are some of the most affordable ones around. We asked for a quote for a 40-year adult based in Illinois. The good news is that a monthly premium can be $0 for Gold Plus HMO. However, there are other costs, including copayments and deductibles. For example, a copay for a specialist is $20, meaning that costs can easily increase.

Product Quality

Humana plans are available in all 50 states, Washington, and Puerto Rico. Its vast network of healthcare institutions and employees means that you can get help closest to your home and an in-network plan. 

When it comes to Humana, their plans are as beneficial as they are versatile. You can choose from several products, including group health insurance, Medicare and Medicaid, dental and vision insurance. 

Humana doesn’t offer plans for individuals. However, Medicare and Medicaid plans are available for individual purchase, but only if you are qualified for Medicare. Also, Humana Medicaid plans are available only in Kentucky and Florida.

Humana’s group plans are perfect for companies, and Humana’s policies might be the best option if you run a small business, with up to 50 employees.

Customer Satisfaction

Customers say a lot of positive things about this insurer. Consumer Affairs gives Humana 3.4 of 5 stars based on 151 consumer ratings in the last 12 months. Client reviews claim Humana is a great place for seniors and anyone who wants top-notch service.

The insurer is also praised for its mail-order pharmacy service. According to the reviews, this is one of the most important benefits that Humana’s clients get.

Final Words

Humana is among the most affordable companies on the market, providing its services in all 50 states, Washington, and Puerto Rico. It offers a wide range of plans, including Medicare plans, pharmacy, and drug prescription services, family health insurance plans, and more.  

Humana's website states that the company is "committed to delivering quality, affordable healthcare and improving the health and well-being of our members."

The company has several initiatives to help achieve this goal, including providing access to preventive care and screenings, promoting healthy living and active aging, and supporting care coordination. Overall, Humana is a fantastic and affordable provider you should definitely keep on your radar.

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A Guide To Health Insurance Benefits and Plans

The short enrollment period for health insurance policies makes it essential to be fully informed about all the coverage plans to find the best possible deal. There are also other important points to consider when choosing a plan for you or your family.

The section below helps you identify the details you’ll need to pay attention to when choosing a health insurance package.

Essential Health Benefits

The Affordable Care Act of 2010 established the ACA Health Insurance Marketplace and introduced a list of 10 essential health benefits that all non-grandfathered health care plans in individual and small group markets had to cover. And while ACA-mandated federal health insurance is no longer mandatory, the essential health benefits remain a requirement wherever you purchase your plan.

The EHBs are as follows:

Ambulatory Patient Services (Outpatient Care)

Patients receive this sort of care when health issues do not require admittance to the hospital. It is already covered within most insurance plans and includes standard doctor’s appointments and in-home visits.

Pediatric Services

This essential benefit includes all care provided to children, dental and vision care, along with annual checkups and vaccinations. 

Emergency Services

If you end up with a potentially debilitating or fatal condition, the emergency health care benefit ensures you receive the required care, even if the health insurance provider is out-of-network. Some states have banned billing in these instances.

Still, if you are out of your provider’s network, there are no federal laws preventing hospitals or ambulance companies from billing you more than your insurance policy covers.

Maternity and Newborn Care

This includes all maternity and newborn care, from prenatal checkups to delivery and postnatal care. There are also some tests for pregnant women covered under the category of preventive care, with no cost-sharing.  

Laboratory Services

With this benefit, medical coverage provides lab work and tests for diagnosing, monitoring, or ruling out certain conditions that fall within preventive care. It is covered with no cost-sharing for the patient. Other lab work is covered under the plan’s standard cost-sharing guidelines.

Hospitalization

Hospital care includes the full range of services at a hospital or nursing facility, like lab and pharmacy services and surgical care, and any other inpatient treatment that you receive at these facilities.

Mental Health and Substance Abuse Treatment

This benefit includes both inpatient and outpatient treatment and predates the ACA that expanded the parity law to apply to both individual and employer-sponsored coverage plans. Any care necessary to diagnose, monitor, and treat mental illness falls under this provision, but some plans limit treatment to a set number of days.

Prescription Drugs

All individual and small group health plans are required to cover at least one medication in every federal category and class of prescription drugs. Most insurance companies place covered drugs in one to four different tiers, with tier one drugs having the lowest out-of-pocket costs while tier four have the highest.

Rehabilitative and Habilitative Services

This essential health benefit includes therapy and devices needed for rehabilitation and habilitation in order to help patients gain or regain abilities that were limited or lost due to injuries or illness and other conditions. Examples include physical, speech, and occupational therapy, but there are limits on the number of sessions per year.  

Chronic Disease Management, Wellness Care and Preventive Services

Under ACA, all 50 procedures recommended by the US Preventive Service Task Force are covered with no cost-sharing for the patient. These procedures include screenings, immunizations, and other services like support for breastfeeding equipment and contraception.

Services for preventing and detecting illness and for the management of chronic conditions are also covered.

Common Health Insurance Plans

Every person should seek to get a plan tailored exactly for their personal needs, but not everyone has the same choices available. Your location may hinder coverage options, quality of service, and pricing. But there are ways to mitigate this if you know what to look for with providers.

For starters, you should understand what each health insurance plan offers and what it does not. 

Preferred Provider Organization 

This is the most flexible plan, which is why it is among the two most popular choices currently available. The reason is that a PPO represents a network of medical professionals and facilities that contract with insurance companies to allow participants free use of any provider within that network.

With this extensive coverage, you will almost always have plenty of providers to choose from for your medical needs, but this wealth of options does not necessarily come with higher premiums. That said, any service from an out-of-network provider might not be covered by the plan or can cost you more out-of-pocket. 

Health Maintenance Organization 

The second most popular plan, HMO, provides lower premiums under a network of local health care providers, but it requires you to choose a primary care physician. This means that the patient will have to get a referral from the primary doctor before seeing a specialist for any medical procedure. The only time that this does not apply is in case of emergencies.

High-Deductible Health Plan 

This is the only plan that qualifies you for a Health Savings Account and allows you to lower insurance premiums by paying a higher minimum deductible for medical expenses. A high-deductible health plan is best for younger and healthier people who don’t have much need for healthcare coverage and mostly require it only in case of serious emergencies.

Exclusive Provider Organization 

An EPO plan does not require a primary care provider and doesn’t provide any out-of-network coverage. It is an excellent medical insurance plan if you seek lower rates than those you’ll have to pay for an HMO or PPO since doctors are paid a service fee rather than a capitation or a monthly fee. 

Point of Service 

A point of service plan is best described as a grouping of HMO and PPO plans. It requires you to choose a primary care doctor that you will need to see for any referrals and provides coverage for out-of-network services. The cost will still go up if you choose an out-of-network service but not as drastically as with an HMO, which is offset by the fact that the list of providers can be much shorter with a POS plan. 

Short-Term Medical

This insurance plan is a good choice while you are changing jobs or outside enrollment periods. A short-term medical fills this gap before your new insurance takes over, so you stay covered in case of an emergency.

The plan usually covers preventive care, doctor visits, urgent care, and emergency care, but they are also not required to comply with Affordable Care Act guidelines.

Flexible Spending Account

While FSA is not a health insurance plan, it represents a way for an employed person to pay for some out-of-pocket costs, copays, deductibles, and medical drugs. A Flexible Spending Account is tax-exempt, so it can be used to reduce your taxes.

However, it is limited to $2,650 annually per employer. Note that an FSA account cannot be used to pay for health insurance premiums.

Comparing Plans

It is always advisable to compare key features of multiple plans before committing to a purchase because prices and our personal healthcare needs vary drastically. Healthier and younger people will usually opt to pay lower premiums for a higher deductible, while persons with pre-existing conditions can benefit from a higher monthly premium but a lower deductible.

You should always check the maximum sum you are required to pay out-of-pocket and the company’s policy on in and out-of-network coverage. Finally, checking the size of the health network, the types of benefits, and the availability of doctors and healthcare institutions is crucial when making a decision.

FAQ

Can you buy private health insurance at any time?

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Private health insurance companies have an established open enrollment period during which you can purchase qualified health plans for yourself or your family without complications.

This period usually runs from November 1 to December 15, but it is best to check ahead because the dates are always subject to change. While open enrollment is active, the exchanges provide plans 24/7, making it the perfect time to take advantage of the best deals and subsidies.

How do I get cheap health insurance?

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There are several different methods for getting the most affordable health plan possible during the enrollment period. First, calculate your annual healthcare spending, including monthly premiums, deductibles, and out-of-pocket costs. Familiarize yourself with current rates to spot good deals on the HealthCare.gov website. The site allows you to compare up to three coverage plans side by side and see all the covered prescriptions, making it easier to identify the best choice available.

What should I look for when buying health insurance?

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The quality of health insurance depends mainly on how much you are willing to spend. Minimal coverage is usually not the best deal, even if it offers the lowest premiums or deductibles. Paying a little extra can get you access to more healthcare services that can lower your total costs in the long run. 

You should always check if your out-of-pocket expenses count toward meeting the deductible and the exact size of the network of doctors that the insurer covers. If the companies you’ve found provide low premiums and deductibles but do not have qualified doctors in your vicinity, it is better to keep searching.