Sifting through the right health insurance companies to find the right one for you and your family can be an overwhelming task.
A variety of factors will determine the ability of a healthcare company to meet the needs of you and your family. The task at hand may seem enormous, but I will explain the different factors that will go into choosing a healthcare company successfully.
Once you know a little bit more about the different elements to consider, we will outline the best healthcare companies in the market. With this combination of information, you will be able to successfully choose the right healthcare plan for you and your family.
Do Your Research Slowly and Carefully
I urge you to not rush through this process, finding the right healthcare plan will take some time. Sifting through the options might sound like self-inflicted torture, but is essential for both your health and your finances that you find the right plan. You do not want to be burdened with an excessive plan or skimp on your coverage and regret your decision later.
It will take a little bit of time to find the right plan, but it will be worth it when you find the right one. It will lift a worrisome burden off of your shoulders to know that you and your family would come through alright in the unfortunate event of a medical emergency.
If you are unsure of where to start then check out EHealthInsurance. The site will help you find all of the available plans in your area.
It should be noted that this article will cover the traditional forms of healthcare, we will be discussing other forms of healthcare like health sharing plans and temporary insurance in another article soon.
What Factors Should You Consider?
The way that the United States healthcare industry is set up means that you may not have many choices, no matter how much research you do. Sometimes the choice really just boils down to where you live.
If you live in a big city then you will likely have many health insurance companies to choose from. But if you live in a smaller community or rural area then you will have fewer health care options.
The ACA (Affordable Care Act) has made attempts to encourage more competition around the country, but so far the results have been small. In the future, rural areas and smaller communities may have more choices but for now, your options may be limited.
Be realistic about what you are able to spend on a healthcare plan. While it would be nice to have platinum level benefits, it may be unrealistic. It is likely that you will be able to find a plan that suits your needs within your budget, you will just have to look for it.
What do you want to be covered by your plan? This depends entirely on your own medical history, preferences, and opinions. It may help to make a list of the things that you absolutely want to be covered. You can compare your list to the plans you find so that you can make the best match.
A few things that you should consider when thinking about coverage include:
- Is your chronic condition covered?
- Ensure that your preferred primary care doctor is on the plan’s network.
- What is the policy on prescription drugs? Are your current medications covered?
- How large is the network of providers? Do you feel comfortable working within that network?
- What is the deductible or the amount you have to pay before your insurance company helps out?
- Is there a limit to the amount you will have to pay out of pocket?
- Is preventive care included?
4. Employer Benefits
Some employers offer healthcare benefits to their employees. You should take advantage of this perk if you have the option. Most health insurance companies will offer more than one type of healthcare plan, so you may still have to choose the best option for you.
You may need to work with various open enrollment restrictions if you plan to sign up for healthcare through your employer. Usually, there is one month of the year in which you can sign up unless you are a new employee. I recommend looking into these options and restrictions as part of your healthcare search.
Types of Health Plans Available
An HMO (health management organization) is the more restrictive plan option. If you are covered by an HMO then you will have to receive care through the available provider network. The provider network may limit your options as far as physicians you are allowed to see. If you receive care outside of the provider network you may have to pay the entire bill, except in the case of a medical emergency.
The major drawback to an HMO is the limited network. If you have to go outside the network for medical care it will always be expensive. In addition to these restrictions, you will have to receive a referral from your primary care physician before you can see a specialist within your network. This restriction will be cumbersome if you want to have a medical problem looked at by a specialist immediately.
The advantage to this plan is the cost savings. Most HMO’s charge a low cost and predictable copay when you need medical care, which is helpful if you know that you will not need to go outside your network.
A PPO (preferred provider organizations) will give you more choices in terms of your healthcare provider. With a PPO, you will not have not to obtain a referral from your primary care doctor. Instead, you can just go see a specialist when it feels necessary.
There will still be a network of doctors to choose from, but you are allowed to go outside of the network. You may have to pay more than you would if you stayed within the network, but you will probably not have to pay the whole bill yourself. The process to allow this might be lengthy though. You may have to file for a reimbursement and wait several weeks for a check from your health insurance company.
PPOs give you more flexibility, but that will come at a cost. Instead of a flat copay, you will pay coinsurance which can be much more expensive. The costs of a PPO can add up, but it may be worth it to you. If you are looking for a flexible plan that will allow you to choose your own doctors, then a PPO is the right option for you.
POS (point of service) is a hybrid of an HMO and PPO. The traits it takes from an HMO include a mandatory referral for specialists from your primary care doctor. However, like a PPO, it will allow you to receive out of network care.
This combination of plans allows for an affordable option with more flexibility. It could be a good option if you like your primary care doctor but would like to have the option of out of network treatments from your health insurance company.
An uncommon type of plan is the EPO (exclusive provider organizations). Like the POS plans, an EPO plan is a combination of an HMO and a PPO.
Like a PPO, you do not have to get a referral from your primary care doctor. But like an HMO, you will have to stay in your network. Similar to a POS plan, the cost of an EPO is in the middle between a PPO and an HMO.
This type of plan might be a good option for you if you plan to stay in your network but hate dealing with referral paperwork as many health insurance companies require.
HDHP (high deductible health plan) is an unusual form of insurance. The rules regarding which doctors you can use vary by plan, which may allow you to find a flexible plan. The benefit is that your monthly premium is low. However, the obvious drawback is the extremely high deductible.
In most cases, the deductible is well over 6,000 dollars. It may be a good option if you are generally healthy and cannot afford to pay a higher premium. An HDHP plan is risky because if you have an unforeseen medical expense, you will have to pay your deductible before your insurance company will help. If you decide to go with an HDHP plan then you should ensure that you have an emergency fund built up to pay for unexpected medical problems. Health insurance companies are not flexible in these situations.
5. Medical Bill Sharing (not insurance)
Healthcare Bill Sharing programs are where a group of people share their financial resources to pay each other’s medical expenses. There are several Health Share organizations in the U.S. including:
- Altrua HealthShare
- Christian Healthcare Ministries
- Aliera Healthcare
- Liberty HealthShare
- Medi-Share (we have many friends who currently use this service)
- Samaritan Health Share
- Solidarity Health Share (for Catholics and Christians)
- United Refuah (the first and only Jewish Health Share organization)
Some of these health sharing organizations have been around, weathered recessions, negotiated payments, and have built remarkable and sustainable companies. These companies are non-profit and several have been in existence for over 25 years.
Each company has different ways of doing business, but the bottom line is to help people reduce the cost of medical care. Some health share plans require individuals to sign a statement of faith.
Unique Things Health Share Organizations Do
One of the impressive things these companies do is to go beyond helping people share resources for medical expenses. Some have options for helping with burial and memorial service expenses (within limits of course). And at least one has a provision that allows funds to be given to those that adopt children.
RELATED ARTICLE: What is Medical Cost Sharing and Is it for You?
Top Healthcare Companies to Choose From
Now that you know more about the different types of health care plans you can choose from, let’s take a closer look at the top health insurance companies in the United States market.
Aetna has been around since 1853 and is a large health insurer that has roughly 5% of the market share. It is known for affordable plans and great customer service. The company is a respected healthcare provider that offers a wide variety of affordable plans. The plans can include dental, vision, plans for students and international plans.
The rates of Aetna plans are less than average for members under 55 and the lowest available for members over 65. In addition to low rates, there are supplemental programs that you can add on including hospital care as well as critical care policies.
The Aetna website is user-friendly, which is great for when you are looking for quotes and more information about their coverage in your area.
Customer service with Aetna is also one of the best in the industry. It has ranked on the J.D. Power list for highest in customer service, claims processing and communication in Florida. As well as the highest in claims processing and customer service in New Jersey. You may want to check out their ratings in your area if you are from another state.
2. Kaiser Permanente
Kaiser Permanente is the largest HMO healthcare provider in the country with over 7% of the market share. This health insurance company maintains its own hospitals and doctors offices which gives them the ability to operate at a low cost. Kaiser Permanente passes those savings along to you and is known to be one of the most affordable HMOs available.
The plans are considered to be either moderate or low but are especially low for people over 55. Most of the plans have an option for vision and dental coverage.
The drawback to Kaiser Permanente is that you will have to stay within your network. Its policies are similar to other HMOs, but the company is very strict about the rule because it has invested millions of dollars in building their own health care network.
This health insurance company only has healthcare facilities in eight states which include California, Colorado, Virginia, Maryland, Georgia, Oregon, Washington, and Hawaii. There are also facilities in the District of Columbia. If you don’t live in these areas, then Kaiser Permanente is not a good option for you.
Kaiser Permanente was also ranked highly by the J. D. Power ranking. They ranked highest in overall experience for multiple regions including Virginia, Washington, South Atlantic, California, Colorado, Maryland, and Oregon. It is the only health insurance company to earn this high rating in multiple regions.
3. UnitedHealth Group
UnitedHealth Group is a company that owns many different insurers and health providers. It owns so many different insurers that it is that has over 12% of the market share, which is the largest in the industry.
This is one of the largest health insurance companies out there, but that does not mean you will have an impersonal experience. In fact, UnitedHealth Group was ranked as the highest in overall experience for Arizona and “among the best” for providers in Texas.
UnitedHealth Group is known for its friendly customer service and comprehensive online support system. The online portal will help you to find doctors, get refills on your prescriptions, track your deductibles and more.
This health insurance company even has a healthy living motivation app called Rally that is available with most plans. Sometimes we all need a little bit of motivation to live a healthy lifestyle, so this is a great perk.
UnitedHealth Group has good plans with many coverage options. The drawback is that UnitedHealth Group is known for being more expensive than most other companies. Keep that in mind if you are searching for a budget-friendly option in top health insurance companies.
4. Blue Cross Blue Shield
Blue Cross Blue Shield has the largest selection of plans available. This top-rated health insurance company has over 37 individual organizations within it. Although it is one of the largest health insurance companies, they still rank as one of the highest in overall customer satisfaction.
The coverage options at Blue Cross Blue Shield vary by state, but most states have both an HMO and PPO option. Blue Cross Blue Shield also offers a variety of short-term health insurance plans.
In addition to the excellent coverage, there are many free perks associated with this health insurance provider. The most notable perk is Blue365, which is a wellness program that offers free discounts on vitamins, gym memberships and more.
This health insurance company also has an easy to use website that will make reordering prescriptions easier. The plans at Blue Cross Blue Shield are considered to be in the average price range, but the extra health perks may make this worth the cost.
Humana holds 7% of the market share. It also offers health insurance in 22 states which means that its network of providers is very large. This could be the perfect health insurance company for you if you frequently visit another state. This way, you would likely be able to find a healthcare provider within your network, if you want to see a doctor but it is not an emergency.
The company offers a variety of plan options and it is known to be one of the most affordable health insurance companies in the industry.
In addition to their wide selection of plans, there are more supplemental coverage options including dental, vision and more. Plus there are home health care coverage options if that is a concern of yours.
Humana was ranked by the J. D. Power award to be the best overall experience in Texas and the best in coverage and benefits in Ohio. An interesting fact about the company is that endorses the accountable care payment model, which gives doctors bonuses for providing excellent care.
Cigna is an independent insurance company that only has 2.5% of the market share, but it is known for its high rating in customer satisfaction.
In fact, it was ranked highly on the J.D. Powers list in many areas. It received the highest overall experience rating in Florida, plus it received the highest rating for claims processing in Colorado, Virginia, and Maryland.
The premiums of this health insurance company are considered to be below average in every age group.
The company has a useful website that will allow you to check if your current medications are covered by Cigna or not. That is a huge consideration when finding a new insurance plan, so make sure to utilize this feature.
Although one of the smaller health insurance companies, this company offers a variety of plans in the 12 states that it operates in. (Arizona, California, Colorado, Connecticut, Florida, Georgia, Maryland, Missouri, North Carolina, South Carolina, Tennessee, and Texas). It is possible there will be a good match here.
Assurant Health has a variety of plan options, but it operates on a secondary network. This function will allow you to have a larger selection of doctors to choose from. If you are looking for flexibility, then this might be the right health insurance company for you.
The flexibility will come at a price though. Most of the plans offered through Assurant cost an above average price. Although most plans are more expensive, it will depend on the different types of coverage you need. I would recommend sorting through the options on their website before you rule out this company, the perfect plan might be waiting for you.
8. Molina Healthcare
If you are struggling to find a health insurance provider in your area then Molina Healthcare might be the answer. This health insurance company was formed in the 1980s to provide better healthcare coverage to underserved communities.
The company owns and operates medical clinics throughout 15 states plus Puerto Rico.
There are a variety of plan options to choose from with Molina Healthcare. This company will also work with you if you are covered by government programs like Medicaid. The people at Molina seem very invested in helping everyone find affordable healthcare, so it is likely that they will have a presence in your community if larger health insurance companies have neglected the area.
Molina Healthcare plans are considered below average in terms of price, so it is an affordable option if they are in your area.
Centene is a company that strives to produce “better health outcomes at lower costs.” Based on that statement, you know that the price of these plans is generally below average. Specifically, this company works to help members find health insurance through government-sponsored programs.
This is another health insurance company that strives to serve areas that lack affordable coverage options. So if you are struggling to find a plan in your area that meets your needs, then check out Centene and their options.
Final Tips for your Health Insurance Companies Search
Even with all of this information available, it can be difficult to make the right decision for your health insurance plan confidently. Although it may seem like a burden, it is crucial to sift through the plans and find the best one for you and your family. You do not want to end up with too much or too little coverage.
Again, if you need some help finding health insurance companies and a good plan in your area, then check out EHealthInsurance. The site will help you find the best plan in your area. Even if you don’t find the exact right plan through EHealthInsurance, it will give a good place to start looking.
Hopefully, this will help you find the best plan for you.
If you’re interested in other options please check out these pages: