Best health insurance companies of November 2023
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BLUEPRINT
Updated 12:35 p.m. UTC Nov. 16, 2023
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Kaiser Permanente is the best health insurance company, according to our analysis.
We evaluated health insurance companies based on cost, coverage options, NCQA quality rating and consumer complaints. Use this rating as a starting point to compare providers and find the best health insurance for your situation.
The best health insurance companies of 2023
- Kaiser Permanente: Best health insurance
- Aetna: Best health insurance for young adults
- Blue Cross Blue Shield: Best health insurance for the self-employed
- UnitedHealthcare: Best health insurance provider network
Why trust our insurance experts
Our team of insurance experts evaluates hundreds of insurance products and analyzes thousands of data points to help you find the best product for your situation. We use a data-driven methodology to determine each rating. Advertisers do not influence our editorial content. You can read more about our methodology below.
- 129 health insurance companies analyzed.
- 864 health insurance plan rates reviewed.
- 5 levels of fact-checking.
Top-rated health insurance companies
Kaiser Permanente
Aetna
Blue Cross Blue Shield
UnitedHealthcare
Compare the best health insurance companies of 2023
Methodology
We analyzed insurers that sell individual health insurance plans to determine the best health insurance companies. Each health insurance company was eligible for up to 100 points, based on its performance in the following key categories:
- Cost (30 points). Health insurance companies with the lowest average premiums and deductible for Silver tier health insurance plans received the highest score.
- Consumer complaints (25 points). Health insurance companies with the lowest levels of complaints received the highest score. We collected complaint data from the National Association of Insurance Commissioners, which shows the volume of health insurance consumer complaints against each company.
- NCQA quality rating (25 points). Health insurance companies with the highest quality ratings received the highest score. We collected data from the National Committee for Quality Assurance (NCQA), an independent, nonprofit organization that accredits health plans and produces ratings based on specific metrics.
- Variety of health insurance plans (10 points). Health insurance companies with the greatest variety of health insurance plans (HMO, EPO, PPO) received the highest score.
- Metal tier offerings (10 points). Health insurance companies with the most options of metal tier plans received the highest score.
What is health insurance?
Health insurance is a contract between a health insurance company and the policyholder. The insurance company agrees to pay for covered medical expenses in exchange for the policyholder’s premium payments.
“Health insurance is designed to help individuals manage costs associated with medical care,” said Ryan Bullock, chief operating officer of Aeroflow Healthcare, a durable medical equipment provider.
You’re more likely to use a service when you pay for it. If you’re uninsured, you may decide not to go to the doctor, even if you have a health concern, due to the high out-of-pocket costs. Health insurance “serves as a safeguard against the high costs of medical treatments, consultations, prescriptions, and hospital stays,” said Tarek El Ali, founder of Smart Insurance Agents health insurance agency.
What does health insurance cover?
All Health Insurance Marketplace, or Marketplace, health insurance plans that are compliant with the the Affordable Care Act (ACA) must cover these 10 essential benefits:
- Ambulatory patient services for outpatient care.
- Chronic disease management, preventive and wellness services.
- Emergency services.
- Hospitalization, including surgery and overnight stays.
- Laboratory services.
- Mental health, behavioral health and substance use disorder services.
- Pediatric services, including dental and vision care.
- Pregnancy, maternity and newborn care, including birth control and breastfeeding coverage.
- Prescription drugs.
- Rehabilitative and habilitative devices and services.
Specific services within these categories can vary depending on your state’s requirements. Plans can also provide adult dental or vision coverage and medical management programs, such as those that assist plan members with back pain, diabetes and weight management.
Plan benefits can also vary by insurance company. It’s important to read the fine print to determine what each health insurance plan covers and excludes.
Does health insurance cover dental?
If you’re getting health coverage for someone 18 or younger, dental coverage is an essential benefit under ACA-compliant health insurance plans. That means it must be available as part of a health plan or as a separate dental plan. Adult dental care is not an essential benefit, however, so your health insurance may not cover dental, depending on your plan.
Some plans include dental, meaning the premium covers both health care and dental. But if your plan doesn’t cover dental, you might be able to buy dental insurance separately through the Marketplace. If you do, you’ll have a premium for your health insurance plan and another for your dental plan.
You can choose between two categories of dental insurance through the Marketplace: low and high. A low coverage plan will have high copays and deductibles but cheaper premiums. A high coverage plan will have lower copays and deductibles but more expensive premiums.
What does health insurance not cover?
Although health insurance plans can vary, according to Shashank Agarwal, senior decision scientist for CVS Health, health insurance may not cover:
- Experimental treatments.
- Cosmetic or elective procedures.
- Non-essential medications or drugs that aren’t FDA-approved.
- Alternative therapies, such as acupuncture and chiropractic care.
- Out-of-network care.
- Dental or vision care, if not part of your health plan.
- Medical care outside of the U.S.
Your health plan might also exclude coverage for fertility treatments, brand-new technologies or off-label drug use. “There may also be limitations or exclusions relating to pre-existing conditions, dental care, vision care and long-term care,” said Bullock.
While most health insurance plans cover rehabilitative care, they might not cover developmental services, warns Adam Rosenfeld, president of Rubicon Benefits, a division of World Insurance. Although your physical therapy following knee surgery would be covered, speech therapy for your child born with developmental delays may not, he explains.
Just like plan benefits can vary by coverage level and insurance company, so can policy exclusions. Comparing plan benefit details, especially what’s excluded from coverage, can help you determine which plan is best for your health care needs.
Cost of health insurance in 2023
The tables below show examples of health insurance costs for Bronze, Silver and Gold plans from the best health insurance companies in our analysis.
Bronze plans: Health insurance monthly cost examples
Silver plans: Health insurance monthly cost examples
Gold plans: Health insurance monthly cost examples
On a tight budget? How to save money on health insurance
How to find the best health insurance for your needs
There are several steps you can take to find the best medical insurance for your needs:
- Assess your health care needs, such as “the frequency of doctor visits, medications, and any specific medical conditions you or your family members have,” said El Ali.
- Evaluate available plans in your area. EPOs, HMOs, PPOs work differently. An HMO may be cheaper, but you’ll have more coverage restrictions. A PPO comes at a higher cost, but you can go out of network for care. Understanding the different plan types and the pros and cons of each can help you find what suits you best.
- Compare health insurance plans. Each plan can have varying benefits, deductibles, copayments, out-of-pocket costs and premiums. Pay close attention to what a plan doesn’t cover to ensure it will meet your needs. Marketplace plans provide a summary of benefits and coverage (SBC) to make comparing plans easier.
- Verify network coverage. “If you have preferred doctors or health care facilities, make sure they are in the network of the plan you’re considering,” said Agarwal. Otherwise, you could face expensive out-of-network costs or have to choose a new doctor.
- Check for prescription coverage. If you take prescription medications, make sure the plan covers them and what your out-of-pocket cost would be. You might have to call the insurance company to determine costs.
- Look for extra benefits, like telehealth services, a 24/7 nurse line or discounts on wellness programs.
- Check for financial assistance eligibility. You might be eligible for financial assistance or premium subsidies if you purchase health insurance through the Marketplace.
- Ask for reviews and recommendations. Have a discussion with coworkers, friends and family members to learn about their insurance company and plan experiences.
The Health Insurance Marketplace’s open enrollment period runs from November 1 through December 15 each year. You can enroll in a new plan or change your current one during open enrollment. Health insurance coverage begins on January 1, when your first health insurance premium payment is due. If you don’t need your health insurance coverage to start until February 1, you can enroll until January 15.
There are multiple reasons why health insurance is so expensive, said Shashank Agarwal, senior decision scientist for CVS Health. Administrative and medical care costs, prescription drug prices, lifestyle factors, an aging population, mandates and regulations, risk pool dynamics and complex billing and pricing impact how much each person pays for health insurance.
“Drugs used to account for less than 10% of overall health care plan costs, and now it’s over 25%,” said Adam Rosenfeld, president of Rubicon Benefits, a division of World Insurance. A lack of tort reform laws and the ability to revise, renew and extend patents to keep drug prices up also factor into higher health insurance costs.
Find a plan that suits your budget: Best cheap health insurance
There are no federal laws that require health insurance, but California, Massachusetts, Rhode Island, New Jersey, Vermont and Washington, D.C. require residents to declare proof of health insurance coverage on state taxes.
Even if you don’t live in a state that requires proof of medical insurance coverage, most Americans should consider health insurance if they can’t afford to pay for health care out of pocket. Having health insurance can help you pay for preventative care, which can keep you happier and healthier longer.
Comparing the cost of health insurance plans and your out-of-pocket expenses to paying for care on your own can help determine if you need health insurance.
Blueprint is an independent publisher and comparison service, not an investment advisor. The information provided is for educational purposes only and we encourage you to seek personalized advice from qualified professionals regarding specific financial decisions. Past performance is not indicative of future results.
Blueprint has an advertiser disclosure policy. The opinions, analyses, reviews or recommendations expressed in this article are those of the Blueprint editorial staff alone. Blueprint adheres to strict editorial integrity standards. The information is accurate as of the publish date, but always check the provider’s website for the most current information.
