Health insurance is a fundamental part of healthcare access and affordability for most Americans. With rising healthcare costs, choosing the right national health insurance company is more important than ever. This comprehensive guide takes an in-depth look at national health insurance companies, examining their coverage options, provider networks, costs, customer satisfaction, and more. Whether you receive employer-sponsored insurance or shop for coverage on your own, read on to make an informed choice about your health plan.
What are National Health Insurance Companies?
National health insurance companies offer private health insurance plans across multiple states. Unlike regional or local insurers, national companies can pool larger risk pools and offer consistent pricing and plans across broader service areas. Many large, national insurance carriers also offer employer-based group health plans.
Some of the biggest national health insurance companies include:
- United Healthcare
These major carriers offer health insurance options across most or all 50 states. National companies like these cover tens of millions of Americans through individual plans as well as group coverage.
Individual and Family Plan Options
National health insurance companies offer a range of individual and family health plans both on and off the public Marketplace exchanges. Plan options include:
Bronze plans feature lower monthly premiums but high deductibles and more out-of-pocket costs when you receive care. These plans are a good option if you rarely visit the doctor and want to minimize what you pay each month for coverage.
Silver plans offer a balance between premiums and deductibles. They cover about 70% of your expected healthcare expenses, while you’re responsible for the remaining 30% through copays and deductibles. Silver plans that are sold on the Marketplaces may offer additional cost-sharing reductions to those who qualify based on income.
Gold plans feature higher premiums but lower out-of-pocket costs when you need care. They cover about 80% of your expected healthcare expenses. This can be ideal if you require frequent medical services and want to limit your total costs throughout the year.
Platinum plans have the highest premiums but the lowest deductibles and copays. They cover approximately 90% of your expected healthcare costs, leaving you responsible for just 10% out of pocket. Platinum plans provide robust coverage for those with chronic health conditions or other ongoing medical needs.
In addition to these metal tier plans, national insurance companies may offer:
- High-deductible health plans (HDHPs) compatible with Health Savings Accounts (HSAs)
- Short-term limited duration insurance
- Catastrophic coverage
- Medicaid managed care plans in some states
Always carefully compare benefits, exclusions, provider networks, drug formularies, and costs across plans to choose the optimal health insurance policy for your situation.
Employer-Sponsored Group Health Insurance
Many Americans have access to health insurance through their employers. National insurance carriers offer group plans to companies in all 50 states.
Employer-based plans come in different types:
Preferred Provider Organizations (PPOs)
PPOs allow you to visit any doctor or hospital without a referral. However, you'll pay less when you choose in-network providers. PPOs offer flexibility but have higher premiums than other plan types.
Health Maintenance Organizations (HMOs)
HMOs require you to designate a primary care physician (PCP) who will refer you to specialists and coordinate your care. Treatment is only covered when using your PCP or authorized in-network providers (except in emergencies). HMOs limit provider choice but offer lower premiums.
Point of Service (POS) Plans
POS plans combine aspects of PPOs and HMOs. Like an HMO, you must choose a PCP to manage your care. But POS plans also offer partial coverage for out-of-network providers like a PPO (although you'll pay more).
High-Deductible Health Plans (HDHPs)
HDHPs have lower premiums but high deductibles and out-of-pocket costs. Many employers pair HDHPs with HSAs that allow tax-advantaged savings for medical expenses.
When enrolling in group coverage, carefully review the plan details to choose the best option for your healthcare needs and budget.
A key consideration when choosing national health insurance is the provider network. This refers to the hospitals, doctors, clinics, pharmacies, and other facilities contracted with the insurer in a given service area.
Nationwide insurance companies establish provider networks in all geographic locations where they operate:
PPO networks are broader, giving members flexibility in choosing doctors.
HMO networks are narrower and may exclude higher-cost providers to contain premiums.
Tiered networks categorize providers with different cost-sharing levels. You'll pay less for “preferred” in-network providers.
Telehealth allows access to providers through phone, video chat, or mobile app. Availability varies by location and plan.
Before enrolling, use the carrier's online directory to search for your current doctors, hospitals, medications, and other care needs. Confirm they are in-network to avoid higher costs and ensure uninterrupted access.
While all ACA-compliant major medical plans must offer a core set of essential health benefits, specific coverage details vary. Possible covered services include:
Preventive care – Annual physicals, immunizations, cancer screenings, women's exams, and more with no out-of-pocket costs.
Outpatient services – Primary and specialty doctor visits, urgent care clinics, lab tests, X-rays, etc. Copays or coinsurance may apply.
Hospitalization – Inpatient and emergency room services are covered, though copays and facility fees may result.
Maternity care – Prenatal and postnatal doctor visits, delivery, hospital maternity stays.
Mental health services – Outpatient therapy and counseling, inpatient psychiatric care.
Prescription drugs – Generic, preferred, non-preferred, and specialty drugs. Tiers determine your cost share.
Rehabilitative services – Physical therapy, occupational therapy, speech therapy, cardiac rehab.
Pediatric care – Well-child visits, pediatrician services, children's dental and vision care.
Again, benefits can vary significantly by health plan. Carefully review what is covered and at what cost before selecting insurance through an employer or Marketplace.
Costs and Premiums
Health insurance costs for coverage through national carriers can range widely depending on:
- Type of plan (Bronze, Silver, Gold, Platinum)
- Benefits included
- Prescription drug formulary
- Provider network
- Your location
- Age and smoking status
- Eligibility for tax credits and subsidies
Monthly premiums may start around $200 for Bronze plan individuals and reach $1000+ for family coverage. Employer-based premium costs also vary significantly.
Deductibles often fall between $500 for more robust plans and up to $7000+ for high-deductible options. You'll also share costs through copays (a fixed amount per visit) and coinsurance (a percentage of the charge).
Use your anticipated healthcare needs and budget to determine the optimal balance of premiums and out-of-pocket spending required. Compare multiple plans carefully.
Health Plan Ratings
It helps to review objective ratings and measures of health plan quality when evaluating national insurance carriers. Look for:
Financial strength ratings – Assess the financial footing and claims payment ability of insurers. AM Best is a leading financial rating agency.
ACOs – Accountable Care Organizations focus on coordinated care and meeting quality metrics. Ask whether your plan's provider network participates in ACOs.
Member satisfaction – Consult Consumer Reports and other member surveys that rate customer service, provider choice, claims processing, and overall enrollee experience.
J.D. Power ratings – An independent reviewer that rates member satisfaction, plan costs, provider choice, claims handling, and other key metrics.
CMS star ratings – The Centers for Medicare and Medicaid Services (CMS) rate plans sold through ACA Marketplaces on performance metrics.
These independent assessments provide crucial insights into the quality and value of plans from the top national health insurance companies.
Top National Health Insurance Companies
Now that we've covered the key factors in evaluating health plans, let's look at some of the specific national insurance carriers in greater detail:
UnitedHealthcare (UHC) is the largest private health insurer in the U.S. Key stats include:
- Insures 85+ million members
- Serves employers in 50 states and D.C.
- Individual plans offered in nearly all states
- 75,000+ physicians and 1,800 hospitals in-network
UHC plans span the full spectrum of premiums, deductibles, and out-of-pocket costs. Members have online and mobile access to virtual visits, provider lookups, insurance cards, and more plan services.
Anthem Blue Cross Blue Shield
Anthem BCBS provides group and individual coverage, mainly in 14 states stretching from California to Maine. Key details include:
- 40+ million members
- 90,000+ physicians and 400+ hospitals
- Bronze, Silver, Gold, and special “Core Direct” plans
- Range of premiums and deductibles to fit different budgets
- Digital member tools and 24/7 nurse line
Anthem BCBS subsidiaries serve parts of California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia, and Wisconsin.
Cigna offerings include employer-based coverage, individual health plans, Medicare Advantage and Part D prescription plans. Fast facts:
- 20+ million U.S. customers
- 1.5 million+ healthcare providers in network
- Strong marks for financial stability from rating agencies
- Range of deductibles from $0 to $6850
- Digital tools through “MyCigna” portal
Cigna achieved 4 out of 5 stars from CMS for its Medicare Advantage plan quality. The company serves all 50 states.
Aetna is a leading insurer that was acquired by CVS Health in 2018. Details include:
- 23+ million medical members
- Vast national network with 1.1+ million doctors
- Range of copays and deductibles based on plan
- Digital tools like “Sydney Health Assistant”
- Medicare Advantage plans with prescription drug coverage
Aetna offers employer group plans plus individual and family coverage. They exited ACA exchanges in 2017 but still offer off-exchange plans.
Humana primarily focuses on senior and Medicaid coverage. Fast facts:
- 17+ million health plan members
- Highest-rated Medicare Advantage plans (4.5 out of 5 stars)
- Options with and without drug coverage
- Strong marks for financial stability from AM Best
- Service areas concentrated in Southeast and Midwest
In addition to Medicare plans, Humana also serves employer groups and offers individual Marketplace options in some states.
This brief overview shows the diversity of national health insurance companies. Evaluate carriers closely based on your location, budget, care needs, and preferences to make the optimal choice.
Shopping for National Health Insurance Plans
When comparing and enrolling in national health plans, use these steps:
1. Decide where to shop – Get employer group coverage, buy through public Marketplaces, or enroll directly with insurance companies.
2. Identify available plans – Use marketplace websites or insurers’ online quote tools to see available plan options by ZIP code.
3. Evaluate networks – Check that your preferred medical providers participate in-network to minimize costs.
4. Assess costs – Estimate total expenditures based on monthly premiums, deductibles, copays, and coinsurance.
5. Compare benefits – Review prescription drug lists, specific services covered, exclusions, limitations, and cost sharing requirements.
6. Check ratings – Consult consumer surveys, quality ratings, and financial strength scores.
7. Enroll – Sign up through your employer, the Marketplace, or insurer during open enrollment periods or after qualifying life events.
8. Understand your plan – After enrolling, examine your coverage details thoroughly so you can use benefits effectively.
Frequently Asked Questions
1. Do I have to get health insurance from a national carrier?
No, you do not have to enroll in coverage from a major national insurance company. Many regional or local health plans are also available that offer quality coverage. However, large national carriers often have extensive provider networks useful for getting care across different parts of the country.
2. How do I know which insurance company is best?
There is no one “best” health insurance company. You'll need to compare costs, coverage details, provider networks, drug formularies, ratings, and other factors to determine the right insurer for your situation. Consider your anticipated medical needs and household budget to guide your decision.
3. Should I choose national insurance or local insurance?
There are pros and cons to both national and local health insurance companies. Large national carriers have expansive provider networks useful if you need medical care outside your area. However, local and regional insurers may have better knowledge of community providers and resources. Evaluate your options carefully based on where you live and receive care.
4. Is it better to get insurance through my employer or through the Marketplace?
For many people, getting health insurance through an employer group plan results in lower premiums than buying through the Marketplace. This is because employer plans pool risk over the whole workforce. However, Marketplace plans make you eligible for premium tax credits and other savings based on your income. Assess both options.
5. How can I find the best marketplace insurance plans?
Use your state or federal ACA Marketplace website to compare plans. Review premium costs, deductibles, provider networks, covered medications, and included benefits. Also research insurers’ quality ratings. Tax credits and subsidies can lower monthly costs for qualifying applicants.
6. What if I don't qualify for subsidies on the marketplace?
Those earning too much for government assistance may still find reasonably priced plans both on and off insurance exchanges. Focus on national carriers with robust provider networks and lower-premium Bronze, Catastrophic, or short-term plans to control costs. You can also consider buying group coverage through an association or other organization.
Choosing health coverage from leading national insurance carriers requires careful research and comparison. Assess your individual needs and finances to select a plan that provides suitable access to medical providers, affordable premiums and cost-sharing, and comprehensive coverage for services you require. Maintaining health insurance protects individuals and families against the high costs of healthcare services. Partnering with a reputable national insurer can ensure robust coverage across the country.