Insurance Health Company: What You Should Know to Get Insured
– Insurance Health Company –
Which insurance health company is the best? When your workplace offers a variety of health plans or you need to choose private health insurance coverage, it’s difficult to know where to look through all the alternatives.
What is Health Insurance?
Health insurance is a contract that requires an insurer to pay some or all of a person’s healthcare costs for a premium.
Health insurance typically pays for the medical, surgical, prescription drugs, and sometimes dental expenses incurred by the insured.
Health insurance can reimburse the insured for expenses incurred from illness or injury, or pay the care provider directly.
They often include it in employer benefit packages to entice quality employees, with premiums partially covered by the employer but often also deducted from employee paychecks.
The cost of health insurance premiums is deductible to the payer, and the benefits received are tax-free, with certain exceptions for S corporation employees. An insurance health company.
Is Health Insurance a Necessity?
Nobody expects to get sick or harmed, but serious sickness can strike. The cost of treating the condition might put a significant strain on any funds you’ve built up.
This means you may have to choose between providing your child with the best education possible and defaulting on your mortgage payments. The expense of medical treatment is flourishing today.
For example, a vial of 440 mg of Herceptin, a cancer treatment, costs around $110,000. Over the course of a year, a patient normally consumes 17-19 bottles, depending on their weight.
Just for the drug, that’s between 18 and 20 lakhs. When you factor in hospitalization expenditures, medical consultation fees, chemotherapy costs, and other expenses, your total outlay might be in the millions of rupees.
These prices, which are already very high, continue to rise year after year. Most intelligent people have taken the essential safeguards to protect their health as soon as possible.
Health insurance is a living benefit that pays out if you need money in an emergency. One ailment can wipe out all of your savings for your children’s education, marriage, homeownership, and even retirement.
You don’t want your family’s goals to be crushed because of an illness, especially when you could have financially secured yourself. When you are young and healthy, it is helpful to have health insurance.
Not only do your premiums rise as you become older, but you also risk being denied health coverage by the insurance provider.
Top Health Insurance Companies
The largest health insurance provider can be defined as the company that has the highest number of members. Also known as covered lives, membership means the number of individuals who have enrolled in a health insurance plan with that provider.
You can enroll in a health insurance policy. For example, your employer’s benefit plan may offer health insurance coverage. Other ways include:
1. UnitedHealthcare
70 million members
UnitedHealthcare is the largest health insurance company in total covered lives. The provider offers a variety of products, from individual health insurance to full employer benefits plans for some of the biggest corporations.
Its policies can be purchased in all 50 states. UnitedHealthcare is headquartered in Minnetonka, Minn.
Along with having the most members, UnitedHealthcare also has a care network of over 1.3 million physicians and health care professionals with over 6,000 hospitals.
This means that if you have UnitedHealthcare, you will have many options to choose from to receive care.
2. Anthem
39.9 million members
Anthem is the second-largest medical insurance provider by total members, with almost 40 million lives covered.
The company’s Commercial and Business health care segment offers network-based care to large and small businesses, individuals, and Medicaid and Medicare markets.
Anthem is a licensee of the Blue Cross Blue Shield Association.
This means that typically when searching for Anthem policies on your state marketplace exchange, you find that its products will be titled BCBS followed by the name of your state, but the insurer you will buy from will be Anthem.
The company currently operates in California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia, and Wisconsin.
3. Aetna
22.1 million members
Aetna was gained by CVS Health Corp. in 2018. CVS Health now operates the company and has been able to seamlessly integrate its provide networks with Aetna’s membership base.
Founded in 1853, Aetna is the third-largest provider of health insurance and services by the membership.
However, most of its membership comes from providing health insurance to employers and their employees in the private market. Since 2015, Aetna has removed itself from all Affordable Care Act marketplaces because of a loss in revenue.
4. Cigna
20.4 million members
Cigna is the fourth-largest major medical insurance company in the United States by the membership. Headquartered in Bloomfield, Conn., Cigna offers health insurance and health services to companies throughout the world.
Besides corporate health insurance policies and management of those plans, Cigna also offers dental, behavioral health, vision, supplemental health, and Medicare/Medicaid retirement benefits.
Cigna currently offers individual health insurance in 11 states: Arizona, California, Colorado, Florida, Georgia, Maryland, Missouri, North Carolina, South Carolina, and Tennessee.
5. Humana
16.6 million members
Humana comes in as the fifth-largest health insurance company by the membership. The provider was founded in 1961 and originally sold long-term care insurance before expanding into selling health insurance policies.
However, in 2017 the company announced that it would no longer be offering individual health insurance in the 11 states where it had previously provided plans.
If you still have a policy from Humana, then it will still honor the responsibilities of offering coverage benefits through your plan.
Largest Major Medical Insurance Provider by State
In 2020, nearly 11.5 million people purchased a health insurance policy through a state marketplace.
Also known as individual health insurance, these policies can be purchased if you currently do not receive health care through an employer or a federally funded program like Medicaid or Medicare.
Below is the biggest health insurance provider in each state.
State |
Company |
| Alabama | Blue Cross Blue Shield of Alabama |
| Alaska | Premera Blue Cross |
| Arizona | Centene Corp |
| Arkansas | Arkansas Blue Cross Blue Shield |
| California | Blue Shield of California |
| Colorado | Kaiser Foundation |
| Connecticut | EmblemHealth |
| Delaware | Highmark |
| District of Columbia | CareFirst |
| Florida | GuideWell |
| Georgia | Centene Corp |
| Hawaii | Hawaii Medical Service Association |
Health Insurance Company Rankings by Revenue
Along with membership, the size of a health insurance company can be broken down by the amount of revenue it generates.
Revenue is created in a health insurance company by the premiums it charges, the number of policies it writes, the services it sells, and the number of businesses it operates in.
Based on our analysis, UnitedHealthcare is the largest health insurance company by revenue, with total revenue topping $257 billion during 2020.
This makes the insurer the largest company both by covered lives and by revenue. Interestingly, although Anthem is the largest health care company by market share and the second-largest by membership, it is only the third-largest by revenue.
Rank |
Company |
Revenue |
| 1 | UnitedHealthcare | $257 billion |
| 2 | Anthem | $122 billion |
| 3 | Centene | $111 billion |
| 4 | Kaiser Permanente | $89 billion |
| 5 | Humana | $77 billion |
| 6 | CVS Health | $75 billion |
| 7 | HCSC | $47 billion |
| 8 | Molina Healthcare | $19 billion |
How Much Does Health Insurance Cost?
Individual health insurance premiums vary. Personal coverage preferences, as well as age, income, geography, the number of family members (if any) covered, and health-care utilization, all influence the cost of health insurance.
1. Premiums
In exchange for healthcare coverage, the insurer charges you a monthly premium.
According to t0 e-Health’s recent study of ACA plans, in 2020, the national average health insurance premium for an ACA plan is $456 for an individual and $1,152 for a family.
This average cost does not include people who receive government subsidies.
You can learn more about the average premium cost for ACA-compliant plans in your state by visiting our resource center or by contacting an e-Health insurance agent at the toll-free number on this page.
2. Deductibles and Cost-Sharing Expenses
A deductible is an amount you pay for health care services each year before your health insurance pays its portion of the cost of covered services.
Our study finds that, in 2020, the average annual deductible for single coverage is $4,364 and $8,439 for family coverage. Keep in mind, individual health insurance plans’ deductibles vary considerably: some may be as low as $0.
Copayments and coinsurance are cost-sharing payments you make each time you get a medical service after reaching your annual deductible.
A copayment is a fixed amount you pay for covered health care services. For example, assume your plan has a $30 copayment and your doctor’s visit is $150. If you:
➢ Haven’t met your deductible, you’ll pay $150 at the time of your visit
➢ Having met your deductible, you’ll pay your $30 copayment
Coinsurance is a percentage of covered health care services you pay for covered services after you have met your deductible. Assume your plan has a 20% coinsurance and your doctor’s visit is $150. If you:
➢ Haven’t met your deductible, you’ll pay $150 for the visit.
➢ Having met your deductible, you’ll pay 20% of $150 (which is $30).
3. Maximum Out-of-Pocket Limits
The maximum out-of-pocket limit is a financial safety net. This dollar amount is the most you have to spend for covered services in a year.
After you reach this amount, the insurance company pays 100% for covered services for the rest of the benefit year. Your deductible, copayments, and coinsurance payments count toward the annual maximum out-of-pocket limit.
For the 2020 plan year, the out-of-pocket limit for an ACA plan can’t be more than $8,150 for an individual and $16,300, as reported on Healthcare.gov. Many plans offer lower out-of-pocket limits.
How Do Health Plans Influence Health Care Cost?
Generally, the more benefits your plan pays, the more you pay in premium. But your medical expenses for care are lower.
To illustrate how these costs may influence your choice of plans, consider the ACA plans.
Bronze plans have the lowest premiums among the ACA metals plan tiers. According to our research, the national average premium for single coverage in 2020 will be $448 per month and $1,041 per month for family coverage.
If your primary goal is to protect yourself financially against the high costs of a major illness or injury while paying a low premium, a bronze plan may be perfect for you.
However, you will be responsible for most of your routine medical treatment. Whether or not the deductible is reached, the plan covers preventative care (such as an annual wellness visit, some screenings, and counseling).
If you can afford a slightly higher premium than a Bronze plan to get greater insurance reimbursement for medical care, a Silver plan may be a good fit for you.
The national average Silver plan premium in 2020 for single coverage is $483 per month. Family coverage averages $1,212 per month.
A Gold plan may be the right choice for you if you will pay even more each month in premiums to have more of your medical care expenses paid by insurance than a bronze or silver plan would pay.
A Gold plan may be especially valuable to you if you or your family require frequent or extensive medical care. The national average Gold plan premium in 2020 for single coverage is $569.
For family coverage, the average premium is $1,437 per month.
If you can afford to pay more in monthly premium costs for small medical expenses related to extensive, ongoing health care, the Platinum plan may be a good choice.
In 2020, the Platinum plan premium averages $732 per month for single coverage and $1,610 per month for family coverage.
Besides the metallic plan categories, some people are eligible to purchase a plan with catastrophic coverage. Catastrophic plans have very low premiums and very high annual deductibles ($8,150 in 2020).
However, they pay for preventive care regardless of the deductible. These plans may be a suitable insurance option for young, healthy people.
To qualify for a catastrophic plan, you must be under age 30 or be of any age with a hardship exemption or affordability exemption (based on job-based or exchange insurance being unaffordable).
How to Find an Affordable Plan that Meets Your Needs?
Among e-Health customers who bought ACA individual health insurance, over 75% chose Bronze or Silver plans.
Your state may host an exchange for comparing and purchasing ACA plans or it may use the federal exchange at Healthcare.gov. Keep in mind, you aren’t limited to the exchange.
The licensed insurance brokers at e-Health can help you find the best health plan to meet your health coverage needs and your budget.
They will listen to your priorities in health coverage and use their expertise to match your needs with health insurance options both on and off the exchange. An insurance health company.
Different Health Insurance Plan
There are two main types of health insurance: private and public, or government. There are also a few other, more specific types. The following sections will look at each of these in more detail.
1. Privately Purchased Health Insurance
The United States’ healthcare system, according to the Centers for Disease Control and Prevention (CDC), is mainly reliant on private health insurance.
According to the National Health Interview Survey, 63.7 percent of adults under the age of 65 in the United States have private health insurance coverage.
2. Public Health Insurance
Health insurance provided by the government is known as public health insurance.
The state subsidizes healthcare for a premium with this sort of insurance.
In the United States, public health insurance includes Medicare, Medicaid, the Veterans Health Administration, and the Indian Health Service. An insurance health company.
Other Types of Health Insurance
Some people may also define an insurer by the way it administers its plans and connects with providers. Here are some examples of the plan available. An insurance health company.
3. Managed Care Plans
The insurer will have contracts with a network of providers to provide lower-cost medical treatment to its policyholders under this type of plan.
Out-of-network hospitals and clinics will face penalties and increased fees, but they will still be able to provide certain treatment.
The more expensive the program, the more flexible the network of hospitals is likely to be.
Indemnity plans, often known as fee-for-service plans, are a type of insurance that reimburses you for the services you get.
A Fee-for-Service plan covers all provide equally, allowing the insured to choose their preferred treatment location. On an indemnity plan, the insurer normally pays 80% of the costs, with the remaining 20% paid by the individual as coinsurance. An insurance health company.
4. Health Maintenance Organization Plans
These are organizations that provide medical care directly to the insured. The policy will usually have a dedicated primary care physician who will coordinate all necessary care.
Health Maintenance Organization (HMO) plans will usually only fund treatment referred by a family doctor and will have negotiated fees for each medical service to minimize costs. This is usually the cheapest type of plan. Insurance health company.
5. Preferred Provider Organization Plans
In a similar way to an indemnity plan, a Preferred Provider Organization (PPO) plan allows the insured to see any doctor they want. In addition, the PPO plan includes negotiated rates with a network of recognized providers.
Treatment from out-of-network doctors will cost the insurer less. People with a PPO plan can self-refer to specialists instead of seeing a primary care physician.
5. Plans for Point-of-Service
A Point-of-Service plan is a hybrid of a health maintenance organization (HMO) and a preferred provider organization (PPO).
The insured can coordinate all treatment through a primary care physician, receive treatment from inside the insurer’s provider network, or seek treatment from non-network physicians.
The therapy progress will be determined by the type of plan they have.
Why is it Important to Know Different Health Insurances?
The sort of plan a person has determines how they will get the treatment they require and how much money it will require them to pay on the day of treatment.
The Health Savings Account was introduced by the US Congress in 2003. (HSA).
It’s a hybrid of a health maintenance organization (HMO), a preferred provider organization (PPO), an indemnity plan, and a tax-advantaged savings account.
In 2020, however, a policyholder must combine this kind with an existing health plan with a deductible of more than $1,400 for individuals and $2,800 for couples.
HSAs can supplement coverage, allowing existing plans to cover more therapies. The contributions to an HSA made by an employer on behalf of their employees are tax-free.
While a person is well, they can save money in an HSA to use in the event of a medical need later in life.
However, people with chronic conditions, such as diabetes, might not save a large amount in their HSA, as they regularly have to pay high medical costs for the management of their health concerns.
These plans often carry very high deductibles, meaning that although premiums can be lower, people often end up paying the full expenses of any required medical treatment.
As plan types evolve, there is increasing overlap. The lines between policy kinds are becoming increasingly blurry.
To control costs and ensure that there are enough resources to pay for proper care, most indemnity plans employ managed care approaches.
Many managed care plans have taken on some characteristics of fee-for-service programs as well. An insurance health company.
How to Determine the Best Health Insurance Plan?
Even the pros struggle with health insurance. Here are a few pointers to assist you in selecting the best plan.
1. Figure Out Where and When you Need to Enroll
You can shop for insurance through either the federal exchanges on HealthCare.gov or your state’s marketplace, depending on where you live.
The District of Columbia, twelve states, and the District of Columbia all have their own exchanges.
The federal exchange’s open enrollment period runs until mid-December, but if you live in a state with its own marketplace, you may have additional time.
2. Even if you Enjoy your Current Plan, Look into Other Choices.
Even if you’re happy with your current plan, Charles Gaba advises consumers who are already enrolled in an ACA plan to log in and see if there’s a better offer.
Gaba is the founder of ACAsignups.net, a website dedicated to health care data and policy research, with an emphasis on the Affordable Care Act.
It can be tempting to skip the whole enrollment rigmarole, especially since you’ll just get rolled into the same plan or a similar plan if you do nothing during open enrollment.
Every year, there can be many changes that affect the kinds of plans available and the costs of those plans. For instance, this year new insurers have entered the marketplace, and premiums have gone down in some states.
It’s always worth logging in and checking to see what’s changed for you and whether it makes sense to switch things up.
3. Compare Estimated yearly Costs, not just Monthly Premiums
When evaluating plans, it’s tempting to focus on the monthly premium payment, but Wong at Duke advises that other costs be considered as well.
When browsing for plans, the premium price is readily shown, but you need also consider additional charges.
You can determine your “estimated total yearly expenditures” using a calculator provided on HealthCare.gov and in some state marketplaces.
This considers the plan’s deductible (the amount you must pay out-of-pocket for approved services before your insurance kicks in) and copays, as well as the amount of health care you intend to consume in the future year.
Wong says that yearly cost estimates can be a really useful tool when picking a plan. “Trying to figure out that math can be a little tricky, especially for people who are not as familiar with health insurance.” She says. An insurance health company.
4. Consider how Much Health Care you Use
Choosing the correct insurance plan causes making educated guesses about how many health conditions you’re likely to suffer in the future year, which might impact how prices are broken down.
Your age is usually a good indicator, but there are always unknowns, such as a cancer diagnosis or a car accident.
Alongside these unknowns, leverage what you know about your health needs. If you have a doctor you like, or if you know you’re going to take a certain prescription drug, look for a plan that covers them.
HealthCare.gov allows you to add your provider and your prescription drugs as you browse plans to see whether they’re covered. Another way to find out is simply to call your doctors and ask what plans they accept, says Wong.
5. Beware too-good-to-be-true Plans
If you discover a decent offer online, check for sure it’s an ACA plan, says Louise Norris, a health policy expert and insurance broker.
When looking for health insurance online, you may come across short-term plans that offer lower monthly prices but do not cover the ACA’s 10 basic features.
Prenatal care and mental health treatment are two of the most crucial of them.
According to Norris, customers can sometimes discover good premium prices in the federal and state marketplaces, but if one plan stands out as being too good to be true, study the tiny print.
6. Get Free Professional Assistance
The Trump administration cut government funds for open enrollment advertising and the navigator program, but both services are still in place:
There are still people trained and ready to sign people up all around the country for free.
Frequently Asked Questions on Health Insurance
Answers to some questions about insurance health companies.
1. What is health insurance?
Health insurance is a type of insurance that pays for a person’s medical and surgical expenses in the event of a medical emergency.
However, in order to have health insurance, you must pay a premium.
2. Why should I buy health insurance?
You should purchase health insurance so that you don’t lose your lifelong savings while paying for medical bills in a critical situation.
3. How will health insurance pay for my emergency medical expenses?
Your health insurance will either pay your hospital bills directly if opted for the cashless facility or it will reimburse any payment made by you towards medical expenses incurred because of an illness or injury.
4. What is the eligible age to buy health insurance?
While the age of eligibility for health insurance policies varies, adults have to be between the ages of 18 and 65. Children must be between the ages of 90 days and 18 years to be eligible.
5. Will I be allowed to cover my family under my health insurance?
Yes! You can gain coverage for self, spouse, children, dependent parents, and multiple other relationships such as parents-in-law, siblings, and others, if your plan allows.
6. Will I be allowed to buy over one health insurance plan?
Yes, you are free to buy an extra plan based on your specific medical needs.
7. What are the health insurance plans I can buy?
Individual Health Insurance Plans, Family Floater Health Insurance Plans, Senior Citizen Health Insurance Plans, Critical Illness Insurance Plans, Maternity Health Insurance Plans, Group Health Insurance Plans, and Personal Accident Insurance Plans are among the options available.
8. Can I pay my health insurance premium for installments?
The health insurance premium is paid annually. But, you can pay your premium in installments (monthly, quarterly, or half-yearly basis) as well.
9. What are the common coverage benefits under my health insurance?
The benefits of health insurance vary depending on the policy.
Inpatient hospitalization, pre and post-hospitalization, childcare procedures, emergency ambulance expenditures, organ donor expenses, domiciliary hospitalization, OPD expenses, and more are all covered under basic health insurance benefits.
10. What are the benefits of buying a critical illness insurance policy?
Critical illness policies provide coverage for life-threatening illnesses such as Cancer, stroke, Heart Attack, Kidney Failure, and others.
If buying a critical illness plan, you can suppose wide cover for critical illnesses (number of illnesses covered depends on the plan), lump-sum amount payment on diagnosis, tax benefits, and more.
Don’t forget to share this information with your friends and loved ones. You can drop your questions and comments in the comment box below.
CSN Team.
