Top 10 health insurance companies in the US

The country's top health insurance companies dominate more than half of the market. Find out what types of coverage these insurers offer in this guide

Top 10 health insurance companies in the US

Life & Health

By Mark Rosanes

The 10 largest health insurance companies in the US control nearly 57% of the market, underwriting $821.5 billion worth of premiums in the past year. These figures are from the latest market share data from the National Association of Insurance Commissioners (NAIC).

In this article, Insurance Business takes a closer look at these industry giants. We will delve into the facts behind the numbers and give you an idea of what these companies offer.

If you want to learn more about the nation’s leading health insurers, you’ve come to the right place. Get to know the top 10 health insurance companies in the country in this guide.

The top 10 health insurance companies in the US revealed

The country’s accident and health insurance industry wrote more than $1.44 trillion worth of premiums in the past year, up by a whopping 112% from $680 billion in 2011. This indicates a robust health insurance space that caters to the medical and healthcare needs of the US population.

Here are the top 10 health insurance companies in the country based on NAIC’s latest industry report. The list is arranged by direct written premiums (DWP).

1. UnitedHealth Group

Head office: Minnetonka, Minnesota
DWP: $221.4 billion
Market share: 15.4%

UnitedHealth Group boasts a strong network of over 1.5 million medical and healthcare specialists and 6,200 hospitals. These professionals provide medical and dental benefits to the insurer’s more than 49 million members across the country. Here’s a breakdown of the group’s membership.

Health insurance companies – UnitedHealth Group memberships in the US

UnitedHealth policies are available nationwide. The health insurance giant delivers benefits and service through its two business units. These are:

1. UnitedHealthcare

UnitedHealthcare is the company’s health insurance unit offering members a range of healthcare services and coverage. These include:

  • UnitedHealthcare Medical Products: A suite of affordable health insurance products provided through its large network of medical professionals and hospitals.
  • UnitedHealth Wellness: The insurer’s selection of wellness programs and services.
  • Oxford Health: A range of affordable healthcare products for members in Connecticut, New Jersey, and New York.
  • Online Services: Easy-to-use online tools accessible through the website.
  • Virtual Visits: Allow members to access healthcare services using their mobile devices.
  • Business Travel Insurance: A selection of travel, medical, and personal assistance services available to mobile employees and their dependents.

2. Optum

Optum is the health insurance giant’s technology arm offering information and tech-enabled services through three platforms:

  • Optum Health: Delivers healthcare and medical services to over 102 million members.
  • Optum Insight: Provides research, analytics, and consulting services to medical professionals, governments, and life sciences firms.
  • Optum Rx: Gives members access to affordable pharmaceutical products and services.


2. Elevance Health

Head office: Indianapolis, Indiana
DWP: $103.4 billion
Market share: 7.2%

Previously known as Anthem, Elevance Health rebranded in June 2022. The insurer draws on its network of 1.7 million doctors and medical facilities to serve its more than 47.5 million members. This figure includes 21 million risk-based patients.

Apart from being among the largest health insurance companies in the US, Elevance Health is the biggest for-profit managed healthcare company in the Blue Cross Blue Shield Association.

The industry giant offers various health insurance plans covering medical, dental and eye care. These policies are available to employers and individuals, as well as their family members, through the group’s Anthem Blue Cross Blue Shield and Wellpoint brands.

Elevance Health also provides members with a range of healthcare services through its Carelon brand and other subsidiaries. The company’s policies are available in 14 states.

 Health insurance companies – Elevance Health, list of states available

Health insurance companies – Elevance Health, list of states available


3. Centene

Headquarters: St. Louis, Missouri
DWP: $96.4 billion
Market share: 6.7%

Centene provides various services to government-funded healthcare programs for uninsured and underinsured Americans, including Medicare and Medicaid. The insurer is the country’s largest Medicaid managed care provider, with more than 28 million members across all 50 states. 

Centene offers local health plans and health insurance products. The company partners with other healthcare and commercial groups to provide members with specialty services. These include:

  • Behavioral health
  • Dental benefits
  • Care management software
  • Correctional healthcare services
  • In-home health services
  • Life and health coverage
  • Managed vision care
  • Pharmacy benefits management
  • Specialty pharmacy
  • Telehealth services

Centene is backed by 67,800 employees nationwide.


4. Kaiser Permanente

Head office: San Francisco, California
DWP: $89.2 billion
Market share: 6.2%

Kaiser Permanente is one of the largest non-profit healthcare organizations in the country. The insurer serves 12.7 million members. Its health plans are available in California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, Washington, and the District of Columbia.

Kaiser Permanente provides budget-based plans that cover the following:

Health insurance companies – what Kaiser health plans cover

These services are delivered through Kaiser’s vast network consisting of:

  • 23,982 physicians
  • 68,218 nurses
  • 39 hospitals
  • 622 medical offices

The health insurer’s plans come with low premiums and zero deductibles. Around 212,970 employees handle the company’s operations.


5. Humana

Head office: Louisville, Kentucky
DWP: $87.0 billion
Market share: 6.0%

Humana is among the largest managed care companies in the country, with more than 17 million members across all 50 states. The health insurer offers individuals, employer groups, and anyone searching for government-sponsored plans affordable options. These include: 

Members can access Humana’s products and services through three platforms:

  • Health Services: Offers wellness and healthcare products and services to individuals, employers, and Humana subsidiaries.
  • Group & Specialty: Provides commercial medical plans and specialty healthcare benefits to individuals and groups.
  • Retail: Consists of individual plans, including Medicare and Medicaid.

Humana’s workforce comprises about 67,100 employees.


6. CVS Health

Head office: Woonsocket, Rhode Island
DWP: $83.9 billion
Market share: 5.8%

CVS Health is a diversified healthcare benefits provider and one of the largest health insurance companies in the nation. It serves more than 23 million members in all 50 states.

CVS Health has more than 9,900 retail locations and nearly 1,100 walk-in clinics across the US. It also operates a pharmacy benefits manager with about 100 million plan members, as well as a senior pharmacy care business that serves over one million patients every year.

The health insurance giant’s policies provide standard benefits. Members can also access specialty pharmacy services and standalone Medicare Part D prescription drug plans.



Head office: Chicago, Illinois
DWP: $51.0 billion
Market share: 3.5%

Health Care Service Corporation, more popularly known as HCSC, operates as a mutual legal reserve firm. It is also the largest customer-owned health insurance company in the country, with about 18.6 million members. The insurer offers life and health insurance policies and related services through its subsidiaries, including:

  • HCSC Insurance Service Company
  • TriWest Healthcare Alliance
  • Prime Therapeutics
  • Medecision
  • Availity
  • Dearborn Group
  • Dental Network of America

HCSC holds membership with the Blue Cross Blue Shield Association, one of the most popular health insurance brands in the US. The insurer’s policies are available in Texas, Oklahoma, New Mexico, Montana, and Illinois. HCSC employs more than 22,000 staff.



8. Cigna

Head office: Bloomfield, Connecticut
DWP: $34.0 billion
Market share: 2.4%

Cigna is a global health insurer that serves around 19.5 million members in the US. It is also one of the largest health insurance companies in the world, catering to about 190 million clients across over 30 countries and territories.

In the US, Cigna offers health and dental policies, including Medicare plans, international healthcare coverage, and supplemental health insurance. It delivers products through two business units:

  • Cigna Healthcare: Consists of products and services that help members improve health and well-being at each stage of their lives.
  • Evernorth Health Services: Designed to make disease-prevention and treatment more accessible by offering pharmaceutical and healthcare products and services to members.

Cigna health plans are available in these 16 states:

Health insurance companies, Cigna health plans list of states available



9. Molina Healthcare

Head office: Long Beach, California
DWP: $28.8 billion
Market share: 2.0%

Molina Healthcare specializes in government-sponsored programs for eligible individuals and families. It has about 5.1 million members in these 18 states:

Health insurance companies – Molina Healthcare plans list of states available

Molina Healthcare partners with state governments and provides a range of healthcare services to individuals and families. The health insurer has been chosen by several states to join dual demonstration projects to manage the care for those qualified for Medicaid and Medicare.


10. GuideWell

Head office: Jacksonville, Florida
DWP: $26.5 billion
Market share: 1.8%

GuideWell operates as a non-profit mutual holding company. It serves around 27 million members in 35 states. The firm offers health insurance through various subsidiaries. These include:

  • Florida Blue: A local Blue Cross Blue Shield member, it provides a range of healthcare services to the state’s residents. These include medical services, wellness programs, and preventative care.
  • Florida Health Care Plans: Offers quality health coverage and care services for local individuals, families, and employers.
  • Truli for Health: Provides affordable healthcare coverage to Florida’s workforce.  
  • Capital Health Plan: Delivers affordable healthcare coverage to communities in the Tallahassee area.
  • Triple-S Salud: The largest health insurance company in Puerto Rico, offering health plans with an open access network.

Apart from health insurance, GuideWell also provides healthcare and health administrative services. 

Here's a summary of the 10 largest health insurance companies in the US.


Which health insurance company has the best coverage?

The US boasts several top health insurance companies known for their excellent coverage. Here are the three leading options:

1. UnitedHealth Group

Written premiums: $221.3 billion
Market share: 15.3%

UnitedHealth Group is a global healthcare company offering comprehensive solutions. The company has a significant market presence and provides diverse coverage options. It sits atop the list of the largest health insurance companies in the US.

2. Kaiser Permanente

Written premiums: $89.2 billion
Market share: 6.2%

Kaiser Permanente, a non-profit entity, focuses on holistic care and member well-being. It holds a substantial market share and offers comprehensive healthcare services in eight states and the District of Columbia.

3. Elevance Health (formerly Anthem)

Written premiums: $76.9 billion
Market share: 6.2%

Elevance Health, formerly Anthem, Inc., is committed to simplifying healthcare for millions across the US. It offers a wide range of healthcare solutions and holds a notable market share.

Considering its premiums and market share, UnitedHealth Group stands out as the health insurance company with the most comprehensive coverage. Its high volume of written premiums and extensive market presence reflect a broad spectrum of services and widespread popularity.

UnitedHealth Group further enhances its offerings through clinical expertise and advanced technology.

Remember that the best health insurance choice hinges on individual needs, including health requirements, budget constraints, and preferred healthcare networks. Consulting a qualified insurance agent or broker can help tailor the selection to specific circumstances.

The health insurance companies mentioned cater to a significant segment of the US population, offering diverse coverage options to suit varying needs.

What are the 4 most common health insurance plans?

The four most common health insurance plans are:

1. Preferred Provider Organization (PPO) Plan:

  • Encourages using a network of preferred doctors and hospitals for discounted rates.
  • No requirement to select a primary care provider (PCP).
  • Offers the flexibility to see any doctor within the network.
  • Features an annual deductible and may involve co-payments or co-insurance.
  • Suitable for those who want to choose their primary care doctor, have some out-of-network coverage, and see specialists without PCP referrals.
  • The downsides include higher monthly premiums and deductibles.

2. Health Maintenance Organization (HMO) Plan:

  • Provides healthcare services through an exclusive network of providers.
  • Requires choosing a primary care doctor and obtaining referrals for specialists.
  • Typically has lower out-of-pocket costs and low co-payments and may not have a deductible.
  • Best for those seeking lower premiums, lower prescription drug costs, and PCP advocacy.
  • Limits flexibility in choosing doctors and restricts out-of-network coverage.

3. Point of Service (POS) Plan:

  • Combines features of HMO and PPO plans.
  • Requires selecting a primary care doctor.
  • Services from the PCP often have no deductible.
  • Services from non-network providers may involve deductibles and lower coverage.
  • Suitable for those desiring flexibility in choosing providers, PCP coordination, and a balance between provider choice and lower premiums.

4. Exclusive Provider Organization (EPO) Plan:

  • Requires using network doctors, except in emergencies.
  • Involves a PCP who provides specialist referrals, co-payments, and possibly a deductible.
  • Ideal for those comfortable with a smaller provider panel and seeking lower rates.

Each plan type has distinct advantages and disadvantages, making the choice dependent on individual preferences and priorities. These include provider flexibility, cost considerations, and preferred healthcare networks.

Find out how health insurance works in the US, as well as in the different regions we cover in this comprehensive guide to health insurance.

What's the most expensive health insurance?

When assessing health insurance costs, premiums can vary significantly due to multiple factors, with the choice of health insurance companies and specific plan being critical.

UnitedHealth Group, a prominent industry player, reports annual direct written premiums of $221.3 billion, holding a substantial 15.4% market share.

Designating a health insurance plan as the "most expensive" isn't solely determined by the provider. It heavily hinges on the plan's coverage and individual circumstances.

The high cost of healthcare in the US stems from a range of contributing factors:

  • Inefficient systems
  • Escalating drug expenses
  • Substantial medical professional salaries
  • Profit-driven healthcare institutions
  • Varying medical practices
  • Pricing related to healthcare services

Prudent consumers must thoroughly assess their healthcare needs and financial limitations when choosing a health insurance plan.

Compare different health insurance companies, study the terms and conditions, and choose a plan that aligns with both your financial capacity and healthcare requirements.

Health insurance plays a crucial role in keeping you and your family financially protected. Find out what other types of insurance you will need in this comprehensive guide.

Is it cheaper to not have health insurance in the US?

In the US, the decision to forgo health insurance may initially appear as a cost-saving measure, but it carries significant risks.

Healthcare costs are high, even when one is covered by insurance. However, those without insurance find themselves at a huge disadvantage. The inability to access necessary healthcare services and the overwhelming burden of medical bills are two compelling reasons to prioritize coverage.

Those lacking health insurance often face higher expenses for medical treatments that would otherwise be covered by their insurance plans.

In the absence of health insurance companies subsidizing healthcare costs, individuals bear full financial responsibility. This can lead to higher charges for identical medical services. When patients are unable to manage these expenses, hospitals or healthcare facilities may resort to legal action.

When making decisions on health insurance, it's important to assess your healthcare requirements and financial constraints. Comparing what providers offer and reviewing the terms and conditions of plans can help you find a plan that’s affordable and meets your needs.

Ultimately, many people and families find health insurance to be a good long-term investment. It brings peace of mind and ease in prioritizing their financial and physical health.

You can check out our Life and Health News section for breaking news and the latest updates in health insurance.

What do you think of the top health insurance companies in our list? Feel free to share your comments below.

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