How We Review Health Insurance Companies

Investopedia’s lists of the best health insurance companies are based on in-depth research into nine companies that provide health insurance plans through federal and state marketplaces. We collected and reviewed costs, customer satisfaction ratings, the availability of plan benefits and medical management programs, and more. This guide explains how we determined what criteria to measure, the methods we used to score each company, and how we chose the best health insurance providers. 

Our editors and researchers independently evaluate all recommended products and services. If you click on the links we provide, we may receive compensation. Our advertising partnerships are not a factor in evaluating products, though they may affect the order of products you see listed in our articles.

How We Research Health Insurance Plans

To form our initial understanding of the health insurance industry—specifically plans that are offered to individuals and families through the Health Insurance Marketplace—we reviewed research conducted by government departments, professional associations, and independent organizations, such as the Department for Health and Human Services (HHS), American Medical Association (AMA), and HealthInsurance.org. Through these sources, we gained insight into market share distribution across the Health Insurance Marketplace, enrollment growth, and nationwide availability for major health insurance providers in the United States. We also gathered data on monthly search volume for each of the health insurance providers mentioned across these sources, as well as any additional companies we reviewed in years prior.  After considering this, we identified nine health insurance providers for our rubric. 

For each company, we gathered information from datasets and tools provided through government websites, such as the federal Health Insurance Marketplace on HealthCare.gov and individual state marketplaces. We also collected data from the National Association of Insurance Commissioners, an independent organization that rates health care plans on quality and customer satisfaction. Finally, any remaining data points were collected directly from company websites. The research process ran from Oct. 24  to Nov. 8, 2024.

We then developed a quantitative model that scores each health insurance company based on the data we collected. We ensured the integrity of our data by cross-referencing the records in our database with primary sources.

Data Collection and Scoring 

• Data points are scored on a 0.00 - 1.00 scale
• Binary criteria = [0,1]
• Scaled criteria (e.g., 5-point) = [0.00, 0.25, 0.50, 0.75, 1.00]
• For continuous criteria, the minimum data value collected was re-scaled to 0.00 and the maximum value was re-scaled to 1.00

Health Insurance Evaluation Categories

We determined key categories with which to evaluate health insurance plans and providers. We weighted them differently depending on the article:

These categories were broken down into 35 criteria, resulting in 315 data points. We collected the following criteria for each category.

Customer Satisfaction

Evaluating customer satisfaction ratings can help you choose a company that fits your budget and coverage needs and delivers reliable service. 

We used two metrics to score customer satisfaction. The first was based on data provided by the National Association of Insurance Commissioners (NAIC) Complaint Index. We also collected data on company mobile app ratings across the Apple and Google Play stores.

We scored customer satisfaction on a continuous scale for both our 3-year weighted NAIC index and mobile app ratings. Each criterion was weighted as shown below:

NAIC Index

A high frequency of complaints can indicate that an insurance company has problems responding to customer needs. The NAIC is a regulatory organization that maintains a database of complaints filed against insurance companies. With this data, the NAIC creates an index that conveys how many complaints an insurance company has received relative to how many complaints it’s expected to receive based on its market share. We averaged each company’s NAIC index over three years.

If a company receives fewer complaints than expected relative to its size in terms of annual premiums written, its index is less than 1. An index of 0 means the company received no complaints. An index greater than 1 means the company received more complaints than expected. Some examples of complaints are delays in benefit payment, poor claim handling, and claim denials.

Using the NAIC Complaint Index, we calculated a three-year weighted average NAIC score for each company’s total premiums and index values from 2021 to 2023. Our three-year average was scored on a continuous scale from 0 to 1. Of the health insurance companies we reviewed, Aetna had the lowest 3-year weighted index value of 0.208, meaning it received the highest score for this category in our evaluation. Oscar Health had the highest average index value at 2.987, giving it the lowest score for this category.

Mobile App Ratings

Most health insurance companies offer mobile applications that allow individuals to manage various aspects of their policy from the convenience of their personal devices. We searched for company mobile apps across the Apple and Google Play stores, the largest app stores for iOS and Android users, respectively. For each company, we recorded the star ratings for their applications as they appear on a 5-point scale and the number of customer reviews written for each app. We used the number of reviews to come up with an average weighted star rating, out of 5, for each company. These star ratings were scored on a continuous scale from 0 (lowest score) to 1 (highest score). Oscar Health had the highest average mobile app rating of 4.85, and Ambetter had the lowest at 3.99.

Plan Types

We gathered information on the types of plans and the different metal tiers companies offer. Understanding plan type offerings, such as whether a company covers care through an HMO, PPO, or other types of plans, can help you pick a company and plan that matches your health care needs, budget, and desired network flexibility. Having a variety of metal tiers can also provide you with greater choice when deciding your cost-sharing preferences. We weighted criteria related to plan types as shown below:

Plan Types Offered

We checked for the availability of three plan types for each company: HMOs, PPOs, and EPOs.

Availability of HMOs

HMO plans are designed to offer in-network coverage, specifically primary care, at a lower monthly cost than EPO’s and PPO’s. For this criteria, companies received a score of 1 if they offered HMO plan options, and a score of 0 if they did not. Of the 9 companies we reviewed, all of them offered HMO’s in at least one state.

Availability of PPOs

PPO’s are typically the most expensive among the three plan types that we measured, but also offer the greatest flexibility. With a PPO plan, you’ll have the option to receive care with either an in-network or out-of-network provider, as well as the ability to see a specialist without a referral. For this criteria, companies received a score of 1 if they offered PPO plan options, and a score of 0 if they did not. Of the companies we reviewed, Blue Cross Blue Shield, Ambetter, Aetna, and Oscar Health all offered PPO plans.

Availability of EPOs

EPO plans combine elements of both HMOs and PPOs. While they typically offer larger networks than HMOs, you’ll still be limited to choosing an in-network provider. However, similar to PPOs, you’ll also be able to see a specialist without receiving a referral from your primary care physician. For this criteria, companies received a score of 1 if they offered EPO plan options and a score of 0 if they did not. In our review, 8 out of 9 companies offered this plan type, with Molina being the lone exception.

Cumulative Plan Type Score

We then took the sum of scores across the three plan types to calculate a cumulative score, which occurred on a 3-point scale, with scores increasing in increments of 0.33. A score of 0.33 meant that only 1 of 3 plan types was offered, and a score of 1 indicated that a company offered all plan types. 

Several companies on our list, including Aetna and Blue Cross Blue Shield, offered all three plan types that we collected data for (HMOs, PPOs, and EPOs). Molina had the most limited offerings for this category, only offering HMO plans.

Metal Tiers

Metal tiers are another important consideration when choosing a health insurance policy. There are six metal tiers: Catastrophic, Bronze, Expanded Bronze, Silver, Gold, and Platinum. They speak to the relationship between monthly premiums and out-of-pocket costs, like deductibles, coinsurance, and copays. Typically, the higher the metal tier (Platinum is the highest), the lower your maximum out-of-pocket contribution; a higher metal tier might be beneficial if you have frequent health care needs or prefer to pay higher monthly premiums in exchange for potential long-term cost savings. Once you reach your maximum out-of-pocket contribution amount, you will be fully covered for any additional care you receive. 

Metal tiers were scored on a continuous scale from 0 to 1, where the company with the most metal tiers received a score of 1, and the one with the least received a score of 0. Blue Cross Blue Shield offered all six types, giving it the highest score of 1 for this category. Aetna, Ambetter, and Molina offered the fewest metal tiers (Expanded Bronze, Silver, and Gold) across the companies we reviewed and received the lowest score of 0 for this category.

Availability

We gathered data on the number of states in which companies offered plans through the Health Insurance Marketplace, and weighted this as shown below:

State Availability

This measure indicates how widely a plan is available across the U.S. Wider availability ensures greater access and flexibility for consumers, especially if they move or travel frequently. We scored this on a continuous scale from 0 to 1, with Blue Cross Blue Shield receiving the highest score of 1 (available in 33 states), and Kaiser receiving a score of 0 (available in 9 states).

Plan Benefits

We checked to see if companies included both adult and child dental benefits as part of their health insurance plans. We assigned the following weights to these criteria:

Adult Dental

We checked to see if companies offered dental benefits for adults as part of their health insurance plans (as opposed to purchasing a separate standalone dental plan to supplement health coverage). This criteria was scored on a binary scale, where companies received a score of 1 if they offered adult dental plans, and a score of 0 if they did not. Five of the nine companies in our review offered adult dental benefits as part of their health insurance plans.

Medical Management Programs

All plans offered on the Health Insurance Marketplace must cover the 10 Essential Health Benefits set by the Department of Health and Human Services (HHS). In addition to these, many plans offer additional services and benefits, such as medical management programs, to help individuals better manage the care and medications they receive for their specific needs. For our review, we gathered data on whether plans offered medical management programs for the following health conditions:

1. Asthma
2. Heart disease
3. Depression
4. Diabetes
5. High blood pressure and cholesterol
6. Low back pain
7. Pain management
8. Pregnancy
9. Weight loss

These medical management programs were first broken out into individual criteria, and we scored each on a binary scale, where a company received a score of 1 for each program that they offered, and a 0 for any that they didn’t. For our review, we assigned equal weight to each of these medical management programs, as shown below:

We took the sum of these scores across all nine medical management programs to come up with a cumulative score for the category, which appeared in a range from 0 to 1, increasing in increments of 1/9. None of the companies on our list offered all nine medical management programs, but Kaiser, Blue Cross Blue Shield, and Aetna all offered eight, giving them the highest score for this category at 0.89. UnitedHealthcare received the lowest score for this category; since they don’t offer any medical management programs across their plans, they received a composite score of 0.

Cost

We considered both Federal and State Marketplace cost data to measure affordability across the nine companies in our review. Shown below are the criteria we collected across both marketplaces, as well as the weights assigned to each:

Federal Marketplace Costs

The Qualified Health Plan (QHP) Landscape File, downloaded from HealthCare.gov, is a data file that contains information on certified health insurance plans offered through the Federal Marketplace, also known as the Federal Exchange. This is distinct from individual state marketplaces in that all aspects of shopping for health insurance, such as eligibility, enrollment, and plan selection, are managed by the federal government. Individuals living in any of these states must purchase their plans through state-specific websites; all other states provide coverage options through HealthCare.gov. There are 31 states that offer coverage through the federal Marketplace for 2025 (29 use the federal Marketplace on HealthCare.gov, and two, Arkansas and Oregon, oversee their own marketplaces while still using HealthCare.gov).

The QHP File is a spreadsheet that contains data on 106,427 Exchange plans offered through all states on the Federal Marketplace. Each row contains information on plan features—such as metal tier, plan type, and dental benefits—as well as cost-sharing information, like premiums, deductibles, and out-of-pocket maximum amounts across various ages and family sizes.

Monthly Premiums

Premiums are monthly costs paid to the health insurance company to maintain coverage. We calculated the average monthly premium for each company across every plan they offered in 31 Federal Marketplace states. Specifically, we calculated these averages across the following personas:

• One 30-year-old individual
• Two 40-year-old adults with two kids

We scored Federal Marketplace premiums on a continuous scale from 0 to 1, where the company with the highest monthly cost received a score of 0, and the one with the lowest a score of 1. Of the companies we reviewed, Anthem had the lowest average monthly premium for individuals ($428.43), and Kaiser had the lowest for families ($1,513.09). On the other end, Blue Cross Blue Shield (excluding Anthem) had the highest average premiums for individuals ($561.47), as well as for families ($2,015.45).

Medical Deductible

A medical deductible is the amount you pay for covered health care services before your insurance plan starts to share costs. Some plans may have a separate drug deductible that you’ll need to pay for your medications, while others will combine your drug and medical deductibles. We calculated the average medical deductible for each company across every plan they offered in 31 Federal Marketplace states. Specifically, we calculated the average medical deductible for both individuals and families.

We scored Federal Marketplace medical deductibles on a continuous scale from 0 to 1, where the company with the highest amount received a score of 0, and the one with the lowest a score of 1. Of the companies we reviewed, UnitedHealthcare had the lowest average medical deductible for individuals ($2,824.47) and families ($5,648.93). On the other end, Aetna had the highest average medical deductible for individuals ($5,879.52) and families ($11,759.05).

Medical Out-of-Pocket Maximum

A medical out-of-pocket maximum is the highest amount of money you'll have to pay for covered health care services in a plan year. Once you reach your out-of-pocket maximum, your health plan will pay 100% of covered health care costs for the rest of the plan year. Some plans may have a separate out-of-pocket maximum for drugs, while others will combine it with your medical costs. For each company, we calculated the average medical out-of-pocket maximum across every plan they offered in 31 Federal Marketplace states. Specifically, we calculated this average for both individuals and families.

We scored Federal Marketplace medical out-of-pocket maximums on a continuous scale from 0 to 1, with the company with the highest amount receiving a score of 0 and the one with the lowest a score of 1. Of the companies we reviewed, Ambetter had the lowest average out-of-pocket maximum for individuals ($6,646.60) and families ($13,293.21). On the other end, Cigna had the highest average medical out-of-pocket maximum for individuals ($7,415.65) and families ($14,831.30).

State Marketplace Costs

State marketplaces provide states with more control over coverage options and eligibility within their jurisdictions and the ability to tailor plans to suit the needs of their residents better. Unlike the Federal Marketplace, where plan options across the 31 participating states are consolidated on the QHP Landscape File or HealthCare.gov plan finder tool, each state marketplace has its own website through which residents can shop and enroll in health coverage. There are 20 states with their own marketplaces for 2025.

Without a data file that consolidated plan information across state marketplaces, we wanted to approximate the average costs for each company across the remaining 20 states not on the federal exchange. Out of these 20, we gathered quotes from the following ZIP codes across five states: 

• 90011: Los Angeles County, California
• 07104: Newark, New Jersey
• 30369: Fulton County, Georgia
• 19120: Philadelphia, Pennsylvania
• 80013: Aurora County (Denver), Colorado

These states were selected based on their high enrollment in exchange plans in 2024. In situations where companies did not offer plans in one or more of these ZIP codes, we substituted the following until we gathered a total of five quotes:

• 22206: Arlington County, Virginia
• 98115: Seattle, Washington
• 06010: Hartford County, Connecticut
• 89108: Las Vegas, Nevada

In each state the company sells plans, we collected quotes for two plans:

• Silver plan with the lowest monthly premium
• Silver plan with the lowest out-of-pocket maximum

We then specifically collected the following criteria:

• Monthly premium
• Medical deductible
• Medical out-of-pocket maximum
• Primary care copay
• Specialist care copay
• Drug copays (Generic, Preferred, Non-Preferred Brand, Specialty tiers)

We used the following two personas:

• 30-year-old individual making $100,000 per year
• Two 40-year-old adults with two children (ages 5 and 10), with a household income of $200,000 per year

Once this data was gathered for individuals and families across each of the 5 states, we aggregated it to get an approximation of state marketplace costs.

Monthly Premiums

Premiums are monthly costs paid to the health insurance company to maintain coverage. We calculated the average monthly premium for each company across the states in which we collected quotes. We calculated different averages for individuals (30-year-old making $100,000) and families (two 40-year-old adults making $200,000 with two children). 

We scored state marketplace premiums on a continuous scale from 0 to 1, where the company with the highest monthly cost received a score of 0, and the one with the lowest a score of 1. Of the companies we reviewed, Molina had the lowest average monthly premium for individuals ($395.54) and families ($1,423.65). On the other end, Blue Cross Blue Shield (excluding Anthem) had the highest average premiums for individuals ($593.61), as well as for families ($2,115.05).

Medical Deductible

A medical deductible is the amount you pay for covered health care services before your insurance plan starts to share costs. Some plans may have a separate drug deductible that you’ll need to pay for your medications, while others will combine your drug and medical deductibles. We calculated the average medical deductible for individuals and families across the five aforementioned state marketplaces.

We scored state marketplace medical deductibles on a continuous scale from 0 to 1, with the company with the highest amount receiving a score of 0 and the one with the lowest a score of 1. Of the companies we reviewed, Blue Cross Blue Shield (excluding Anthem) had the lowest average medical deductible for individuals ($2,428) and families ($4,530). Conversely, Cigna had the highest average medical deductible for individuals ($5,167) and families ($12,500).

Medical Out-of-Pocket Maximum

A medical out-of-pocket maximum is the highest amount you'll have to pay for covered health care services in a plan year. Once you reach your out-of-pocket maximum, your health plan will pay 100% of covered health care costs for the rest of the plan year. Some plans may have a separate out-of-pocket maximum for drugs, while others will combine it with your medical costs. For each company, we calculated the average medical out-of-pocket maximum across our sample for state marketplaces. Specifically, we calculated this average for both individuals and families.

We scored state marketplace medical out-of-pocket maximums on a continuous scale from 0 to 1, with the company with the highest amount receiving a score of 0 and the one with the lowest a score of 1. Of the companies we reviewed, Ambetter had the lowest average out-of-pocket maximum for individuals ($7,635) and families ($13,820). Conversely, Cigna had the highest average medical out-of-pocket maximum for individuals ($8,904) and families ($17,458).

Copays

Another important aspect to consider when selecting a health insurance plan is the copays or coinsurance associated with doctor visits and purchasing medications. Copays are a fixed dollar amount for a covered service, while coinsurance refers to a percentage of the cost of a covered service you are responsible for. Plans will specify whether certain copay/coinsurance fees kick in from day one of your policy, or only after you have paid your deductible. If it’s the latter, you will be responsible for 100% of the cost of the covered service until the specified amount has been met.

As we were collecting quotes across the state marketplaces, we noticed that copays and coinsurance for doctor visits and drug tiers fell under one of these three categories:

• Flat copay or coinsurance (before deductible)
• Flat copay after deductible
• Coinsurance after deductible

For the purpose of our review, we considered any copay or coinsurance before the deductible to be the most desirable pricing model within plans, as insurance companies will share the financial burden of any care or prescription that you need from the start of your policy. After this, we determined that the next best option would be a flat copay amount after your deductible has been met, as opposed to coinsurance after the deductible; given that medical expenses can range in cost, a flat copay offers more predictability, stability, and transparency in the long run as compared to coinsurance. 

We devised a scoring structure to reflect this logic, as shown below:

• Flat copay or coinsurance (before deductible): Scores between 0.8 and 1, where the highest flat copay/coinsurance before the deductible receives a score of 0.8, and the lowest a score of 1
• Flat copay after deductible: Scores between 0.4 and 0.79, where the highest flat copay after the deductible receives a score of 0.4, and the lowest a score of 0.79

Coinsurance after deductible: Scores between 0 and 0.39, where the highest coinsurance after the deductible receives a score of 0, and the lowest a score of 0.39

Doctor Visits

We gathered copayment data across two types of doctor visits: primary and specialist care visits. This could be a flat copay or coinsurance before or after the deductible. If a company offered the same type of payment structure across all five state marketplaces, we only calculated an average amount across that specific structure. If a company offered different copayment structures across various plans in the five states, we then calculated averages for all applicable criteria. Once we did this, we applied the following scoring structure for each primary care copay category:

• Flat copay or coinsurance (before deductible): Scores between 0.8 and 1, where the highest flat copay/coinsurance before the deductible receives a score of 0.8, and the lowest a score of 1
• Flat copay after deductible: Scores between 0.4 and 0.79, where the highest flat copay after the deductible receives a score of 0.4, and the lowest a score of 0.79
• Coinsurance after deductible: Scores between 0 and 0.39, where the highest coinsurance after the deductible receives a score of 0, and the lowest a score of 0.39

Then, for each of the two doctor visit types (primary and specialist), we took the average across all the individual copay category scores to come up with the following 

• Primary Care Copay Cumulative Score: Cigna received the highest cumulative score of 1, and UnitedHealthcare received the lowest at 0.46
• Specialist Care Cumulative Score: Molina received the highest cumulative score of 0.95, Ambetter received the lowest score of 0.4

We then took the average of the Primary Care Copay Cumulative Score and the Specialist Care Cumulative Score to get another criteria we called Doctor Visits Score. Cigna had the highest Doctor Visits score of 0.96, and UnitedHealthcare had the lowest of 0.45.

Drug Copays

We gathered copayment data across four drug tiers: generic, preferred, non-preferred, and specialty. Similar to doctor visit copays, this could either be a flat copay or coinsurance before the deductible or after. We followed the same methodology for this category as we did for Doctor Visits. We applied the following scoring structure for each drug tier category.

• Flat copay or coinsurance (before deductible): Scores between 0.8 and 1, where the highest flat copay/coinsurance before the deductible receives a score of 0.8, and the lowest a score of 1
• Flat copay after deductible: Scores between 0.4 and 0.79, where the highest flat copay after the deductible receives a score of 0.4, and the lowest a score of 0.79
• Coinsurance after deductible: Scores between 0 and 0.39, where the highest coinsurance after the deductible receives a score of 0, and the lowest a score of 0.39

For each drug tier, we took the average across all the individual copay category scores to come up with the following:

• Generic Tier Cumulative Score: Cigna received the highest score (0.98), and Oscar Health received the lowest (0.42)
• Preferred Tier Cumulative Score: Aetna received the highest score (0.95), and Oscar Health received the lowest (0.44)
• Non-Preferred Tier Cumulative Score: Anthem received the highest score (0.72), and Oscar Health received the lowest (0.48)
• Specialty Tier Cumulative Score: Kaiser received the highest score (0.54), and Aetna received the lowest (0.29)

We then averaged all the drug tier cumulative scores to get another criterion we call Drugs Cumulative Score. Aetna had the highest score of 0.69, and Oscar Health had the lowest score of 0.41.

Criteria That Did Not Receive a Score

Network Size

This measure refers to the number of health care providers included in the health plan's network, such as doctors, hospitals, and pharmacies. A larger network typically offers more choices for patients. We collected data on the size of the provider network for each company. However, because it came directly from the companies, and we weren’t able to independently verify it, we chose not to score it.

Articles That Use Our Methodology

We have many articles about the best health insurance companies for specific products or to meet the needs of particular readers. The research conducted and data collected to create this methodology have been used to compile our list of the Best Health Insurance Companies for 2025. Other articles that list the best health insurance companies for certain products or readers (for example, Best Health Insurance for the Self-Employed, Best Health Insurance Companies in Texas, Best Health Insurance Companies in Florida, and Best Affordable Health Insurance Companies) rely on information collected as part of the grading process described here. But selections and order of providers are based on additional product-specific criteria plus subjective insights from our editors and industry experts.

Meet the Research Team

Shanker Narayan

Research Analyst, Financial Product Reviews

As a Research Analyst for Investopedia's financial product reviews team, Shanker formulates evaluation criteria for various financial product categories, with a focus on consumer and small business insurance products. His responsibilities include overseeing the data collection, verification, and analysis processes that fuel our financial product reviews.Shanker's background in Applied Statistics has equipped him with both the tools and logical framework necessary to develop, refine, and execute research methodologies. Combined with his passion for reading and writing in his personal life, Shanker believes that the best, most meaningful content is generated when using both quantitative and qualitative techniques in research and delivery.

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