The American health insurance marketplace is flooded with buying options for the consumer. Choosing a carrier and plan can be daunting. In some situations, you’ll only need to worry about picking a plan because a carrier has already been chosen, which is often the case when choosing an employer health plan. Other times, you may need to decide on both a carrier and a plan.
Keep reading to learn how Kaiser Permanente, the provider with the second-largest market share within the health insurance industry, stacks up to some of its competitors.
Kaiser Permanente is a private, not-for-profit company. They offer a variety of plan types, including HMO, PPO, POS, and Medicare, but focus mainly on their HMO product. They own their own health facilities and employ their own doctors and specialists, which helps to keep their costs down. This organizational structure also gives them the ability to create a “one-stop shop” for their members to receive all levels of care.
If you purchase a plan through Kaiser, you’ll be limited to receiving medical care at one of their facilities. They also only operate in nine states, so Kaiser is only an option for people living or working in:
- District of Columbia (Washington, D.C.)
Even if you live or work in one of these states, you’ll want to check the location of their facilities and make sure that it will be convenient for you to receive care.
Kaiser may be a good option for you if you:
- live or work in one of the areas they cover
- are interested in a HMO plan
- are a woman
- have mental or behavioral health concerns
- have heart disease
Cigna is one of the oldest insurance companies in the world. They provide a variety of medical plans and are recognized as a top-tier carrier. By having a long-standing reputation as a reliable insurer, Cigna has created vast network of doctors and facilities for their members to choose from.
Cigna offers coverage across the United States as well as in 29 other countries. They offer HMO, PPO, POS, and Medicare plans.
Cigna may be a good option for you if you:
- live or work in more remote areas of the United States or overseas
- are a woman
- have asthma
United Healthcare (UHC) has the largest market share in the health insurance industry. They offer a diverse range of products and have a strong presence in employer-sponsored plans, individual plans, and Medicare coverages. UHC has recently announced that they will pull their individual health plans from most of the Affordable Care Act (ACA) exchanges.
UHC plans are available nationwide in the United States, and they can also be found in additional countries, including:
- United Kingdom
UHC may be a good option for you if you:
- are on an employer-sponsored healthcare plan
- have heart disease
- are planning to become pregnant
Blue Cross Blue Shield
Blue Cross Blue Shield (BCBS) is a recognizable brand among the top insurance providers. They are the third largest carrier in terms of market share. They offer a range of plan types, but their PPO offerings are the most popular among consumers. BCBS also has one of the largest provider networks, giving its members extensive choice and flexibility for care.
BCBS may be a good option for you if:
- you’re interested in a PPO plan
- you want access to a wide range of specialists
- you have children or are considering having children
What should you
consider when choosing a plan?
You should now have a better understanding of Kaiser, how this carrier compares to other leading insurance companies in the United States, and what type of plans each of them offer. When enrolling in health insurance, however, you’ll also need to determine what type of plan suits you.
Choosing a plan
- PPO plans offer maximum flexibility
- HMO plans are user-friendly
- CDHP plans are affordable
PPO plans allow you to choose your primary care provider (PCP) and healthcare facilities, and self-refer to specialists within the provider’s network. If you find a doctor or specialist outside of the network, you can still receive care, but just expect a higher out-of-pocket cost when you get the bill.
HMO plans provide in-network benefits only, but at an affordable price with a local facility acting as a one-stop shop for subscribers. You choose a PCP who coordinates all of your required care. No self-referrals are allowed, and you’ll be financially responsible for any care received out of network.
Consumer-driven health plans (CDHP) offer low-tier benefits at affordable prices. These plans are built for the young, the healthy, or those who are on a budget.
Stephen has over 10 years of experience working in the healthcare industry on both the carrier and broker side. He has spent his career concentrating on sales effectiveness, ACA compliance, and long-term health and welfare strategic planning as it pertains to group insurance. He is currently working in a business development role at Craford Benefit Consultants.