Choosing health insurance doesn't have to feel overwhelming. We analyzed plan types, pricing, maximum out-of-pocket (MOOP) and denial rates across major insurers to find the best health insurance options for different needs. The right option for you depends on your budget, network flexibility and state availability.
Best Health Insurance Companies (2025)
Updated: October 21, 2025
Advertising & Editorial Disclosure
Key Takeaways
Ambetter is the best health insurance for Exclusive Provider Organization (EPO) plans.
Anthem (BCBS) has the best Health Maintenance Organization (HMO) plans.
Aetna has the best Preferred Provider Organization (PPO) plans.
Blue Cross Blue Shield has the best Point of Service (POS) plans.
Compare the Best Health Insurance Companies
Best For | Provider | Avg. Monthly Rate (Silver) | Plan Types | Metal Levels | State Availability | Overall Score |
|---|---|---|---|---|---|---|
EPO | Ambetter | $576.64 (EPO), $558.85 (HMO), $481.83 (POS), $503.02 (PPO) | EPO, HMO, POS, PPO | Bronze, Silver, Gold | 29 States | 98 |
HMO | Anthem (BCBS) | $600.59 (EPO), $537.98 (HMO), $651.41 (POS), $646.18 (PPO) | EPO, HMO, POS, PPO | Catastrophic, Bronze, Silver, Gold, Platinum | 14 States | 97 |
PPO | Aetna | $561.53 (EPO), $554.60 (HMO), $705.33 (PPO) | EPO, HMO, PPO | Bronze, Silver, Gold | 25 States | 88 |
POS | Blue Cross Blue Shield | $656.08 (EPO), $569.84 (HMO), $647.92 (POS), $730.75 (PPO) | EPO, HMO, POS, PPO | Catastrophic, Bronze, Silver, Gold, Platinum | 50 States | 84 |
* Monthly premiums are based on a 40-year-old buyer for the silver plan of the plan type noted. Rates vary by age, location, tobacco use, plan type, and household size. These are estimates for comparison purposes only. Request personalized quotes from multiple providers to determine your actual costs.
Best EPO Plans: Ambetter
Ambetter
MoneyGeek Score:
98/ 100
Overview
Ambetter has the best health insurance policies for EPO plans. Its EPO plans require you to use network providers but don't require referrals to see specialists, giving you flexibility without the paperwork. With Bronze EPO plans averaging $498.09 monthly and Gold plans at $630.50, Ambetter balances competitive pricing with comprehensive coverage.
Ambetter's Gold 202 EPO plan features a $2,000 individual deductible and $6,000 out-of-pocket maximum, with copays of $25 for primary care and $50 for specialists. Its Silver 203 plan has a lower $15 primary care copay but a higher $4,450 deductible and uses coinsurance for most services after the deductible. Both plans cover preventive care at no charge and include unlimited telehealth visits through Ambetter's designated provider with no copay. Available in 29 states, Ambetter has three metal levels (Expanded Bronze, Silver and Gold), with four-tiered prescription drug coverage starting at $3 for preferred generic medications.
State Availability
Alabama, Arizona, Arkansas, California, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Washington
Best HMO Plans: Anthem (BCBS)
Anthem Blue Cross and Blue Shield
MoneyGeek Score:
97/ 100
Overview
Anthem is the best health insurance company for HMO plans. With Bronze HMO plans averaging $405.06 monthly, Silver plans at $537.98 and Gold plans at $597.54, it has some of the most affordable health insurance rates in the market. Anthem achieved perfect MoneyGeek scores for affordability and out-of-pocket costs, making it ideal for budget-conscious consumers who don't mind the structure of an HMO network.
Anthem's Gold 80 D HMO features no deductible and copays of $35 for primary care and $65 for specialists, though you'll need referrals to see specialists. Its Silver 70 plan has a $5,400 individual deductible but keeps primary care accessible at $50 per visit without applying the deductible. The Bronze 60 D HMO has the highest deductible at $5,800 but uses a unique structure where your first three specialist visits cost $95 without applying the deductible. All three plans cover preventive care at no charge and provide virtual telehealth visits.
State Availability
California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia, Wisconsin
Best PPO Plans: Aetna
Aetna Medicare
MoneyGeek Score:
88/ 100
Overview
Aetna is our top pick for PPO plans. With Bronze PPO plans averaging $557. monthly and Gold plans at $821.94, its rates are higher than some competitors but reflect the added flexibility of out-of-network coverage. The company earned a perfect 5 in MoneyGeek's maximum out-of-pocket scoring and a 4.1 MoneyGeek denial rate score, meaning claims get processed reliably.
Operating across 25 states, Aetna offers three plan types (EPO, HMO and PPO) with three metal levels (Bronze, Silver and Gold). Its PPO plans average $705 monthly, higher than HMO ($555) or EPO ($562) options, but provide the freedom to see specialists without referrals and access out-of-network providers at a higher cost share.
State Availability
California, Colorado, Connecticut, District of Columbia, Georgia, Illinois, Indiana, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, New Jersey, New York, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Washington, West Virginia, Wyoming
Best POS Plans: Blue Cross Blue Shield
Blue Cross Blue Shield
MoneyGeek Score:
84/ 100
Overview
Blue Cross Blue Shield is a leading provider of Point-of-Service (POS) health insurance plans, giving members flexibility when accessing care. The company's Medicare Blue Choice Advanced (HMO-POS) plan provides comprehensive coverage with the option to see out-of-network providers when needed. With an extensive nationwide network of doctors and hospitals, competitive pricing and robust benefits, Blue Cross Blue Shield delivers a balance between managed care and flexibility. Its strong financial stability, backed by an A++ AM Best rating, means claims get paid when you need them.
Blue Cross Blue Shield's POS plans stand out for their combination of comprehensive benefits at reasonable costs. Members get access to preventive care, dental and vision services, prescription drug coverage and wellness programs, all while maintaining the ability to seek out-of-network care when needed. The plans include extras like Silver&Fit fitness benefits, over-the-counter item allowances and telehealth services through MDLive. While out-of-network services come with a maximum annual reimbursement cap and higher coinsurance, the flexibility is valuable for members who split time between locations or have established relationships with doctors outside the primary network.
State Availability
All 50 states
How to Find the Best Health Insurance for You
Choosing health insurance can feel overwhelming with so many options and factors to consider. Find the best health insurance plan for your situation by balancing your coverage needs with affordability while considering your current health status and future medical expectations. These key factors help you make a confident decision:
- Healthcare needs and usage patterns. Think about how often you visit doctors, any ongoing medications or treatments you require and whether you have chronic conditions that need regular management. If you rarely see a doctor, a high-deductible plan with lower premiums could save you money. Frequent medical users benefit from plans with higher premiums but lower out-of-pocket costs per visit.
- Budget and financial situation. Calculate monthly premiums and how much you can afford to pay out-of-pocket if you need significant medical care. A plan with a $200 monthly premium and $6,000 deductible costs differently than one with a $400 premium and $2,000 deductible, depending on your healthcare usage and emergency savings.
- Provider network and doctor access. Out-of-network care costs more or may not be covered at all. Verify that your current doctors, preferred hospitals and any specialists you see regularly are in-network. If you're willing to switch providers for better rates, check the network size and whether it includes quality facilities in your area.
- Prescription drug coverage. Review the plan to confirm your medications are covered and check which tier they fall into, since this affects your copay amounts. Some plans require prior authorization or step therapy for certain drugs, which delays access to the medications you need.
- Additional benefits and wellness programs.Look for extras like telehealth services, gym membership discounts, mental health support and preventive care programs that improve your overall health while reducing costs. These extras vary between insurers and make a difference in your healthcare experience and expenses.
Health Insurance Plan Types
Different health insurance plan types might seem like alphabet soup. If you're confused by terms like HMO, PPO and EPO, you're not alone. Health insurance plans differ in how they structure provider networks and manage your access to specialists and out-of-network care. Understanding these differences helps you choose the right balance between flexibility, cost and coverage.
Plan Type | How It Works | Best For | Typical Costs |
|---|---|---|---|
HMO (Health Maintenance Organization) | Requires you to choose a primary care physician who coordinates all your care and provides referrals to see specialists. Care must stay within the network except for emergencies. | People who want lower premiums and don't mind coordinating care through a primary doctor. Good if you live near quality in-network providers. | Lower premiums, lower deductibles, minimal or no coverage for out-of-network care. |
PPO (Preferred Provider Organization) | Flexibility to see any doctor or specialist without referrals, both in-network and out-of-network. You pay less when using in-network providers. | People who want freedom to choose providers and see specialists without referrals. Ideal if you travel frequently or have established relationships with specific doctors. | Higher premiums, moderate deductibles, partial coverage for out-of-network care. |
EPO (Exclusive Provider Organization) | Similar to HMO but doesn't require a primary care physician or referrals to see specialists. You must stay in-network except for emergencies. | People who want the flexibility to see specialists directly without the higher costs of a PPO. Good middle ground between HMO and PPO. | Moderate premiums, moderate deductibles, no out-of-network coverage except emergencies. |
POS (Point of Service) | Combines HMO and PPO features by requiring a primary care physician for referrals but allowing out-of-network care at higher costs. | People who want a primary doctor coordinating care but occasionally need out-of-network flexibility. | Moderate to higher premiums, varying deductibles based on network usage. |
HDHP (High Deductible Health Plan) | Features high deductibles and lower premiums, often paired with Health Savings Accounts (HSAs) that offer tax advantages for medical expenses. | Healthy people with minimal healthcare needs who want to save on premiums and build tax-advantaged savings. Good for those who can afford high upfront costs. | Lowest premiums, high deductibles ($1,600+ individual, $3,200+ family in 2025), HSA contribution eligibility. |
Health Insurance Metal Classifications
Metal tiers like Bronze and Gold might seem like quality ratings, but they indicate something different. Marketplace health plans are categorized into metal tiers that show how you and your insurer split the costs of your care. These tiers don't reflect the quality of coverage but the percentage of medical expenses the plan pays versus what you pay out-of-pocket.
Metal Tier | Coverage Split | Monthly Premiums | Out-of-Pocket Costs | Best For |
|---|---|---|---|---|
Bronze | Plan pays 60%, you pay 40% | Lowest | Highest deductibles and copays | Healthy individuals who rarely need medical care or those who want financial protection for major expenses only. |
Silver | Plan pays 70%, you pay 30% | Moderate | Moderate deductibles and copays | People seeking a balance between affordability and coverage. Essential if you qualify for cost-sharing reductions based on income, which lower deductibles and out-of-pocket maximums. |
Gold | Plan pays 80%, you pay 20% | Higher | Lower deductibles and copays | People with regular medical needs, ongoing prescriptions, or chronic conditions where predictable, lower out-of-pocket costs provide better value than saving on premiums. |
Platinum | Plan pays 90%, you pay 10% | Highest | Lowest deductibles and copays | People who need frequent medical care, have complex health conditions, or want to know exactly what they’ll pay. |
How Much Does Health Insurance Cost?
Understanding what you'll actually pay helps you budget confidently. We've broken down the average cost of health insurance by plan type and metal level based on actual estimates from providers. Your individual rate will vary based on your specific circumstances, but these averages provide a helpful baseline for comparison:
EPO | HMO | PPO | POS | |
|---|---|---|---|---|
Bronze | $472.58 | $413.25 | $503.91 | $482.35 |
Silver | $634.96 | $580.09 | $681.86 | $646.22 |
Gold | $681.08 | $621.84 | $766.17 | $759.35 |
Platinum | $843.18 | $767.00 | $947.05 | $975.23 |
* Rates shown are average quotes for people between 31 and 45 years old. Your rates will change based on your age, location, and other factors.
HEALTH INSURANCE COST FACTORS
- Age. Insurers charge older adults higher premiums because they use more healthcare services, with rates up to three times higher than younger adults under ACA regulations.
- Location. Your zip code impacts premiums due to regional differences in healthcare costs, provider competition and state regulations. Premium variations can be substantial even within the same state.
- Tobacco use. Insurance companies charge tobacco users up to 50% more than non-users in most states due to increased health risks from smoking. Some states like California, Massachusetts and Vermont prohibit or limit tobacco rating. Check your state's regulations for specific rules.
- Plan category and coverage level. The metal tier and network type you choose directly affects your premium, with more comprehensive coverage and flexible networks costing more monthly.
- Number of people covered. Family plans cost more than individual plans, with premiums increasing for each additional person added to your policy.
- Income and subsidies. If you purchase through the Health Insurance Marketplace, your household income determines eligibility for premium tax credits that reduce monthly costs by hundreds of dollars.
What Does Health Insurance Cover?
Knowing what your health insurance actually covers saves you from unexpected bills and helps you maximize your benefits. Health insurance plans sold through the Health Insurance Marketplace and most employer-sponsored plans must cover essential health benefits mandated by the Affordable Care Act.
Check what health insurance covers and doesn't cover:
What Health Insurance Covers | What Health Insurance Doesn't Cover |
|---|---|
• Preventive care and screenings (annual checkups, immunizations, cancer screenings) | • Cosmetic procedures (plastic surgery, Botox, teeth whitening) |
How to Get Health Insurance
There are multiple ways to get health insurance. Here are your options:
- Through your employer. Most Americans get health insurance through employer-sponsored plans, where your company pays a portion of the premium and deducts your share from your paycheck, often providing the most affordable coverage option with pre-tax savings.
- Through the Health Insurance Marketplace. You can shop for individual or family plans at Healthcare.gov during Open Enrollment or after a qualifying life event, with potential access to premium tax credits and subsidies based on your income.
- Directly from insurance companies. You can purchase plans directly from insurers outside the Marketplace, though you won't be eligible for premium tax credits, making this option best for those who don't qualify for subsidies or prefer working with a specific insurer.
- Through government programs. If you have low income, you may qualify for Medicaid (income-based coverage that varies by state), while anyone 65 and older may qualify for Medicare, and children may be eligible for the Children's Health Insurance Program (CHIP).
- Through COBRA. If you lose employer-sponsored coverage, you can temporarily continue your previous plan for up to 18 months by paying the full premium plus a small administrative fee, providing bridge coverage while you find a new plan.
- Through a spouse or parent's plan. You can join a spouse's employer plan during open enrollment or after marriage, and young adults can stay on a parent's plan until age 26 regardless of student, employment or marital status.
Best Health Insurance Companies By State
Finding the best health insurance policies often depends on where you live. Plan availability, pricing, and provider networks vary by state. To see which insurers offer the strongest combination of coverage, affordability, and customer satisfaction in your area, explore our detailed state-by-state guides:
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FAQ About Health Insurance
Check answers to common questions about health insurance providers and how to get health insurance in 2025.
Is health insurance required?
Health insurance is not federally required. Some states have their own mandates with penalties for going uninsured, including California, Massachusetts, New Jersey, Rhode Island and Vermont. Even without penalties, maintaining coverage protects you from catastrophic medical bills. Learn more: Health Insurance Requirements.
What's the difference between a deductible and out-of-pocket maximum?
A deductible is what you pay before insurance shares costs. The out-of-pocket maximum is the most you'll pay annually before insurance covers 100%. Once you reach your out-of-pocket max, all covered services are free for the rest of the year.
Can I keep my current doctor with any health insurance plan?
Not necessarily. It depends on whether your doctor is in the plan's network. HMO and EPO plans require in-network providers, while PPO plans allow out-of-network care at higher costs. Always verify your doctor participates before enrolling.
When can I buy health insurance?
You can enroll during Open Enrollment (November 1 to January 15) or during a Special Enrollment Period triggered by qualifying life events like losing coverage, marriage, birth or moving. Special Enrollment Periods last 60 days from the qualifying event.
What are premium tax credits, and do I qualify?
Premium tax credits are federal subsidies that reduce monthly costs for Marketplace plans. Most people with household incomes between 100-400% of the federal poverty level qualify, with enhanced subsidies extending to higher earners.
Is health insurance from the Marketplace different from private insurance?
Marketplace and private insurance are often the same plans from the same companies. The key difference is that Marketplace enrollment gives access to premium tax credits and cost-sharing reductions if you qualify based on income.
What's the difference between health insurance and Medicare?
Medicare is federal health insurance for seniors 65 and older or those with certain disabilities, while health insurance refers to private plans for working-age adults. Medicare includes Original Medicare (Parts A and B) or Medicare Advantage (Part C), which are private plans that bundle coverage. If you're under 65, you'll purchase private health insurance through employers, the Marketplace, or directly from insurers.
Our Methodology
Health insurance shoppers need accurate comparisons to choose the right plan and provider. We ranked health insurance providers based on premiums, out-of-pocket expenses, claims denial rates and plan selection.
MoneyGeek scores were weighted as follows:
- Rate score (50%): The provider with the lowest average monthly cost gets the highest score.
- Maximum out-of-pocket (MOOP) score (20%): The MOOP is the most you'll pay for health care outside of your monthly premiums. Providers with the lowest average MOOP scores get the highest rating.
- Plan type score (20%): Providers with plans that offer broad coverage, especially those with PPOs, get higher ratings than providers with narrow HMO-only plans.
- Claims denial score (10%): The provider that denies the fewest claims scores highest.
Data sources: Health insurance plan and provider data was updated with the Centers for Medicare & Medicaid Services (CMS) exchange data released in October for the 2025 enrollment period.
Sample consumer profile: We collected data on all available health plans for consumers ages 18, 26, 40, 50 and 60. Monthly premiums are based on a 40-year-old buyer unless otherwise noted, such as the category for seniors. We analyzed plans for each cited metal tier, which include Catastrophic, Bronze, Expanded Bronze, Silver, Gold and Platinum.
About Deb Gordon
Deb Gordon, the co-founder and CEO of Umbra Health Advocacy, has held executive roles in health insurance and health care technology services. She authored a book titled “The Health Care Consumer’s Manifesto,” based on her research as a senior fellow at Harvard Kennedy School’s Mossavar-Rahmani Center for Business and Government. Her works have been published on JAMA Network Open, Harvard Business Review blog, USA Today and RealClear Politics, among others.
Gordon is an Aspen Institute Health Innovators Fellow and an Eisenhower Fellow. She was a 2011 Boston Business Journal 40 Under 40 honoree and a volunteer at MIT’s Delta V start-up accelerator, the Fierce Healthcare Innovation Awards. She earned her bioethics degree from Brown University and her MBA with distinction from Harvard Business School.
sources
- Ambetter Health. "Health Insurance Marketplace Benefits." Accessed December 26, 2024.
- Oscar Insurance. "Oscar." Accessed December 26, 2024.
- U.S. Department of Human Health & Services. "What’s the Difference between Medicare and Medicaid?." Accessed December 26, 2024.