Cigna vs. Anthem: 2026 Comparison

Anthem sells ACA marketplace plans in 13 states with access to all major network structures. Cigna operates in 11 states with HMO and EPO plans only. Colorado, Georgia and Indiana are the three states where both carriers compete, giving shoppers direct comparison opportunities. 

Network flexibility distinguishes these insurers. Anthem members in some markets access PPO and POS options that Cigna doesn't provide anywhere. Plan types match coverage to your provider preferences and affect how you access care: 

• HMO plans: Coverage stays in-network except emergencies. You select a primary care physician who coordinates all medical care and issues specialist referrals.
• EPO plans: No primary care physician requirement and no referrals needed for specialists. Coverage remains in-network only except emergencies.
• POS plans: Primary care physician required with referral system, but out-of-network care available at increased cost.
• PPO plans: Maximum provider flexibility. Specialist visits require no referrals. Out-of-network care covered at reduced benefit levels.

HMO premiums favor Anthem at $683 monthly, coming in $73 below Cigna and just $5 above the national average. Cigna saves EPO members $24 per month at $753 versus Anthem's $777, though both exceed the $731 national rate. Anthem's exclusive POS and PPO options cost $806 and $874, with both exceeding national benchmarks by $54 and $71. 

The best health insurance depends on network preference. Anthem HMO plans provide lower costs, while Cigna EPO coverage costs less for members who skip the primary care physician requirement. Anthem's POS and PPO availability provides flexibility Cigna can't match.

Cigna sells Medigap coverage in 43 states with consistent plan availability. The insurer offers Plans A, F, G and N in most markets, supplemented by Plans B, C and D in select states. Anthem operates in 12 states only, with complete overlap in Cigna's service territory. Maine is Anthem's single exclusive market. Cigna maintains sole coverage in 31 additional states. 

State-specific structures apply in Minnesota and Wisconsin, where both insurers meet local requirements instead of selling standard lettered plans. Ohio is the only market where neither carrier provides Plan N.

• Cigna Availability: Alabama, Arizona, Arkansas, Colorado, Connecticut, Delaware, Florida, Georgia, Illinois, Kansas, Kentucky, Maryland, Mississippi, Missouri, Nevada, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, Washington
• Anthem Availability: California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Missouri, Nevada, New York, Ohio, Virginia, Wisconsin

Cigna sells Medicare Advantage coverage in 29 states with complete overlap in Anthem's 12-state territory. Colorado, Connecticut, Georgia, Kentucky, Missouri, Nevada, New York, Ohio and Virginia are markets where both carriers compete. Anthem exclusively serves California, Indiana and Wisconsin. Cigna maintains 20 markets where Anthem doesn't operate.

HMO plans heavily favor Cigna on both premium costs and out-of-pocket protection. 85% of Cigna HMO plans charge nothing beyond Part B premiums, versus 40% for Anthem. Average monthly costs are $8 for Cigna and $29 for Anthem when premiums apply. Maximum annual spending caps at $5,585 with Cigna compared to $7,890 for Anthem, a $2,305 difference protecting members from higher medical costs.