Cigna vs. Kaiser Permanente: 2026 Comparison

Compare Cigna and Kaiser Permanente across ACA marketplace plans, Medicare Advantage coverage and Medicare Supplement options to determine which health insurer offers the best value and quality for your needs.

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Written by Mark Fitzpatrick

Updated: June 5, 2026

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Cigna vs. Kaiser Permanente: ACA Health Insurance

In Moneygeek's analysis of 2026 ACA marketplace plans, Kaiser Permanente earned a 94.6 Quality Rating System score versus Cigna's 73.71 and approved 92% of claims versus Cigna's 77% approval rate. Kaiser Permanente's monthly premiums are $158 to $205 lower than Cigna's across both plan types.

Cigna covers 11 states while Kaiser Permanente operates in seven, with Colorado and Virginia as the only overlapping markets. ACA plans apply to working-age adults under 65, while Medicare sections apply to adults 65 and older or those with qualifying disabilities.


Availability	11 States	7 States
Plan Types	HMO, EPO	HMO, EPO
Avg. QRS Score	73.71	94.6
Avg. Denial Rate	23%	8.3%

Neither insurer offers PPO or POS coverage. Both Cigna and Kaiser Permanente limit network options to HMO and EPO plans. HMO plans require selecting a primary care doctor who manages treatment and issues specialist referrals. Coverage is limited to network providers except for emergencies. EPO plans allow seeing specialists without referrals, but coverage is also limited to network providers except for emergency care.


ACA State Availability	Arizona, Colorado, Florida, Georgia, Illinois, Indiana, Mississippi, North Carolina, Tennessee, Texas, Virginia	California, Colorado, Hawaii, Maryland, Oregon, Virginia, Washington
Plan Types	HMO, EPO	HMO, EPO

Neither insurer offers PPO or POS coverage that allows out-of-network care. Cigna and Kaiser Permanente both limit network options to HMO and EPO plans.

HMO plans: Require selecting a primary care doctor who manages treatment and issues specialist referrals. Coverage is limited to network providers except emergencies.
EPO plans: Allow seeing specialists without referrals but coverage is limited to network providers except for emergency care.

Kaiser Permanente's HMO plans cost $598 per month. Cigna's HMO plans average $756, a $158 monthly gap that adds up to $1,896 per year. Kaiser Permanente charges $548 while Cigna charges $753, a $205 monthly difference. Cigna's HMO premiums run $78 above the national average of $678, while Kaiser Permanente's come in $80 below it.
HMO
$756
$598
$678
EPO
$753
$548
$731
Kaiser Permanente's 20.9-point quality advantage doesn't come with a higher price tag. HMO members save $1,896 per year by choosing Kaiser Permanente over Cigna; EPO members save $2,460.
Kaiser Permanente scores 96.11 in medical care quality, Cigna scores 71.73. That 24-point gap is the largest single-dimension difference in our QRS comparison. Plan administration tells a similar story: Kaiser Permanente at 91.68 versus Cigna's 80.29.

Cigna scores 93.59 versus Kaiser Permanente's 91.51. That 2-point lead doesn't close the overall gap: Kaiser Permanente's total QRS score is 94.6 against Cigna's 73.71.
Overall QRS Score
73.71
94.6
Medical Care QRS Score
71.73
96.11
Member Experience QRS Score
93.59
91.51
Plan Administration QRS Score
80.29
91.68
Avg. Denial Rate
23%
8.3%
Kaiser Permanente rejects 8.3% of claims while Cigna rejects 23%. Cigna members see their claims denied at nearly three times the rate of Kaiser Permanente members.
Kaiser Permanente wins on price and quality, but its seven-state footprint is a real constraint. If you live outside California, Colorado, Hawaii, Maryland, Oregon, Virginia or Washington, Kaiser Permanente isn't an option. Cigna's 11-state presence covers nine states Kaiser Permanente doesn't: Arizona, Florida, Georgia, Illinois, Indiana, Mississippi, North Carolina, Tennessee and Texas.

For residents of those states, Cigna is the only choice between these two insurers. If you're in an overlapping state and have frequent out-of-state travel or care needs, Kaiser Permanente's tighter network may also create coverage problems since both insurers limit you to HMO and EPO networks.
Cigna's 23% denial rate is the number that should give prospective members pause. In our analysis, that's nearly one in four submitted claims rejected, versus one in 12 at Kaiser Permanente. Members who anticipate regular care, prescription management or specialist visits will notice that difference.

Cigna's medical care QRS score of 71.73 also trails Kaiser Permanente by 24 points, a gap too large to attribute to measurement variance. Buyers in Colorado or Virginia, where both insurers operate, should compare Kaiser Permanente plans first given the price and quality data.


HMO	$756	$598	$678
EPO	$753	$548	$731


Overall QRS Score	73.71	94.6
Medical Care QRS Score	71.73	96.11
Member Experience QRS Score	93.59	91.51
Plan Administration QRS Score	80.29	91.68
Avg. Denial Rate	23%	8.3%

Cigna vs. Kaiser Permanente: Medicare Supplement

Cigna sells Medicare Supplement plans in 43 states while Kaiser Permanente doesn't offer Medigap coverage at all. For Medicare Supplement shoppers, Cigna is the only choice between these two insurers.


Availability	43 States	N/A
Plan Types	A, B, C, D, F, G, N	N/A
High-Deductible F and G	Yes	N/A
Dominant Pricing Style	Attained Age	N/A

Cigna's Plans A, F, G and N appear in nearly all markets. Cigna's Plan B is available in 41 of 43 states, excluding Delaware and Ohio. New Jersey offers the complete lineup including rarely available Plans C and D. Minnesota and Wisconsin residents get state-specific Medigap options instead of standard lettered plans.

Idaho, Illinois, Maine, Massachusetts, New York, Rhode Island, Vermont and Washington don't have Cigna Medicare Supplement coverage. Delaware and Ohio lack Plans B and N.


Alabama	A, F, G, N	N/A
Alaska	A, F, G, N	N/A
Arizona	A, F, G, N	N/A
Arkansas	A, F, G, N	N/A
California	A, F, G, N	N/A
Colorado	A, F, G, N	N/A
Connecticut	A, F, G, N	N/A
Delaware	A, F, G	N/A
Florida	A, F, G, N	N/A
Georgia	A, F, G, N	N/A
Hawaii	A, F, G, N	N/A
Idaho	N/A	N/A
Illinois	A, F, G, N	N/A
Indiana	A, F, G, N	N/A
Iowa	A, F, G, N	N/A
Kansas	A, F, G, N	N/A
Kentucky	A, F, G, N	N/A
Louisiana	A, F, G, N	N/A
Maine	N/A	N/A
Maryland	A, F, G, N	N/A
Massachusetts	N/A	N/A
Michigan	A, F, G, N	N/A
Minnesota	Medigap $20 & $50 Copay Plan, Medigap Basic Plan, Medigap Extended Basic Plan, Medigap Extended Basic Plan-new, Medigap High Deductible Plan	N/A
Mississippi	A, F, G, N	N/A
Missouri	A, F, G, N	N/A
Montana	A, F, G, N	N/A
Nebraska	A, F, G, N	N/A
Nevada	A, F, G, N	N/A
New Hampshire	A, F, G, N	N/A
New Jersey	A, C, D, F, G, N	N/A
New Mexico	A, F, G, N	N/A
New York	N/A	N/A
North Carolina	A, F, G, N	N/A
North Dakota	A, F, G, N	N/A
Ohio	A, F, G	N/A
Oklahoma	A, F, G, N	N/A
Oregon	A, F, G, N	N/A
Pennsylvania	A, B, F, G, N	N/A
Rhode Island	N/A	N/A
South Carolina	A, F, G, N	N/A
South Dakota	A, F, G, N	N/A
Tennessee	A, F, G, N	N/A
Texas	A, F, G, N	N/A
Utah	A, F, G, N	N/A
Vermont	N/A	N/A
Virginia	A, F, G, N	N/A
Washington	N/A	N/A
Washington D.C.	A, F, G, N	N/A
West Virginia	A, F, G, N	N/A
Wisconsin	Medigap Basic Plan	N/A
Wyoming	A, F, G, N	N/A

Cigna uses Attained Age pricing, which means premiums increase as policyholders age. Plan G starts at $162 per month at 65 and reaches $203 by 75. Plan N costs $175 at 65 and rises to $227 at 75. Plans A through D range from $205 to $269 at 65 and from $249 to $318 at 75.


A	$237	N/A	$295	N/A
B	$205	N/A	$249	N/A
C	$269	N/A	$318	N/A
D	$218	N/A	$270	N/A
F	$252	N/A	$307	N/A
G	$162	N/A	$203	N/A
N	$175	N/A	$227	N/A

Plan G is Cigna's most cost-efficient starting point at $162 per month for a 65-year-old, the lowest entry price among Cigna's available plans. The $41 monthly increase to age 75 reflects Attained Age pricing compounding over time. Buyers who expect to hold a Medigap plan for 15-plus years should model total 10-year cost, not just the age-65 rate.

Plan G costs $1,944 per year at 65 and $2,436 per year at 75, a $492 annual increase over that decade. A buyer who enrolls at 65 and holds Plan G to 75 pays $492 more in their 10th year than in their first. That's the Attained Age curve made concrete. Issue Age and Community Rated Medigap plans don't work this way, your age at enrollment either locks your rate or pools it with other members.

And because Kaiser Permanente doesn't sell Medigap at all, shoppers in this category should compare Cigna against other Medigap carriers. Plan G from a Community Rated insurer in your state is the most direct alternative to Cigna's Attained Age Plan G for buyers concerned about long-term rate growth.

Cigna vs. Kaiser Permanente: Medicare Advantage

Cigna operates Medicare Advantage plans in 29 states compared to Kaiser Permanente's eight-state footprint. Cigna includes 86% of plans with $0 premiums versus Kaiser Permanente's 36%. Kaiser Permanente has a 4.37 CMS Star rating compared to Cigna's 3.66 and lower maximum out-of-pocket limits. Cigna offers PPO plans while Kaiser Permanente limits plan types to HMO and HMO-POS networks.


Availability	29 States	8 States
Plan Types	HMO, HMO-POS, PPO	HMO, HMO-POS
Avg. CMS Star Rating	3.66	4.37
Drug Benefits	Basic, Enhanced	Enhanced
% $0 Premium Plans	86%	36%

Cigna and Kaiser Permanente overlap in Colorado, Georgia, Maryland, Oregon, Virginia and Washington. California and Hawaii are Kaiser Permanente's exclusive markets in this comparison, with neither served by Cigna's Medicare Advantage plans. Cigna is the single Medicare Advantage option in 23 states. Kaiser Permanente limits plan types to HMO and HMO-POS networks while Cigna adds PPO flexibility for members who want out-of-network provider access.
- Kaiser Permanente Availability: California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, Washington
- 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

Cigna HMO plans average $8 per month, with 85% requiring no premium beyond Medicare Part B. Kaiser Permanente charges $46 per month on average for HMO plans, with 38% offering $0 premiums. HMO-POS plans cost $34 for Cigna versus $46 for Kaiser Permanente and Cigna has more zero-premium options at 60% compared to Kaiser Permanente's 31%.


HMO	85%	38%	$8	$46	$5,585	$4,815
HMO-POS	60%	31%	$34	$46	$5,329	$5,708
PPO	83%	N/A	$1	N/A	$6,578	N/A

Kaiser Permanente's HMO maximum out-of-pocket limit is $4,815 versus Cigna's $5,585. That $770 difference is what a member with serious illness or hospitalization could pay out-of-pocket before coverage takes effect. Cigna's lower premiums don't eliminate that gap, for high-utilization members, Kaiser Permanente's lower ceiling likely saves more than Cigna's $38 monthly premium advantage on HMO plans.

That $456 annual premium saving deserves a closer look. Cigna's HMO members pay $456 less per year than Kaiser Permanente's, but carry $770 more in maximum out-of-pocket exposure, a member who hits the MOOP ceiling in a high-utilization year ends up $314 worse off with Cigna than with Kaiser Permanente, even after accounting for the premium saving. The math only favors Cigna for members who stay healthy enough to avoid large claims. For anyone managing a chronic condition or expecting surgery, Kaiser Permanente's $4,815 ceiling is the number that matters.

HMO
3.77
4.37
HMO-POS
3.96
4.37
PPO
3.01
N/A
Kaiser Permanente holds 4.37 stars for both HMO and HMO-POS plans. Plans at this rating qualify for special enrollment periods and Medicare quality bonuses. Cigna's HMO plans average 3.77 stars and its HMO-POS plans reach 3.96. Cigna's PPO plans average 3.01, below the 4-star threshold for quality bonuses. Plans rated four stars or higher receive enhanced dental, vision or hearing benefits, Kaiser Permanente's plans qualify; none of Cigna's plans do.
Buyers outside California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia and Washington have no access to its plans at all. Kaiser Permanente provides only HMO and HMO-POS plans, so members who need out-of-network provider access, whether for a specialist, a second opinion or care while traveling, have nowhere to go within this insurer.

Buyers on fixed incomes who need a $0-premium plan should also look elsewhere first. Only 36% of Kaiser Permanente's Medicare Advantage plans carry no monthly premium, compared to 86% at Cigna. And for HMO-POS plans specifically, Kaiser Permanente's average maximum out-of-pocket of $5,708 is actually $379 higher than Cigna's $5,329, the one plan type where Kaiser Permanente's cost protection advantage disappears entirely.
None of Cigna's Medicare Advantage plans reach the four-star CMS threshold that qualifies members for enhanced dental, vision or hearing benefits. Its HMO plans average 3.77 stars, its HMO-POS plans 3.96 and its PPO plans 3.01. For buyers who use their Medicare Advantage coverage heavily, that quality gap translates directly into fewer supplemental benefits and no access to Medicare's quality bonus enrollment periods.

Cigna's PPO plans offer the out-of-network flexibility Kaiser Permanente can't match, but they carry a $6,578 average maximum out-of-pocket the highest of any plan type in this comparison and the weakest star rating at 3.01. Buyers choosing Cigna PPO for flexibility are accepting both higher cost exposure and lower rated coverage. Members with high usage who qualify for Kaiser Permanente's service area are better protected by Kaiser Permanente's $4,815 HMO maximum out-of-pocket ceiling.


HMO	3.77	4.37
HMO-POS	3.96	4.37
PPO	3.01	N/A

Which One Should You Choose?

Kaiser Permanente is the stronger ACA marketplace option: its 94.6 QRS score, 8.3% claim denial rate and lower premiums across both plan types make a clear case. Cigna is the only Medicare Supplement option since Kaiser Permanente doesn't sell Medigap. For Medicare Advantage, the choice comes down to priorities: Cigna's 86% zero-premium plans and 29-state reach versus Kaiser Permanente's 4.37 CMS star rating and $770 lower HMO out-of-pocket cap. Buyers in overlapping states with frequent care needs should lean toward Kaiser Permanente. Buyers prioritizing low monthly cost or PPO access should compare Cigna.

Compare plans directly on the CMS Plan Finder to see which options are available in your ZIP code and confirm current premiums before enrolling.

Frequently Asked Questions

These answers cover the most common questions about how Cigna and Kaiser Permanente compare across ACA marketplace plans, Medicare Supplement and Medicare Advantage coverage:

Is Kaiser Permanente or Cigna better for ACA coverage?

Kaiser Permanente scores 94.6 on QRS versus Cigna's 73.71, denies 8.3% of claims versus Cigna's 23% and charges $598 per month for HMO plans versus Cigna's $756. It's the stronger ACA option but covers only seven states: California, Colorado, Hawaii, Maryland, Oregon, Virginia and Washington. Residents elsewhere should compare Cigna against other insurers.

Does Kaiser Permanente offer Medicare Supplement plans?

Kaiser Permanente doesn't sell Medicare Supplement plans. Cigna is the only option between these two, with coverage in 43 states across Plans A, B, C, D, F, G and N. Buyers in Idaho, Illinois, Maine, Massachusetts, New York, Rhode Island, Vermont and Washington can't get Cigna Medigap either and should compare other carriers through Medicare.gov.

Which states have both Cigna and Kaiser Permanente ACA plans?

Only Colorado and Virginia. Cigna operates ACA plans in 11 states; Kaiser Permanente in seven. Buyers in those two overlapping states can compare both insurers directly. Buyers in Arizona, Florida, Georgia, Hawaii, Illinois, Indiana, Maryland, Mississippi, North Carolina, Oregon, Tennessee, Texas or Washington have only one of the two available.

What is Kaiser Permanente's CMS Star rating for Medicare Advantage?

Kaiser Permanente's HMO and HMO-POS Medicare Advantage plans average 4.37 CMS Stars, qualifying for special enrollment periods and enhanced dental, vision or hearing benefits. Cigna's plans don't reach the four-star threshold in any category: HMO plans average 3.77, HMO-POS plans reach 3.96 and PPO plans average 3.01.

How does Cigna's Medicare Advantage compare to Kaiser Permanente on cost?

Cigna's HMO premium averages $8 per month versus Kaiser Permanente's $46, but Cigna's HMO maximum out-of-pocket is $5,585 versus Kaiser Permanente's $4,815. A member who hits that ceiling ends up $314 worse off with Cigna after accounting for the $456 annual premium saving. For high-utilization members, Kaiser Permanente's lower ceiling costs less overall.

What Medigap plans does Cigna offer?

Cigna sells Plans A, B, C, D, F, G and N, plus high-deductible F and G, across 43 states. Plans A, F, G and N are in most markets. Plans C and D are only in New Jersey. Cigna uses Attained Age pricing: Plan G costs $162 per month at 65 and $203 at 75.

Does Cigna or Kaiser Permanente have better claim approval rates?

Kaiser Permanente approves 92% of ACA claims. Cigna's approval rate is 77%. Kaiser Permanente's 8.3% denial rate is less than a third of Cigna's 23%. Members who file claims regularly are nearly three times more likely to get approved with Kaiser Permanente than with Cigna.

About Mark Fitzpatrick

Mark Fitzpatrick, a Licensed Property and Casualty (P&C) Insurance Producer in Connecticut, is MoneyGeek's resident insurance expert. He has spent nearly a decade analyzing the market, first at LendingTree and now at MoneyGeek, where he has produced original research on hundreds of carriers and millions of rates across auto, home, renters, health and life insurance.

He covers economics and insurance at MoneyGeek, and his work has been featured in The Washington Post, The New York Times and NPR, among other outlets.

Like all MoneyGeek analysts, he draws on independent cost and consumer experience data, and no insurance company partnership influences his recommendations.

Fitzpatrick earned his degrees from Johns Hopkins University (M.A. Economics and International Relations) and Boston College (B.A.). He began his career in financial risk management at State Street. He's also a five-time “Jeopardy!” champion.

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Sources

CMS.gov. "Five-Star Quality Rating System." Accessed June 5, 2026.
Medicare.gov. "Explore your Medicare coverage options." Accessed June 5, 2026.