Cigna vs. UnitedHealthcare (2026 Comparison)

Both insurers offer HMO and EPO plans, but UnitedHealthcare is available in many more states than Cigna.

With an HMO plan, you choose a primary care physician (PCP) who coordinates your care and provides referrals to specialists. Coverage is limited to in-network providers, except in emergencies. An EPO doesn’t require you to select a PCP or obtain referrals to see specialists, but coverage is still restricted to in-network providers.

Both Cigna and UnitedHealthcare charge premiums above the national average for HMO and EPO plans. UnitedHealthcare's premiums run $18 to $25 higher per month on average than Cigna's across both plan types. 

Cigna charges an average of $756 monthly for HMO coverage and $753 for EPO plans, while UnitedHealthcare charges $774 for HMO and $778 for EPO. The premium difference between these two carriers is relatively small, so other factors like network size, quality ratings and plan availability in your state should weigh more heavily in your decision.

Cigna outperforms UnitedHealthcare on most customer experience metrics, though both insurers score competitively in different areas. Cigna's overall Quality Rating System (QRS) score of 73.71 beats UnitedHealthcare's 69.64, with particularly strong advantages in Medical care quality and member experience ratings. Cigna also denies 23% of claims compared to UnitedHealthcare's 25% denial rate.

UnitedHealthcare performs better in plan administration, scoring 88.66 vs. Cigna's 80.29, showing that UnitedHealthcare handles billing, enrollment and policy management more efficiently. Member experience scores are high for both insurers, with Cigna at 93.59 and UnitedHealthcare at 92.0. The quality gap is widest in Medical care, where Cigna scores nearly seven points higher. If quality ratings and claim approval rates matter most to you, Cigna holds the edge. If administrative efficiency is your priority, UnitedHealthcare's is a good choice.

Cigna has cheaper Medicare Supplement rates than UnitedHealthcare across nearly all plan types for both 65- and 75-year-olds. The difference in Plan G costs is substantial, at $162 monthly through Cigna vs. $344 through UnitedHealthcare for 65-year-olds. That’s a difference of $182 per month or $2,184 annually.

Plans K and L are UnitedHealthcare's most affordable options at $120 and $211 per month for 65-year-olds. Cigna doesn't offer these plans. Cigna's upfront savings are significant, but UnitedHealthcare's stable community pricing structure costs less over time as you get older.

Cigna offers more no-cost plans overall at 86% compared to UnitedHealthcare's 59%, but the advantage varies by plan type. UnitedHealthcare's HMO plans are all zero-premium, while only 85% of Cigna's HMO plans have no monthly cost. For PPO plans, Cigna dominates with 83% at zero premium compared to UnitedHealthcare's 53%.

Average premiums follow similar patterns. UnitedHealthcare charges nothing for HMO coverage, while Cigna averages $8 monthly. Cigna's PPO plans cost just $1 per month on average, while UnitedHealthcare charges $37.

UnitedHealthcare's HMO plans have lower maximum out-of-pocket (MOOP) limits at $3,233 vs. Cigna's $5,585, which means better financial protection after you meet your deductible. PPO plans have similar MOOP limits around $6,575 for both insurers. Cigna wins on upfront affordability, while UnitedHealthcare offers better financial protection against high medical costs in HMO plans.

UnitedHealthcare outperforms Cigna across all comparable plan types. UnitedHealthcare's HMO plans earn an average 4.5-star rating compared to Cigna's 3.77, showing substantially better quality on measures like preventive care, chronic disease management and customer satisfaction.

The quality gap is significant across other plan types as well. UnitedHealthcare's PPO plans average 4.16 stars versus Cigna's 3.01, the widest performance difference between the two insurers. HMO-POS plans are more competitive, with UnitedHealthcare at 4.0 stars and Cigna at 3.96.

UnitedHealthcare's PFFS plans are its weakest offering at 2.5 stars, below the 3.0-star threshold that usually indicates acceptable quality. Higher star ratings usually mean better health outcomes, fewer member complaints and more dependable access to care, giving UnitedHealthcare a noticeable edge in quality, even if Cigna may have the pricing advantage.