Largest Health Insurance Companies of 2020
In the United States, there are currently more than 900 health insurance companies that offer medical coverage.
However, the health insurance industry is dominated by five companies: Anthem, UnitedHealthcare, Humana, Health Care Service Corporation (HCSC) and CVS Health Corp., who control more than 38% of the market.
All of these providers offer basic health insurance products to individuals and companies, along with other services that include Medicaid and Medicare policies, long term care insurance, dental insurance and vision benefits.
What are the biggest health insurance companies?
The biggest health insurance companies in the United States include well-known insurance providers. Many of these companies offer similar products but some tend to specialize in additional products such as Medicaid and Medicare. We break down the largest health insurers by membership, by revenue and by state below:
Top 5 largest health insurance companies by membership
The largest health insurance provider can be defined as the company that has the highest number of members. Also known as “covered lives,” the amount of membership means the number of individuals who have enrolled in a health insurance plan with that provider. You can enroll in a health insurance policy in many different ways. For example, through your company’s benefit plan, it may offer health insurance coverage. Other ways include:
- Medicare and retirement plans
- Medicaid services
- Individual health insurance (through open enrollment)
1. UnitedHealthcare Group
UnitedHealthcare is the largest health insurance company by total covered lives. The provider offers a variety of products from individual health insurance to full employer benefits plans for some of the biggest corporations. Furthermore, its policies can be purchased in all 50 states. UnitedHealthcare is headquartered in Minnetonka, Minnesota.
Along with having the most members, UnitedHealthcare also has a care network of over 1.3 million physicians and health care professionals with more than 6,000 hospitals. This means that if you have UnitedHealthcare, you will have many options to choose from to receive care.
2. Anthem
Anthem is the second-largest medical insurance provider by total members with over 40 million lives covered. The company's Commercial and Business health care segment offers network-based care to large and small businesses, individuals, Medicaid and Medicare markets.
Anthem is a licensee of Blue Cross Blue Shield health insurance products. This means that typically, when searching for Anthem policies on your state marketplace exchange, you will find that its products will be titled BCBS followed by the name of your state, but the insurer you will be buying from will be Anthem.
The company currently operates in California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia and Wisconsin.
3. Aetna
Aetna was acquired by CVS Health Corp. in 2018. CVS now operates the company and has been able to seamlessly integrate its provider networks with Aetna's membership base. Founded in 1853, Aetna is the third-largest provider of health insurance and services. However, most of its membership comes from providing health insurance to employers and its employees in the private market. Since 2015, Aetna has removed itself from all Affordable Care Act marketplaces due to a loss in revenue.
4. Cigna
Cigna is the fourth largest major medical insurance company in the United States. Headquartered in Bloomfield, Connecticut, Cigna offers health insurance and health services to companies throughout the world. Including corporate health insurance policies and management of those plans, Cigna also offers dental, behavioral health, vision, supplemental health and Medicare/Medicaid retirement benefits.
Cigna currently offers individual health insurance in 11 states: Arizona, California, Colorado, Florida, Georgia, Maryland, Missouri, North Carolina, South Carolina, Tennessee and Texas.
5. Humana
Humana comes in as the fifth-largest health insurance company by membership. The provider was founded in 1961 and originally sold long term care insurance before expanding into selling health insurance policies. However, in 2017 the company announced that it would no longer be offering individual health insurance in the 11 states that it had previously provided plans. If you still have a policy from Humana, then it will still honor the responsibilities of offering coverage benefits to your plan.
Largest major medical insurance provider by state
In 2019, over 11 million people purchased a health insurance policy through a state marketplace. Also known as individual health insurance, these policies can be purchased if you currently do not receive health care through an employer or have a federally funded policy like Medicaid or Medicare. Below is the biggest health insurance provider in each state.
| State | Company |
|---|---|
| Alabama | Blue Cross Blue Shield of Alabama |
| Alaska | Premera Blue Cross |
| Arizona | Centene Corp. |
| Arkansas | Arkansas Blue Cross Blue Shield |
| California | Blue Cross Blue Shield California |
| Colorado | Kaiser Foundation |
| Connecticut | Emblem Health |
| Delaware | Highmark |
| District of Columbia | Carefirst Inc. |
| Florida | Guidewell Mutual Health |
| Georgia | Centene Corp. |
| Hawaii | Hawaii Medical Service |
| Idaho | Blue Cross of Idaho |
| Illinois | Health Care Service Corp. |
| Indiana | Caresource |
| Iowa | Wellmark Inc. |
| Kansas | Blue Cross Blue Shield of Kansas |
| Kentucky | Anthem Inc. |
| Louisiana | Louisiana Medical Serv |
| Maine | Maine Comm Health Options |
| Maryland | Carefirst Inc. |
| Massachusetts | Tufts |
| Michigan | Blue Cross Blue Shield of Michigan |
| Minnesota | HealthPartners |
| Mississippi | Centene Corp. |
| Missouri | Cigna Health |
| Montana | Montana Health Cooperative |
| Nebraska | Medica |
| Nevada | UnitedHealth |
| New Hampshire | Anthem Inc. |
| New Jersey | Blue Cross Blue Shield of New Jersey |
| New Mexico | Molina Health Care Inc. |
| New York | Mulberry Health |
| North Carolina | Blue Cross Blue Shield of North Carolina |
| North Dakota | Noridian Mutual Insurance Co. |
| Ohio | Medical Mutual of Ohio |
| Oklahoma | Health Care Service Corp. |
| Oregon | Providence Health |
| Pennsylvania | Independence Blue Cross |
| Rhode Island | Neighborhood Health Plan of Rhode Island |
| South Carolina | Blue Cross Blue Shield of South Carolina |
| South Dakota | Wellmark Inc. |
| Tennessee | Blue Cross Blue Shield of Tennessee |
| Texas | Health Care Service Corp. |
| Utah | IHC Inc. |
| Vermont | Blue Cross Blue Shield of Vermont |
| Virginia | Cigna Health |
| Washington | Kaiser Foundation |
| West Virginia | Highmark |
| Wisconsin | Common Ground Healthcare Corp. |
| Wyoming | Blue Cross Blue Shield of Wyoming |
Health insurance company rankings by revenue
Along with membership, the size of a health insurance company can be broken down by the amount of revenue it generates. Revenue is created in a health insurance company by the premiums it charges, the number of policies it writes, services it sells and the number of businesses it operates in.
Based on our analysis, UnitedHealthcare Group was the largest health insurance company with total revenue of over $201 billion during 2018. This made the insurer the largest company by both covered lives and by revenue. Interestingly, although Cigna is the fourth largest health care company by membership, it was only the sixth largest by revenue.
| Rank | Company | Revenue ($bn) |
|---|---|---|
| 1 | UnitedHealthcare Group | $201.00 |
| 2 | Anthem | $90.00 |
| 3 | Aetna | $60.60 |
| 4 | Humana | $53.70 |
| 5 | Centene | $48.30 |
| 6 | Cigna | $41.60 |
| 7 | Molina Healthcare | $18.80 |
| 8 | WellCare Health Plans | $16.90 |
Sterling Price is a research analyst at ValuePenguin specializing in health and life insurance. He graduated from Syracuse University with a bachelors degree in Finance and Accounting and has previous experience as a licensed life insurance representative.
Editorial Note: The content of this article is based on the author’s opinions and recommendations alone. It has not been previewed, commissioned or otherwise endorsed by any of our network partners.