Last reviewed: October 2026 · SmartCoverage Editorial Team · How we research
There is no single best health insurance company in the United States, and any list that names one is skipping the most important fact about health coverage: it is local. The plans, doctors and prices available to you depend on your state, often your county, and whether you get coverage through work or buy it yourself.
What the data does show is a pattern. In J.D. Power’s 2026 study of members with employer and individual commercial plans, Kaiser Permanente ranked first in five of the 22 regions, and Blue Cross Blue Shield companies took first place in most of the rest. If one of those is available where you live, it deserves a close look. The rest of this guide covers how to judge the others, and what changed in 2026 for people who buy their own coverage.
Who ranks highest where you live
| Region | Highest-ranked plan | Score |
|---|---|---|
| Virginia | Kaiser Permanente | 682 |
| Maryland | Kaiser Permanente | 660 |
| California | Kaiser Permanente | 640 |
| Michigan | Blue Cross Blue Shield of Michigan | 614 |
| Texas | Baylor Scott and White Health Plan | 604 |
| Florida | Cigna and Florida Blue (tie) | 603 |
| New York | CDPHP | 603 |
| Pennsylvania | UPMC Health Plan | 599 |
| Illinois/Indiana | Blue Cross Blue Shield of Illinois | 596 |
| New Jersey | Horizon Blue Cross Blue Shield | 580 |
Two findings from the same study are worth knowing before you compare plans. Satisfaction has barely moved in three years, and the biggest drags were rising premiums and deductibles. More telling, members who rated their claims experience as excellent scored 734, while those who rated it anything less scored 404. How a company handles claims and denials matters more than any feature on the brochure.
If you buy your own coverage, 2026 changed a lot
The enhanced premium tax credits that had made marketplace plans cheaper since 2021 ended with 2025. KFF found that the average monthly premium people actually paid rose 58%, from $113 to $178, and the average deductible jumped 37% to $3,786, the largest increase since the marketplaces opened. People with incomes above 400% of the federal poverty level once again receive no subsidy at all.
People responded by moving to cheaper plans. Silver plans fell from 57% of enrollees to 43%, a record low, while Bronze rose to 40%. That saves money on premiums, but Bronze plans have much higher deductibles, so the trade-off only works if you will not need much care. The calculator below shows how the math changes depending on your year. If you are self-employed, our guide to health insurance for the self-employed covers the subsidy rules in more detail.
Bronze, Silver or Gold: what would a year really cost?
The cheapest premium is not always the cheapest year. Enter the plans you are offered, then pick the kind of year you expect.
Example plans are illustrative, not real prices; replace them with your quotes. Simplified model: you pay costs up to the deductible, then coinsurance (Bronze 40%, Silver and Gold 20%) up to the out-of-pocket maximum. Real plans also use copays and may cover some visits before the deductible. For guidance only.
One protection does not change with the metal level: in 2026, no marketplace plan can make you pay more than $10,600 a year for covered in-network care as an individual, or $21,200 for a family. That cap is why a Bronze plan can still make sense for a healthy person with savings, and why it matters to check whether your doctors are in the network.
The main insurers, briefly
Company names can mislead in health insurance, because the same brand runs very different plans in different states. Use these as starting points, not verdicts.
Kaiser Permanente runs its own hospitals and doctors, which explains its satisfaction scores: care and coverage are coordinated in one system. The catch is that you generally must use Kaiser facilities, and it operates in a limited number of states, mainly California, the Pacific Northwest, Colorado, Georgia, Hawaii and the Mid-Atlantic.
Blue Cross Blue Shield is not one company but more than 30 independent ones, including Anthem, Florida Blue and Highmark. They usually have the widest networks in their states and, in NerdWallet’s marketplace review, lower complaint rates and fewer denied in-network claims than average. Premiums are rarely the lowest.
UnitedHealthcare is the largest health insurer in the country and sold marketplace plans in 30 states in 2026, according to KFF. It is a strong option through employers, with a broad national network, but its satisfaction results vary widely by region.
Centene (Ambetter) sold marketplace plans in 29 states and often has competitive premiums. NerdWallet noted that about half of the Ambetter plans it reviewed included adult dental coverage. Deductibles can be high.
Oscar operated in 20 states and often has some of the lowest Silver premiums, with a well-designed app. NerdWallet found it denies more in-network claims than average, so check the network and drug list carefully.
Cigna and Molina round out the large marketplace insurers, in 11 and 14 states respectively. Aetna CVS, previously in 17 states, left the individual marketplace for 2026, so former Aetna members had to choose a new plan.
How to judge a plan in your area
Start with the network, because a cheap plan without your doctors is not cheap. Search each plan’s directory for your doctors, nearest hospital and any specialists, and call the offices to confirm, since directories are often out of date. Then look up every prescription you take in the plan’s drug list and note its tier.
After that, two quick checks narrow the field. Marketplace plans carry a one-to-five star quality rating on HealthCare.gov and state marketplaces, and the NAIC Consumer Insurance Search shows complaint records for many insurers. Finally, compare total yearly cost, premiums plus what you are likely to pay for care, rather than the monthly premium alone.
If you are between jobs or retiring before 65, also read our guides to health insurance without an employer and coverage for early retirees. If you are weighing a high-deductible plan, our HSA vs FSA guide explains how a health savings account can offset the deductible.
When you can sign up
For individual coverage, the annual open enrollment period starts on November 1. Deadlines differ between HealthCare.gov and state-run marketplaces, so check yours early rather than waiting until December. Outside that window, you can enroll only after a qualifying life event, such as losing job-based coverage, moving, marrying or having a baby, usually within 60 days. Employer plans have their own enrollment period, typically in the fall; your HR team will tell you the dates.
This guide gives general information, not medical, legal or financial advice. Plans, prices and subsidies vary by location and income and change every year. Check details on HealthCare.gov or your state marketplace, or with a licensed agent or navigator.
Sources
- Becker’s Payer Issues: J.D. Power 2026 U.S. Commercial Member Health Plan Study rankings (May 2026)
- KFF: What we know so far about 2026 ACA marketplace enrollment, premiums and deductibles (updated July 2026)
- KFF: How has insurer participation in the ACA marketplaces changed in 2026? (June 2026)
- NerdWallet: Best health insurance companies on the marketplace (December 2025)
- HealthCare.gov: Out-of-pocket maximum