Written by Alice Stevens | Last Updated January 20th, 2020Alice Stevens is a language enthusiast, loves history, and enjoys traveling. She manages content for BestCompany.com specializing in finance, insurance, and car warranty.
Updated January 2020.
Shopping for health insurance can be quite the endeavor:
- Terms are confusing.
- Plans can be tricky to figure out.
- And, health is sometimes unpredictable.
When it comes to the bottom line, you’re trying to find:
- The most cost-effective plan,
- That also has great coverage,
- And comes from a trustworthy company.
Most of the advice published about health insurance focuses on how to choose the plan that meets your needs. This article focuses on choosing a health insurance company.
Granted, health insurance is regional and not all companies offer plans in the same states, so your choice of insurers may be limited.
What you’ll find here is an overview of three major health insurance companies: Aetna, Cigna, and Kaiser Permanente with as many details as we could find.
If you’re considering plans from any of these three companies, this article will help you better understand what each company offers and which company may be best for you.
You can view customer reviews for each of the companies by following these links:
Specific plans and costs discussed in this article may vary depending on your location, age, and other demographic information.
Individual and family plans
While some people receive health insurance through their employer, others purchase their own directly from health insurance companies. Aside from premiums, deductibles, and cost-sharing, the biggest difference between plans is the networks that plan members have access to.
There are several kinds of health insurance plans:
- Health Maintenance Organizations (HMO) plans provide coverage for in-network care. A Primary Care Physician (PCP) oversees all medical care received.
- Preferred Provider Organizations (PPO) plans provide both in- and out-of-network coverage and allow members to see specialists without a referral. Coverage is higher for in-network care providers.
- Point of Sale (POS) plans provide discounted health care services with limited cost-sharing. These plans are more common for dental insurance, but there are some available in the health insurance industry.
- Exclusive Provider Organization (EPO) plans offer coverage for in-network medical services and generally don’t require a referral.
- Short Term health insurance plans offer health insurance coverage for less than one-year. These plans can be useful if you know you’ll be without health insurance for a certain period of time or are between health insurance plans.
- Catastrophic health insurance plans have low premiums and high deductibles. These plans only provide health insurance coverage for serious injury or illness. These plans can be a good deal for people with good and stable health.
Some health insurance plans feature different kinds of savings accounts for medical expenses:
- Flexible Spending Accounts (FSAs) contain tax-free funds that must be used throughout the calendar year for medical expenses.
- Health Savings Accounts (HSAs) build tax-free funds for health expenses. These accounts don’t have an expiration date like FSAs, so plans that are HSA-compatible are popular among people in good health.
When purchasing health insurance independently, individuals can purchase any plan offered by a health insurance company or choose a Marketplace (Obamacare) plan.
Marketplace plans can be found, compared, and enrolled in through HealthCare.gov, unless your state has its own website.
Marketplace plans share the same labels that other health insurance plans do. They are also categorized into bronze, silver, gold, and platinum based on the level of cost-sharing the plan offers. Bronze plans have lower premiums and the lowest level of cost-sharing. Platinum plans have the highest premiums and the highest level of cost-sharing.
Aetna individual and family plans
Aetna offers three kinds of health insurance plans:
- Network Only plans
- Network Option plans
- Traditional Choice ® Indemnity plans
The Network Only plans include HMO, Aetna Select (SM), Open Access Aetna Select, and Health Network Only.
Aetna also offers its Elect Choice ® in California and Washington and Aetna Open Access ® Elect Choice in California, New York, Texas, and Washington.
Some of Aetna’s Network Only plans allow patients to see specialists without PCP referrals. Others require referrals.
Aetna’s Network Option plans include the following:
QPOS ® (Quality Point-of-Service ® ), Aetna Choice ® POS II, Managed Choice ®, Aetna Open Access ® Managed Choice, Open Choice ® PPO, and Health Network Option.
Some of these plans require referrals to see specialists. Members of these plans have a PCP who manages care. They can go to providers in or out of network. These plans are a little more flexible and can be customized.
Aetna’s Network Option plans can be connected with an HSA or health fund in most states. The plans also include gym membership, eyewear, and other health and wellness product offerings.
Aetna’s Traditional Choice ® Indemnity Plans are self-funded and do not have network limitations. These plans also do not require PCPs or referrals. People with these plans are responsible for their deductible and coinsurance.
Discounts for gym membership, eyewear, and other health and wellness products are also included with the indemnit plans.
International Health Insurance
Aetna also offers international health insurance to independent buyers all over the globe.
U.S. citizen plans
Its Mobile Healthcare Plans provide health insurance to U.S. citizens.
The MHP Classic Plan covers emergency assistance, maternity care, accidental damage to teeth, and preventive care.
The MHP Exclusive Plan provides the same coverage with the following additional features:
- Additional pregnancy and childbirth coverage
- Routine and restorative dental care
- Additional preventive coverage
These plans have a $4 million annual maximum, a range of deductibles, and provide full coverage once the $1,000 coinsurance is met. These plans also provide two years of free health coverage if the primary individual insured dies.
Plans for everyone else
For others, Aetna offers five different plans:
- Aetna Pioneer (SM) 1750
- Aetna Pioneer (SM) 2500
- Aetna Pioneer (SM) 4000
- Aetna Pioneer (SM) 5000
- Aetna Pioneer (SM) 5000+
Each plan has an increasing annual maximum starting at $1,750,000 (Aetna Pioneer (SM) 1750) and ending with $5,000,000 (Aetna Pioneer (SM) 5000 and Aetna Pioneer (SM) 5000+) These plans cover the following:
- Inpatient and daycare treatment
- Parent hospital accommodation
- Emergency inpatient treatment out of coverage area
- Outpatient post-hospitalization treatment
- Outpatient surgery
- Outpatient dental treatment for accidental damage following hospitalization
- Local ambulance
- Cancer care
- Organ transplants
- Mortal remains
- Rehabilitation (30-120 days)
- Emergency assistance services
- Durable medical equipment
- Hospital cash
- Further benefits (unspecified)
Non-emergency medical evacuation coverage can be added to these plans. Routine dental care can be added to Aetna Pioneer (SM) 1750 and 2500 plans.
The Aetna Pioneer (SM) 1750, 2500, 4000, and 5000 plans also include inpatient treatment for acute conditions for newborns. The Aetna Pioneer (SM) 5000+ plans provide coverage for newborn congenital abnormalities.
The Aetna Pioneer (SM) 2500, 4000, and 5000 plans provide additional coverage for outpatient complementary medicine like podiatry, osteopathic, and chiropractic treatment with referrals.
The Aetna Pioneer (SM) 2500, 4000, 5000, and 5000+ plans provide additional coverage for the following:
- Inpatient psychiatric treatment
- Outpatient consultations, treatment and tests (MRI)
- Outpatient physiotherapy
- Outpatient traditional Chinese medicine
- Outpatient psychiatric treatment
- Emergency outpatient treatment outside of coverage area
- Terminal care
- Chronic condition and disease management
- Congenital abnormalities
- HIV or AIDS
The Aetna Pioneer (SM) 4000, 5000, and 5000+ plans include coverage for compassionate emergency visits and routine health checks.
The Aetna Pioneer (SM) 5000 and 5000+ plans include coverage for sight and hearing examinations.
Keep in mind that these benefits are subject to the annual benefit maximum. Some of the benefits have lifetime limits.
Cigna individual and family plans
Cigna’s plans are available in Arizona, California, Florida, Illinois, Kansas, Missouri, North Carolina, Virginia, Utah, and Tennessee.
Cigna’s Marketplace plans and other individual and family plan options are easy to view on its website state by state. Each plan listing includes detailed coverage information regarding deductibles, out-of-pocket limits, and cost-sharing.
Plan offerings vary depending on location, however, consumers can expect to see several different HMO plans.
Most of Cigna’s plans include access to telehealth providers so members can quickly get medical advice or be seen by a doctor remotely in non-emergency situations. Many plans include this as a complimentary service, though some do not. Plan members also can use Cigna’s Health Information LineSM to talk to a nurse 24/7. These features allow patients to easily get non-emergency medical help.
Cigna’s plans also include Healthy Rewards®. This program provides discounts for certain nutrition programs, fitness clubs, eyewear, alternative medicine, yoga, and vitamins. The availability of these discounts and their amounts vary by state.
Cigna also offers supplemental health insurance:
- Lump Sum Heart Attack and Stroke Insurance
- Lump Sum Cancer Insurance
- Cancer Treatment Insurance
- Whole Life Insurance
These additional offerings allow consumers to purchase additional coverage for certain kinds of medical care.
International health insurance
Consumers living or traveling abroad can also purchase a customizable international insurance plan. These plans provide coverage for mental health, essential hospital stays, cancer treatment, and more.
Additional coverage can be added for the following:
- Outpatient care
- Medical evacuation
- Health and wellness (health screenings)
Cigna’s international health care plans have deductible and cost sharing options. The plans come in three tiers: Silver, Gold, and Platinum. Each plan has a different annual benefit limit. Take these limits into account as you determine what kind of plan you'll need.
Kaiser Permanente Individual and Family Plans
Kaiser Permanente offers marketplace and other individual and family health insurance plans. Specific plans available depend on your zip code and can be easily viewed from Kaiser Permanente’s website.
Speaking in general terms, Kaiser Permanente offers Affordable Care Act-tiered HSA-compatible plans, catastrophic plans, copayment plans, and deductible plans.
Copayment plans have an out-of-pocket limit but do not have a deductible. However, the plans have specific copayments or coinsurance for each kind of doctor visit or medical treatment.
Deductible plans have set copayments and coinsurance that contribute to the deductible total. Once the deductible is met, then the insurance kicks in at a higher level. These plans also have out-of-pocket limits that are higher than the deductible.
Charitable health insurance
Kaiser Permanente also provides charitable health coverage for low-income individuals who don’t qualify for public health insurance or have access to private health insurance.
Kaiser Permanente provides subsidies on premiums for these plans and additional financial assistance for out-of-pocket costs when care is received at Kaiser Permanente facilities for covered services.
These plans are available in California, Colorado, Georgia, the Mid-Atlantic (Maryland and Virginia), and Oregon. The name of the Kaiser Permanente’s charitable health coverage is different in each region:
- Northern California: Community Health Care Program
- Southern California: Child Health Program
- Colorado: Colorado Bridge Program
- Georgia: Bridge Program
- Maryland and Virginia: Community Health Access Program
- Oregon: Community Health Coverage Program
The U.S. government offers health care plans to people who meet the qualifications. The most common of these plans are as follows:
- Children’s Health Insurance Program (CHIP)
- Medigap (Medicare supplement insurance)
Medicaid and CHIP
Eligibility requirements for Medicaid are determined by each state independently. In general, Medicaid provides coverage for low-income people, families and children, pregnant women, the elderly, and people with disabilities.
Medicaid benefits are also determined by state governments. However, under the Affordable Care Act, essential medical services like preventive care are covered.
More information on Medicaid eligibility and benefits can be found on Medicaid.gov.
CHIP provides health insurance to children whose families do not qualify for Medicaid and who also can’t afford to buy their own health insurance health care coverage. Specifics of eligibility also vary by state.
Aetna Medicaid and CHIP
Aetna offers Medicaid in the following states:
- New Jersey
- New York
- West Virginia
In most of these states, Aetna offers one plan options for Medicaid. Aetna also offers CHIP. More specific details can be found by reaching out to Aetna directly.
Kaiser Permanente Medicaid and CHIP
Kaiser Permanente offers Medicaid in the following states:
- Washington, D.C.
Medicare and Medigap
Medicare is for people who are age 65 and older. It’s best to enroll in Medicare Part B as soon as you are eligible. There are four main parts: Part A, Part B, Part C, and Part D. Each part can be purchased separately and provides a different kind of coverage.
Part A covers hospital expenses and stays. Part B covers doctor visits and check-ups.
Part C is more commonly referred to as Medicare Advantage plans. These plans combine Part A and Part B coverage.
Part D is for prescription medications.
Medigap is Medicare supplemental insurance that provides additional coverage for out-of-pocket expenses not covered by Medicaid. There are several different kinds of Medigap insurance that are referred to as Parts A-N. Some of these include health care coverage abroad.
Aetna carries Medicare plans that individuals can purchase for themselves and Medicare plans that employers can provide to their employees.
Aetna’s individual plans are as follows:
- Medicare Advantage HMO (health care is coordinated through an in-network primary care physician)
- Medicare Advantage HMO-POS (includes some out-of-network coverage for certain services)
- Medicare Advantage PPO (can see any doctor that accepts Medicare)
- Medicare Advantage Dual Special Needs (DSNP) (Medicare Advantage plan for people with Medicaid and Medicare combined)
Most Aetna Medicare plans also include dental, vision, and hearing coverage.
Additional Aetna Medicare plan benefits include the following:
- Resources for Living ® (assistance finding local resources)
- SilverSneakers ® (fitness membership program)
- Ask a nurse 24/7
- Aetna Rx home delivery
For Medicare Part D (prescription drug coverage), Aetna offers the following:
- SilverScript Choice (PDP)
- SilverScript Plus (PDP)
These plans have no deductible for Tier 1 and Tier 2 prescriptions. The SilverScript Choice plan has a $215–$435 deductible for Tier 3-Tier 5 prescriptions. The SilverScript Plus plan has no deductible for Tier 3-Tier 5 medications. These numbers may vary slightly depending on your region. Some plans may not be available in every state. Both plans include a mail-order benefit.
Aetna also offers Medicare Supplemental Insurance, or Medigap, insurance in some states. Medigap provides additional cost-sharing to cover some expenses that Medicare does not cover on its own. Interested consumers should visit Aetna’s website to learn more specific details.
Medicare plans available may vary depending on location.
Cigna offers Medicare Advantage, Part D, and Medigap plans for individuals and employers. Its Medigap insurance plans are renewable for life and provide emergency medical coverage abroad.
Cigna’s supplemental Medicare insurance also includes access to a Health Information LineSM and Cigna Healthy Rewards® which provides discounts for health and wellness programs.
Cigna’s Medicare plans are available in most states.
Kaiser Permanente Medicare
Kaiser Permanente carries Medicare in the following states:
- Washington, D.C.
Interested consumers can view plan specifics for their area on Kaiser Permanente’s website.
Kaiser Permanente offers the following plans:
- Advantage Plus plans
- Senior Advantage (HMO) plans
- Medicare Advantage (HMO) plans
- Medicare Plus (Cost) plans
The Senior Advantage, Medicare Advantage, and Medicare Plus plans come in several tiers, which allows consumers more choices when finding coverage.
Kaiser Permanente’s Advantage Plus plans include dental, hearing, and additional vision coverage. The Advantage Plus plans include participation in a Silver&Fit ® fitness program. It also has an higher premium.
Keep in mind that plan availability may vary by region.
Plans for businesses and companies
One of the largest incentives that employers can offer current and potential hires is a good benefits package, including the following:
Because medical care is so expensive and the plans that can be purchased independently are not nearly as good as what most employers can offer, a good health insurance plan can be a deal maker or deal breaker for employees.
Aetna employer offerings
Aetna has group health insurance plans designed to meet the needs of small businesses, mid-size businesses, national accounts, and international businesses.
The plans fall into the same categories Aetna offers independent buyers: Network Only, Network Option, Indemnity, and Medicare/retiree plans. These plans are also customizable to the business’s needs.
Aetna has programs and offerings geared for health care providers, hospitality workers, high-tech workers, and people in education.
Aetna also offers multi-employer labor funds, health insurance for public sector employers, voluntary benefit options, and retiree health care.
Supplemental insurance plans like dental and vision insurance through Aetna are also available.
For business owners providing health insurance to individuals 65 and older, Aetna has several options:
- Aetna Medicare Advantage
- Standalone Aetna Medicare Prescription Drug
International health insurance
For employers that need to provide international health insurance to their employees, Aetna provides global health insurance plans. Some plans can also be customized.
In North America, Aetna offers the following:
- Traditional Choice ® indemnity plans
- Aetna HealthFund ® Health Reimbursement Arrangement (HRA)
- Open Choice ® Preferred Provider Organization (PPO)
- Aetna International Expatriate Trust includes PPO medical plan, emergency assistance, pharmacy, vision, 24-Hour Nurse Line, counseling, and the Aetna Global Health Connections wellness program.
- Aetna Ascent ® includes PPO medical benefits, pharmacy, vision, emergency assistance, counseling and mental health resources.
- Aetna International WorldTraveler and WorldTraveler Plus plans include coverage to medical assistance services, travel assistance services, emergency assistance, and translation.
- Aetna WorldTraveler Plus includes lost luggage benefit, trip interruption insurance, return of personal effects for evacuation, political and natural disaster assistance, indemnity medical coverage, prescriptions, accidental dental coverage, emergency assistance and evacuation. Business Travel Accident, dependent coverage, and sojourn coverage may also be added.
Aetna also offers additional international products and services like vision and dental coverage, emergency assistance services, and a 24-Hour Nurse Line.
More information on plans available thorugh Aenta for Latin America can be found by contacting Aetna directly.
Aetna SummitSM plans provide coverage for employees traveling to Europe, Singapore, Hong Kong, and the Middle East.
These plans are fully customizable. Once a plan is chosen, it can be customized in the following ways:
- Coverage area
- Kind of underwriting
- Coinsurance or excess options
- Add Aetna travel insurance or Aetna personal accident insurance
Aetna SummitSM plans are not available for Thailand, the Philippines, Morocco, Oman, Jordan, or China.
However, Aetna does provide two plans for coverage in the Asia Pacific and Middle East regions: International Healthcare Plan and Aetna Healthy Aessentials.
It also provides coverage in Africa through the Executive Healthcare Plan.
Cigna employer offerings
Cigna offers seven kinds of plans that employers can provide their employees:
- Cigna SureFit® (highly personalized plans available in some areas)
- Open Access Plus (OAP) (access to Cigna’s nationwide network)
- LocalPlus® (local provider network)
- Preferred Provider Organization (PPO) (in- and out-of-network coverage)
- Health Maintenance Organization (HMO) (care overseen by Primary Care Provider (PCP))
- Health Savings Account (HSA), Health Reimbursement Account (HRA), or Flexible Spending Account (FSA) compatible plans
- Network (care overseen by Primary Care Provider)
- Indemnity (no network limitations)
Cigna offers Medicare plans that employers can offer their employees and retirees. Plan options include Medicare Advantage and Prescription Drug plans.
Cigna also has its own insurance plans designed to supplement Medicare plans. While these plans are not Medigap, they are a good option for those looking to supplement their Medicare plans.
In addition to these Medicare plans, Cigna also offers benefit administration and support services for finding prescription subsidies.
International health insurance
Cigna also offers international insurance programs to employers, intergovernmental organizations (IGOs), non-governmental organizations (NGOs), and government employees that can be customized based on needs.
For employers based in North America, it offers seven plans:
- Cigna Global Health Advantage® 10+ (United States, flexible)
- Cigna Global Health Advantage® 2-20 (United States, set plan designs)
- Protect n’Go ® (designed for NGOs)
- Short Term Abroad (short assignments abroad, unexpected illness, injury, and routine care)
- Worldwide Advantage 2-20 (Canada, set plan designs)
- Worldwide Advantage 10+ (Canada, flexible)
- Medical Benefits Abroad (international business travelers)
Cigna also offers plans designed for government employees, overseas students, and health care travelers. You can also purchase Short Term Abroad health insurance if your employees go on business trips or do mission work.
Kaiser Permanente employer offerings
Kaiser Permanente offers health insurance plans designed for small businesses, large business, national or multi-state businesses, and federal employees. It also offers group Medicare plans.
Kaiser Permanente’s small business plans vary depending on location.
In Georgia and California, Kaiser Permanente has the following:
- Copayment HMO
- Deductible HMO
- HRA- or HSA-qualified plans
In Colorado, Kaiser Permanente offers the following:
- Copayment HMO
- Deductible HMO
- PPO plans
- POS plans
In Hawaii, Kaiser Permanente offers the following:
- Copayment HMO
- Deductible HMO
- Occupational Health Care (specific coverage for work-related injuries or illnesses)
In Maryland, Washington, D.C., and Virginia, Kaiser Permanente offers the following:
- Copayment HMO
- Deductible HMO
- HRA- or HSA-qualified plans
- Supplemental Benefit Plans (adds acupuncture, chiropractic, dental, and vision coverage)
In Oregon and southwest Washington, Kaiser Permanente has the following:
- Traditional Copayment plans
- Deductible Plans
- Added Choice POS plans
- HSA-qualified plans
- Occupational Health Care
In some Washington counties, Kaiser Permanente provides the following:
- Core Network Plans
- PPO Plans
- Occupational Health Care
Some of the options available in Washington are HSA-compatible.
For large businesses, Kaiser Permanente offers the following:
- Traditional plans
- Deductible plans
- Consumer-directed health plans (HRA/HSA/FSA)
- Point of Service
- Out-of-area plans
- Group Medicare
- Occupational Health
- Supplemental Benefits
For multi-state and national businesses, Kaiser Permanente offers the following:
- Consumer-directed health plans
- PPO, POS, and Out-of-Area plans
- Traditional plans
- Deductible plans
It also has health plan options for federal agencies.
Aetna vs. Cigna
Both Aetna and Cigna are great options when buying a health insurance plan independently for coverage within the United States and internationally. Cigna’s domestic plans have a few more perks than Aetna’s plans do.
Cigna and Aetna are also similar in their Medicare and Medigap plan offerings. The biggest difference is the inclusion of additional programs.
When choosing between Cigna and Aetna, consumers purchasing plans independently or buying Medicare should compare specific plan coverage, included network, and costs from both companies.
Consumers seeking Medicaid or CHIP will find options from Aetna.
Businesses of any size can find their needs met from either Aetna or Cigna. It’s worth comparing cost specifics for domestic plans and cost specifics, coverages, and regions for international plans to find the best deal.
Aetna vs. Kaiser Permanente
Aetna and Kaiser Permanente are similar in their domestic health insurance offerings for individuals and families.
With Medicaid and CHIP, the biggest difference between the two is the states available. If both companies offer Medicaid and CHIP in your state, it’s worth doing further research into what distinguishes the offerings of each company.
Kaiser Permanente’s and Aetna’s Medicare plans are also similar. What makes Aetna stand out with its Medicare offerings are the perks and Medigap products.
Employers seeking domestic health insurance for their employees can find good plans from both Aetna and Kaiser Permanente. However, if global health insurance is necessary, Aetna is a good option because Kaiser Permanente focuses on domestic health insurance.
Cigna vs. Kaiser Permanente
While Cigna could provide more general information about the plans it offers independent buyers, its plans stand out for the wide variety of discounts and other included programs. Cigna also offers a nice variety of supplemental health insurance plans that are great for people seeking additional coverage for specific situations.
Cigna is also a great choice for purchasing independent international health insurance.
Kaiser Permanente stands out for its Medicaid, CHIP, and Charitable Health Insurance offerings. For consumers interested in this kind of health insurance, Kaiser Permanente is the clear choice.
Both Cigna and Kaiser Permanente offer Medicare Advantage plans. The biggest differences between the two are the additional programs that are included with some plans.
Cigna also offers Medigap insurance, which is great for consumers looking for additional cost-sharing help.
Kaiser Permanente and Cigna both offer a nice selection of employer-provided health insurance plans. Employers who are choosing between the two should contact each company directly to compare pricing and coverage.
Cigna also offers international insurance.