What Is the Difference between Private Medical Insurance and Public Insurance?

There are two primary categories used to describe health insurance. The first is public insurance and the second is private healthcare insurance. Private health insurance companies offer plans and coverage through an employer or another organization.

Private medical insurance can also be used to describe plans that are purchased by individuals or families, and the primary policy types that are available with private insurance include HMOs, PPOs, and point of service, which is less common than the first two.

Best Private Health Insurance Companies

Award Emblem: Top 6 Best Private Health Insurance Companies

On the other hand, as compared to private healthcare insurance, public insurance is offered through government programs. Two of the biggest public insurance programs are Medicaid and Medicare.

With private health insurance, plans have defined enrollment periods and may have special enrollment periods also, and they’re paid for through premium payments. If someone purchases private medical insurance through their employer, they may have their premiums automatically deducted from their pay, while individuals who purchase private health insurance are responsible for keeping up with when premiums are due.

It’s important to note that private healthcare and private health insurance options are different depending on where you live in the U.S.

While the following ranking of the best private health insurance gives a general overview of some of the top private healthcare companies in the U.S., availability and options with these companies may different depending on the state in which a consumer lives.

See Also: Tips to Find the Best Health Insurance Plans for Individuals & Small Business

AdvisoryHQ’s List of the Top 6 Best Private Health Insurance Companies

List is sorted alphabetically (click any of the names below to go directly to the detailed review section for that private medical insurance):

Top 6 Best Private Health Insurance Companies | Brief Comparison

Best Private Health Insurance

Key Locations

Key Plans Offered

AetnaCalifornia, Connecticut, Illinois, New Jersey, Texas (and others)Individual and family options, as well as plans for businesses ranging from large to very large corporations
BlueCross BlueShieldThe BCBS network offers products and services across the U.S.Members are part of the Blue Distinction program for exceptional care
CignaArizona, California, Colorado, Florida, Texas (and others)Personal, business, and international
HumanaMichigan, Texas, Georgia (and others)Personal and business, Medicare, Medicaid
Kaiser PermanenteThe Mid-Atlantic states, Northwest, Hawaii, Georgia, California, ColoradoIndividual and family plans, losing coverage, Medicaid, Medi-Cal, Medicare, employer plans
UnitedHealthcareAvailable in most statesIndividual and family, small business, large business, Medicaid, and Medicare

Table: Top 6 Private Health Insurance Companies | Above list is sorted alphabetically

What Are the Essential Benefits Covered by Private Medical Insurance?

As the result of the implementation of the Affordable Care Act, both private medical insurance, and public insurance are in most cases required to cover ten essential health benefits. These benefits are covered whether you purchase your plan through a state or federal health exchange, directly from an insurance broker, or from an insurance company.

The essential covered benefits of major private medical insurance include:

  • Outpatient care including doctor’s office visits and in-home healthcare
  • Emergency care
  • Care at a hospital or skilled nursing facility
  • Lab services
  • Maternal health and newborn care
  • Mental healthcare and addiction treatment
  • Pediatric services
  • Prescriptions
  • Preventative care
  • Rehabilitation and habilitative care

While these essential covered benefits can seem cut and dry, there are often limitations on these areas of coverage from private medical care and private health care insurance, and some private medical insurance plans may cover more than these essential benefits. It’s important to understand the specifics of coverage before choosing private medical insurance.

private health insurance

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Detailed Review—Top Ranking Private Health Insurance Companies

Below, please find the detailed review of each of the best private health insurance companies. We have highlighted some of the factors that allowed each private healthcare insurance provider to score so well in our selection ranking.

Aetna Review

Aetna is a private health insurance company founded in 1853 in Hartford, CT. The company offers plans to individuals and employers and has a number of subsidiaries providing their own services including ActiveHealth Management, Inc.

Key Factors That Led to Our Ranking of This as a Best Private Health Insurance Company

Some things to know about Aetna, as well as a few reasons it was included on this list of the best private healthcare insurance companies are below.

Plan Options

Specific plan options that are available from Aetna vary based on the state the consumer lives in, but one of the reasons Aetna is ranked as one of the best private health insurance companies is because they have a wide variety of options.

In many states, the insurance plans are described based on something called “Metallic Level Description,” although this may change because the company has announced they will be leaving state exchanges after this year.

Regardless, plan options vary based on the out-of-pocket costs and deductible requirements that must be met, but there is a good combination of high and low-cost plans for individuals and families.

For Businesses

Along with plans that can be purchased directly from the company or a broker, Aetna also offers many private healthcare options for businesses, ranging from small businesses up to large corporations and public organizations.

The company offers customized benefit solutions for each business based on the specific needs of employees, and they offer not just private healthcare but also dental, pharmacy, vision, disability, and retiree plans. They also feature options for part-time, seasonal, and hourly employees.

Business plan holders can manage their company benefits online using a secure, user-friendly employer website as well.

Easy-to-Use Insurance

Private health insurance can be complicated and overwhelming, and Aetna is unique because they strive to make life easier for their members. They work to offer affordable policies that are also easy to use and understand.

This private healthcare company also offers a variety of innovative tools such as the iTRIAGE app which lets members of Aetna make informed, empowered healthcare decisions that are right for them.

private health care

Image Source: Aetna

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BlueCross BlueShield Review

BlueCross BlueShield has been providing private health insurance to consumers since 1929, which is personalized to the areas they serve. The Blue Cross Blue Shield Association is a national association of 36 community-based, independent, local Blue Cross Blue Shield companies that serve most of the country.

Key Factors That Led to Our Ranking of This as a Best Private Health Insurance Company

Specific elements of BCBS that led to its inclusion on this ranking of private healthcare companies are below.

Localized Plans

BCBS is one of the most widespread providers of private medical care insurance and private health insurance cost sharing products. They serve members in all 50 states as well as Washington, D.C., and Puerto Rico. This helps ensure this private healthcare company can tap into an extensive network of resources that bring value to members.

At the same time, BCBS puts a lot of emphasis on the delivery of localized private medical care insurance, and that allows them to tailor their plans to the very specific needs of people who live throughout the country.

Consumers may have different needs regarding what their private healthcare covers, their needs in terms of private health insurance cost, and other aspects of insurance, and BCBS works to localize their products and services as much as possible.

Federal Employees

BCBS has a federal employee program, with extensive coverage and benefits called the Blue Cross Blue Shield Federal Employee Program.

This is the number one choice for private healthcare for many federal employees as well as their families and retirees of the federal government. More than half of all U.S. federal employees are part of this program, and it’s the largest single health plan group in the world.

Global Coverage

One of the unique elements of private healthcare available from BCBS is global coverage. This private health insurance company offers coverage to people who live permanently outside the U.S. as well as solutions aimed at both short- and long-term travel.

BCBS members also get exclusive discounts on health and wellness products and services, and through the Blue Distinction program, members are part of primary care and specialty care programs that ensure they’re receiving exceptional care.

Related: Compare Health Insurance Plans and Rates | Guide | How to Find the Best Insurance Options

Cigna Review

Cigna is a private healthcare company that is often considered a best private medical insurance provider. As a leader in private healthcare coverage, Cigna has products and solutions for businesses and their employees, as well as individuals and families.

Key Factors That Led to Our Ranking of This as One of 2017’s Best Private Health Insurance Companies

Specifics of Cigna that led to its inclusion as a top private healthcare insurance company are below.

Cost and Quality Tools

Consumer Reports recently scored Cigna as one of the best private healthcare insurance businesses regarding providing cost and quality tools to members. The Consumer Reports Health Ratings Center looked at dozens of consumers and tested out tools offered by national insurance companies to help members save money while getting superior quality care.

Overall, Cigna scored the highest, beating out even United Healthcare and Aetna, among others. Areas where Cigna excelled in particular included “Ease of Use,” “Content,” and “Scope and Reliability.”

Cigna Informed Choice

Cigna Informed Choice is a program offered by this private healthcare insurance company that helps members make informed medical decisions.

This program is an outreach and support initiative where individuals are educated if they’ve scheduled something like an MRI or PET scan. They can go through the program to explore their options and learn how they can save money on these services while also ensuring they can go to convenient facilities.

Cigna Home Delivery Pharmacy

For members of this leader among private healthcare companies, there is something called the Cigna Home Delivery Pharmacy.

This is a program that offers lower prices in most cases than retail pharmacies, and members have them delivered to their door, so they don’t have to worry about running out of their essential medications.

As part of the program as well as paying less and not running out, there are benefits such as the ability to talk with a licensed pharmacist anytime, and get your medication wherever you are, even if you’re on vacation within the U.S.

Humana Review

A national best private health insurance company, Humana delivers private health insurance to individuals, families, military members, self-employed people, and seniors.

Key Factors That Led to Our Ranking of This as One of the Top Private Health Insurance Companies

Among private medical insurance and private healthcare companies, the following are specific ways Humana excels.

Plan Options

Humana, regarding what private health insurance will cover, has some of the most extensive choices and plans. The primary private medical care plans available from Humana include:

  • Medicare Plans: These are for people who can switch plans or who are newly eligible and they include all-in-one Medicare Advantage Plans, Medicare Supplement plans and standalone Part D plans.
  • Individual and Family Plans: This best private health insurance company features individual and family plans for not only private medical care insurance, but also dental, vision, and Medicaid options.
  • Plans for Employees: Regarding what private healthcare covers, Humana offers many different plans for employers that are budget-friendly and provide value to employees.


Go365 is an exclusive program available from this private healthcare insurance company, which focuses on member wellness. Go365 rewards members of Humana for living healthier lives and making smarter decisions. This could include things like joining a gym or getting a flu shot.

Then, members earn rewards that they can redeem for anything from gift cards to movie tickets.

Personalized Service

First and foremost, Humana is one of the top private health insurance companies because they strive to offer plans that are user-friendly and easy to understand. They also have tools and online resources that help members do everything from locating in-network doctors to learning more about what certain medical procedures will cost.

It’s easy for clients to communicate with the company, and service is very tailored at Humana.

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Kaiser Permanente Review

Kaiser Permanente is a private healthcare insurance company founded more than 60 years ago. KP is one of the largest not-for-profit health plans in the country, with more than 11.3 million members.

Key Factors That Led to Our Ranking of This as a 2017 Best Private Health Insurance Company

Top features of KP in terms of private health insurance and private healthcare companies are below.

Doctor Choice

Flexibility was an important consideration when choosing the best private health insurance companies, and measuring private health insurance cost against quality. With KP, members can use the SearchDoctors tool to find information on doctors including their education, specialties, and credentials. Doctors can be selected from adult/internal medicine, family medicine, and pediatrics/family medicine.

Members of this best private health insurance company can select a single doctor for their entire family or a different doctor for everyone in the family, and they can change their doctor whenever they want.

Mobile App

One of the most important things that can be done to keep private health insurance costs low is for members of private health insurance companies to be informed and empowered. KP makes this possible with their mobile app.

Features of the mobile app include the ability to:

  • Schedule and change appointments
  • View most lab results when they’re available
  • Email your doctor’s office
  • Print vaccination records
  • Use private health insurance cost savings tools
  • Refill prescriptions with no shipping charges

No-Cost Preventative Care

KP features no-cost preventative care so that members can stay healthier and avoid potential complications. Preventative screenings and routine appointments are available for free, regardless of which particular plan is chosen by members of this private healthcare company.

UnitedHealthcare Review

UnitedHealthcare is one of the country’s top providers of private medical insurance. This best private medical insurance company features everything from individual and family plans to short-term health insurance and Medicare plans.

Key Factors That Led to Our Ranking of This as a 2017 Top Private Health Care Insurance Company

As a provider of the best private medical insurance, the following are unique features of UnitedHealthcare that led to its ranking on this list.

Small Business Plans

One area of focus at UnitedHealthcare, a best private medical insurance company, are small business plans. UHC recognizes the importance of choosing the right health insurance in terms of recruiting and retaining employees, particularly in the face of increasingly complex changes that impact small businesses.

UHC offers options to keep the private health insurance cost down for employers and their employees, while also keeping them healthier and more informed.

Self-Employed Insurance

Another area of focus on UHC, one of the leading providers of private healthcare, is self-employed health insurance. UHC strives to make it simple and efficient for self-employed individuals to choose the right plan for them, particularly with their user-friendly tools and resources.

private medical insurance

Image Source: UnitedHealthcare

Cost Control

As mentioned, UHC really excels at helping members keep their private health insurance cost and their medical costs down. They have put in place a variety of simple, yet effective online tools so that members can find not only the right private healthcare plan for their needs, but also compare quality and value before they make appointments with any care providers.

The ultimate goal with these tools is to ensure members get superior care at a reasonable price.

Read More: The Best Healthcare Consulting Firms This Year (Ranking and Review)

Conclusion—Top 6 Best Private Health Insurance Companies

In recent years, the concept of private medical care, private health insurance cost, and private medical insurance have gotten a lot of attention. There has been political debate as to the best way to tackle what private health insurance covers, as well as how to best approach the provision of private healthcare insurance.

It has become a relatively complicated subject, and many people feel like their costs for private medical care continue to rise.

That’s why it’s so important to choose the best private medical insurance based on your needs, the needs of your family, or the needs of your business.

Each of the above private health insurance companies has some key benefits including robust tools to help members save on their healthcare services, good customer service, and a wide variety of private health insurance plan options.

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Reasonable efforts have been made by AdvisoryHQ to present accurate information, however all info is presented without warranty. Review AdvisoryHQ’s Terms for details. Also review each firm’s site for the most updated data, rates and info.

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