Top 10 Worst Health Insurance Companies

Anthem's subsidiary plans have been sued in multiple states for systematically underpaying out-of-network claims using a database the New York Attorney General found artificially deflated reasonable charges. Their prior authorization requirements for emergency care have drawn particular ire from emergency physicians and patient advocacy organizations.

A 2023 investigation found Cigna medical directors denied over 300,000 claims in a two-month period, spending an average of 1.2 seconds per case review. The company's PXDX system flagged claims for automatic denial without individual patient records being opened, prompting a California Department of Insurance probe and congressional scrutiny.

Centene's Ambetter marketplace plans attracted members with low premiums but narrow provider networks that left rural enrollees driving hours for in-network care. Multiple state lawsuits alleged Centene overcharged Medicaid and pharmacy benefit programs by hundreds of millions of dollars, resulting in settlements exceeding $1.2 billion across a dozen states.

Specializing in Medicaid managed care, Molina has faced criticism for provider network adequacy failures that left vulnerable low-income populations without timely access to specialists. CMS audit findings cited Molina for failing to process claims within required timeframes in multiple states and for inadequate mental health parity compliance.

Following its acquisition by CVS Health, Aetna faced allegations of steering patients toward CVS pharmacies and MinuteClinics while restricting competitor access. A former medical director testified in a California lawsuit that Aetna's policy was to deny claims without reviewing patient medical records, relying solely on diagnosis codes.

Humana's Medicare Advantage plans have been flagged by CMS for aggressive upcoding practices that inflate patient risk scores to extract higher government payments. A Department of Justice investigation alleged Humana submitted inflated diagnoses for thousands of patients, and their complex prior authorization requirements for senior care have drawn bipartisan congressional criticism.

This startup insurer rapidly expanded into ACA marketplace plans without adequate infrastructure, leaving policyholders stranded when providers refused to accept their coverage due to unpaid claims. Bright Health exited most markets by 2024 after losing billions, and state regulators in multiple jurisdictions cited the company for failing to maintain required financial reserves.

Friday Health Plans entered state exchanges with attractively low premiums that proved financially unsustainable. The company was placed into receivership in multiple states after failing to pay providers, leaving tens of thousands of members scrambling for new coverage mid-year and providers absorbing millions in unpaid claims.

Despite sleek branding and tech-forward marketing, Oscar Health has struggled with profitability and narrow networks. Consumer complaints cite difficulty finding in-network specialists, surprise out-of-network billing despite using Oscar's own provider search tool, and customer service representatives who lack authority to resolve complex claims disputes.

Anthem's subsidiary plans have been sued in multiple states for systematically underpaying out-of-network claims using a database the New York Attorney General found artificially deflated reasonable charges. Their prior authorization requirements for emergency care have drawn particular ire from emergency physicians and patient advocacy organizations.

A 2023 investigation found Cigna medical directors denied over 300,000 claims in a two-month period, spending an average of 1.2 seconds per case review. The company's PXDX system flagged claims for automatic denial without individual patient records being opened, prompting a California Department of Insurance probe and congressional scrutiny.

Centene's Ambetter marketplace plans attracted members with low premiums but narrow provider networks that left rural enrollees driving hours for in-network care. Multiple state lawsuits alleged Centene overcharged Medicaid and pharmacy benefit programs by hundreds of millions of dollars, resulting in settlements exceeding $1.2 billion across a dozen states.

Specializing in Medicaid managed care, Molina has faced criticism for provider network adequacy failures that left vulnerable low-income populations without timely access to specialists. CMS audit findings cited Molina for failing to process claims within required timeframes in multiple states and for inadequate mental health parity compliance.

Following its acquisition by CVS Health, Aetna faced allegations of steering patients toward CVS pharmacies and MinuteClinics while restricting competitor access. A former medical director testified in a California lawsuit that Aetna's policy was to deny claims without reviewing patient medical records, relying solely on diagnosis codes.

Humana's Medicare Advantage plans have been flagged by CMS for aggressive upcoding practices that inflate patient risk scores to extract higher government payments. A Department of Justice investigation alleged Humana submitted inflated diagnoses for thousands of patients, and their complex prior authorization requirements for senior care have drawn bipartisan congressional criticism.

This startup insurer rapidly expanded into ACA marketplace plans without adequate infrastructure, leaving policyholders stranded when providers refused to accept their coverage due to unpaid claims. Bright Health exited most markets by 2024 after losing billions, and state regulators in multiple jurisdictions cited the company for failing to maintain required financial reserves.

Friday Health Plans entered state exchanges with attractively low premiums that proved financially unsustainable. The company was placed into receivership in multiple states after failing to pay providers, leaving tens of thousands of members scrambling for new coverage mid-year and providers absorbing millions in unpaid claims.

Despite sleek branding and tech-forward marketing, Oscar Health has struggled with profitability and narrow networks. Consumer complaints cite difficulty finding in-network specialists, surprise out-of-network billing despite using Oscar's own provider search tool, and customer service representatives who lack authority to resolve complex claims disputes.