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U.S. health insurance companies ranked by membership in 2018

The largest health insurance companies in the U.S. include big names such as UnitedHealthcare Group, Anthem and Aetna. As of 2018 the largest health insurance company in the U.S. was UnitedHealthcare with approximately 49.5 million members. Anthem was the second largest at that time with just over 40 million members. Health insurance is an important part of the health care landscape in the U.S. and enrollment has been on the rise since the passing of the Affordable Care Act in 2010 by U.S. President Barack Obama.

Health insurance in the U.S.

The health insurance industry in the United States is a combination of both private and publicly funded schemes that provide a range of health services to individuals and families. The overall health care administration costs and net cost of private health insurance in the U.S. has increased rapidly since the early 2000s. As of 2017, the U.S. had experienced a surge in the cost of monthly health insurance premiums. At that time an average monthly health insurance premium in the individual market earned an insurer over 440 U.S. dollars on average.

Health care costs

However, despite the combination of private and public funding, the U.S. health system has some of the highest per capita costs globally. The reason behind the increase and difference in health care costs in the U.S. is said to be a combination of doctors’ earnings, the cost of diagnostics and cost of health care administration and overhead. Compared to other developed countries such as France, Germany and Canada, the U.S. spends significantly more of it’s GDP on health care costs. As an example, the cost of a heart bypass surgery in the United States in 2018 was over 4 times as expensive as a heart bypass surgery in Israel.

Largest health insurance companies in U.S. in 2018, by membership

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Release date

January 2019


United States

Survey time period


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Statistics on "UnitedHealth Group"

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