If you have ever tried to use your health coverage during a stressful medical situation, you already know how much the insurer matters. On paper, many providers look similar. Monthly premiums, deductible ranges, and plan names often blur together. The real difference shows up when you file a claim, call customer support, or need approval for care that cannot wait.
So what are the worst rated health insurance companies? In simple terms, these are insurers that consistently receive poor reviews from policyholders, face frequent complaints with regulators, and struggle with issues like delayed claims, denied coverage, confusing billing, or weak provider networks. I am not talking about one-off bad experiences. I am talking about long-running patterns reported by thousands of members across multiple states.
This article breaks down ten large, legitimate insurance carriers in the United States that are often criticized by customers and consumer watchdogs. These companies are real, widely used, and regulated, but their track records raise serious concerns for many people shopping for coverage.
I am writing this from the point of view of someone who understands how insurance works and how frustrating it can feel when the system does not. My goal is not to scare you, but to help you know what to watch for before you commit to a policy that could affect your finances and your health.
10 Poorly Rated Health Insurance Companies in the United States
Below is an overview table that summarizes the insurers discussed in this guide. The ratings and issues are based on recurring consumer complaints, state insurance department data, Better Business Bureau trends, and large-scale customer feedback platforms. Individual experiences can vary by state and plan type, but these companies tend to appear repeatedly in negative rankings.
| Insurance Company | Primary Coverage Types | Common Customer Complaints | States of Operation |
| UnitedHealthcare | Employer plans, Medicare Advantage, ACA | Claim denials, slow approvals, network confusion | Nationwide |
| Anthem Blue Cross Blue Shield | Employer plans, ACA, Medicaid | Billing errors, poor support, prior authorization delays | Multiple states |
| Molina Healthcare | Medicaid, ACA marketplace | Limited providers, denied services, long wait times | Select states |
| Cigna | Employer plans, global coverage | Customer service issues, mental health coverage gaps | Nationwide |
| Aetna | Employer plans, Medicare, ACA | Claim disputes, network shrinkage | Nationwide |
| Humana | Medicare Advantage, employer plans | Authorization delays, provider disputes | Nationwide |
| Oscar Health | ACA marketplace | Narrow networks, system glitches, denied claims | Select states |
| Ambetter | ACA marketplace, Medicaid | Payment errors, policy cancellations | Multiple states |
| CareSource | Medicaid, ACA | Poor communication, claim processing delays | Select states |
| Kaiser Permanente | Integrated care plans | Access limitations, appointment delays | Regional |
UnitedHealthcare
UnitedHealthcare is one of the largest health insurers in the country, covering tens of millions of Americans through employer-sponsored plans, Medicare Advantage, and individual marketplace policies. Size alone does not make a company bad, but it often creates complexity, and that is where many members report trouble.
A frequent complaint involves claim denials for services that patients believed were covered. For example, someone may receive treatment at an in-network hospital, only to later discover that a specific provider involved in their care was considered out of network. This can lead to unexpected medical bills that run into thousands of dollars.
Customer service is another area where frustration builds. Members often report being transferred multiple times, receiving inconsistent answers, or waiting weeks for prior authorizations. In cases involving chronic conditions like diabetes or heart disease, these delays can directly affect care.
Common issues reported by members include:
- Denied or delayed claims for specialist visits
- Confusing explanation of benefits statements
- Difficulty resolving billing disputes
- Long wait times for phone support
While UnitedHealthcare does offer competitive pricing in some regions, the volume of complaints suggests that many policyholders feel overwhelmed when problems arise.
Anthem Blue Cross Blue Shield
Anthem operates Blue Cross Blue Shield plans in several states and serves millions through employer coverage, government programs, and marketplace plans. The Blue Cross name carries trust for many people, but Anthem-specific plans often receive criticism.
One recurring issue is billing accuracy. Members report being billed incorrectly for services that should have been covered, then spending months trying to correct the error. Even when mistakes are acknowledged, refunds or corrections can take a long time.
Another concern is prior authorization. Doctors may recommend imaging, surgery, or specialist care, only to have Anthem delay or deny approval. Patients are then left coordinating appeals while dealing with health problems.
Real-life examples often involve:
- Emergency room visits later classified as non-emergency
- Prescription medications removed from formularies mid-year
- Difficulty accessing mental health providers
Anthem plans vary by state, so some members have smoother experiences than others. Still, the overall pattern of complaints places it among the more criticized insurers.
Molina Healthcare
Molina Healthcare focuses heavily on Medicaid and lower-cost marketplace plans, which means it serves a population that often has limited healthcare options to begin with. This makes service quality even more important.
One of the most common complaints about Molina is the limited provider network. Members may find that only a small number of doctors or hospitals in their area accept the plan. In rural or underserved regions, this can mean traveling long distances for care.
Claim denials are another issue. Patients report being denied coverage for services that their doctors consider medically necessary. Appeals are possible, but they can take time and require extensive documentation.
Reported concerns include:
- Long waits for appointments
- Difficulty finding specialists
- Poor communication during claim reviews
For people who qualify for Medicaid, Molina may be one of the few available options. Even so, understanding these limitations ahead of time is critical.
Cigna
Cigna is known for employer-sponsored plans and international health coverage. While it has a strong global presence, domestic customers frequently report dissatisfaction with certain aspects of care.
Mental health coverage is a major pain point. Members often struggle to find in-network therapists or psychiatrists, leading to high out-of-pocket costs. Some report that approved therapy sessions are limited or reduced without clear explanation.
Customer support experiences vary, but complaints often focus on:
- Inconsistent information from representatives
- Delays in claim processing
- Difficulty resolving prescription coverage issues
For example, a patient may receive approval for a medication one month, only to be told later that it now requires additional authorization. These disruptions can be especially challenging for people managing ongoing conditions.
Aetna
Aetna, now part of CVS Health, provides a wide range of plans including employer coverage, Medicare Advantage, and individual policies. Despite its reach, it often ranks poorly in customer satisfaction surveys.
One common issue is network changes. Members may sign up for a plan because their doctor is listed as in network, only to discover later that the provider has been removed. This forces patients to switch doctors or pay higher costs.
Claim disputes also appear frequently. Some members report having to resubmit claims multiple times or provide documentation that should already be on file.
Typical complaints include:
- Slow resolution of appeals
- Confusing online account tools
- Unexpected cost sharing
While integration with CVS pharmacies can be convenient, it does not always offset the administrative challenges members describe.
Humana
Humana is especially well known for its Medicare Advantage plans, which are popular among seniors. These plans often advertise extra benefits like dental, vision, and fitness programs, but customer experiences are mixed.
A major complaint involves authorization delays. Seniors may need approval for imaging, rehabilitation, or specialist care, and delays can disrupt treatment plans. In some cases, services are denied outright, leading to appeals.
Provider disputes are another issue. Doctors may leave the network due to reimbursement disagreements, leaving patients scrambling to find new providers.
Members frequently mention:
- Complicated plan rules
- Limited specialist availability
- Confusion around coverage limits
For older adults managing multiple health issues, these obstacles can feel overwhelming.
Oscar Health
Oscar Health entered the market as a technology-driven insurer focused on marketplace plans. While the digital tools appeal to some users, others report significant shortcomings.
Narrow provider networks are a consistent complaint. Members may find that only a handful of hospitals or specialists are covered in their area. If a preferred provider is out of network, costs can rise quickly.
Technical issues also play a role. Users report app glitches, incorrect billing information, or delayed updates to coverage status.
Common frustrations include:
- Claims stuck in pending status
- Difficulty reaching live support
- Limited options for specialty care
Oscar may work for healthy individuals who rarely need care, but it can be risky for those with complex medical needs.
Ambetter
Ambetter, operated by Centene, offers marketplace and Medicaid plans in many states. It is often chosen for its lower premiums, but the trade-offs can be significant.
Payment processing errors are widely reported. Members describe making premium payments on time, only to be told their coverage lapsed. Restoring coverage can take weeks, during which claims may be denied.
Policy cancellations and reinstatement issues are another recurring theme. Even small administrative mistakes can lead to major disruptions.
Reported issues include:
- Claims denied due to system errors
- Difficulty confirming active coverage
- Poor communication during disputes
Low cost is appealing, but reliability matters just as much when healthcare is on the line.
Find additional consumer-focused financial insights on FinTechRevo.Com.
CareSource
CareSource primarily serves Medicaid and marketplace members in select states. Like Molina, it caters to lower-income populations, which makes service quality especially important.
Many complaints focus on slow claim processing and poor communication. Members may not receive clear explanations for denials, making it hard to appeal decisions.
Access to care can also be limited, with fewer specialists accepting the plan.
Common member experiences include:
- Long hold times for support
- Confusing benefit explanations
- Delayed approvals for treatment
CareSource may be the only option in some areas, but understanding its limitations can help set realistic expectations.
Kaiser Permanente
Kaiser Permanente operates differently from traditional insurers. It combines insurance and healthcare delivery, meaning members typically must use Kaiser doctors and hospitals.
While some people appreciate this integrated model, others find it restrictive. Access to specialists can be limited, and appointment wait times are a frequent complaint.
If you need care outside the Kaiser system, coverage may be minimal or nonexistent, which can be a problem when traveling or relocating.
Members often report:
- Difficulty scheduling timely appointments
- Limited choice of providers
- Challenges transitioning care when moving
Kaiser works well for some, but poorly for those who value flexibility.
Conclusion
Choosing health coverage is not just about monthly cost. It is about what happens when you actually need care. The insurers listed here are legitimate, regulated companies that serve millions of Americans, yet they consistently receive poor feedback from policyholders who feel let down when it matters most.
I always tell people to look beyond marketing materials. Check provider networks, understand authorization rules, and read real customer experiences from your state. A lower premium can quickly lose its appeal if it comes with denied claims, endless phone calls, or delayed treatment.
No insurance company is perfect, but being aware of the worst rated health insurance companies can help you avoid preventable stress. An informed choice today can save you time, money, and frustration tomorrow.
Frequently Asked Questions
How can I check if a health insurance company has a history of complaints in my state?
I always recommend starting with your state’s department of insurance website. Most states publish complaint ratios, enforcement actions, and consumer alerts by insurer. You can also look at public complaint databases and compare how often a company is reported relative to its number of members. This gives a clearer picture than online reviews alone, especially since insurance performance can vary widely by state.
Do low-rated health insurers deny more claims, or do they just have slower processes?
In many cases, it is a mix of both. Poorly rated insurers often have stricter internal review systems that lead to more denials, especially for specialist care, imaging, or ongoing treatments. At the same time, slow internal workflows can delay approvals and payments even when claims are eventually accepted. From a member’s point of view, both feel equally frustrating because care gets postponed or bills pile up.
Can a poorly rated insurer still be a good option if my doctor is in network?
Yes, it can work in limited situations. If your primary care doctor, specialists, and preferred hospital are all confirmed in network and you rarely need complex care, a lower-rated insurer may be manageable. The risk increases when you need referrals, prior approvals, or out-of-area care. I always suggest rechecking the provider directory directly with the doctor’s office, not just the insurer’s website.
What warning signs should I look for before enrolling in a health plan?
Some early red flags include unclear coverage language, frequent prior authorization requirements for basic services, very narrow provider networks, and a lack of local customer support numbers. If it is difficult to get clear answers during the enrollment phase, that same issue usually becomes worse after you are a member and need help with claims or billing.
Is switching away from a poorly rated insurer difficult once I am enrolled?
It depends on timing and plan type. For employer-sponsored coverage, you usually have to wait until open enrollment or a qualifying life event. For marketplace plans, switching is also limited to enrollment periods unless you qualify for a special enrollment window. This is why I always stress researching insurers upfront, because once you are locked in, options can be limited for months.
