The 10 largest health insurers by commercial market share

UnitedHealth Group was the largest health insurer by national-level market share in 2021, according to a Nov. 1 analysis from the American Medical Association. 

For the 2022 study of U.S. health insurance markets, researchers with the AMA analyzed market concentration in 380 metropolitan statistical areas, 50 states and Washington, D.C., according to the report. The researchers used the Herfindahl-Hirschman Index, a commonly accepted measure of concentration used in federal antitrust cases, to analyze competitiveness. 

The 10 largest health insurers in the U.S. at the national level by market share in 2021 were:  

1. UnitedHealth Group: 15 percent

2. Elevance Health: 12 percent

3. CVS Health (Aetna): 11 percent 

4. Cigna: 10 percent

5. Kaiser Permanente: 7 percent

6. Health Care Service Corp.: 6 percent 

7. Blue Cross Blue Shield of Michigan: 2 percent 

8. Blue Cross Blue Shield of Florida: 2 percent

9. Blue Shield of California: 2 percent

10. Highmark: 2 percent

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